A Randomized Controlled Trial of an Employment Program for Veterans Transitioning from the Military: Two-Year Outcomes

Work Disability Prevention and Management

OBJECTIVE

This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Work Disability Prevention and Management Guideline reviews the available evidence and provides recommendations to clinicians regarding interventions to help patients remain at or return to work.

METHODS

Systematic literature reviews were conducted. Studies were graded and evidence tables were created, with involvement of a multidisciplinary expert panel that evaluated the evidence and finalized recommendations for all clinical questions. Extensive peer review was performed. Consensus recommendations were formulated when evidence was lacking.

RESULTS

Evidence-based recommendations have been developed to guide work disability prevention and management.

CONCLUSIONS

Clinicians should utilize quality evidence in determining treatment methods to prevent and alleviate work disability for workers. This guideline offers an evidence-based framework for preventing and mitigating work disability for individual adults in the active workforce. It is designed for use by healthcare clinicians who desire to minimize the negative impact of health conditions on working people's lives and livelihoods.

Among Transitioning Veterans with Service-Connected Disabilities: Who Benefits Most from Career Coaching?

U.S. service members transitioning from the military face formidable challenges to securing meaningful employment matching their preferences and qualifications. Despite diverse employment services, many veterans settle for dead-end jobs. This study examined personal characteristics predicting successful employment outcomes. In a secondary analysis of a controlled trial assessing 2-year employment outcomes for 205 transitioning veterans with service-connected disabilities participating in a career coaching program, multivariate regression analyses were conducted to identify personal characteristics associated with employment outcomes, including characteristics differentiating who benefits more from a career coaching program, compared to usual services. Two employment outcomes were examined: job acquisition and employment earnings. The single best predictor of job acquisition was assignment to the career coaching intervention. Among 18 demographic, military service, and health and well-being measures, the only predictor of job acquisition was gender (91% of men and 79% of women worked during follow-up). Twelve personal characteristics were associated with mean monthly earnings from employment, including four demographic measures, three military service measures, and five measures of health and well-being. Disability ratings did not predict employment outcomes. Overall, career coaching helped veterans gain employment, regardless of their personal characteristics. Three personal characteristics differentiated veterans who benefited more from career coaching. Veterans reporting alcohol use and those who had a longer period of military service benefited more, as did veterans who were not depressed. The authors conclude that most veterans obtain civilian employment soon after separation from the military, but personal characteristics strongly influence their employment earnings.