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Shepherd Center Research Reveals Keys to Successful Return to Work

Spinal Cord Injury Model System study finds workplace accommodations and job training contribute to return-to-work success.

Returning to work after sustaining a spinal cord injury requires workplace accommodations and/or job training – depending on the age at which the injury occurs, according to a long-running study conducted by researchers in the Spinal Cord Injury Model System (SCIMS) at Shepherd Center.

These findings are important to both patients with spinal cord injury (SCI) and organizations, such as Shepherd Center and other rehabilitation facilities, that develop programs to promote post-injury employment.

SCIMS researchers, under the direction of senior research scientist James S. Krause, Ph.D., have gathered and analyzed return-to-work data for more than 30 years with funding from the National Institute on Disability, Independent Living and Rehabilitation Research. They have focused on the processes and predictors for post-injury employment, distinguishing between people who transitioned to new employment after SCI and those who retained work with their pre-injury employers.

These are some of the key conclusions their research has revealed:

  • Transition to new employment is highest among those youngest at the time of injury and decreases in a relatively linear pattern with increasing age. It may take several years for sufficient training or education to successfully start new employment.
  • Those 45 and older at the time of injury rarely transition to new employment. Rather, when they do work after SCI, it almost always is with the pre-injury employer either at the same job or a new job.
  • While SCI is more prevalent in younger people, the mean age is rising steadily. This information is important for facilities whose rehabilitation programs include an emphasis on returning patients to employment. Training for jobs different than those held before injury is likely to be more successful in younger individuals.
  • Job retention, as defined by returning to the pre-injury employer, rarely occurs among those in the youngest age group, but increases to higher levels among those in the late 20s and early 30s. Relatively high rates occur among those in the oldest age groups at injury. Individuals injured in the younger age bracket have not developed the element of work longevity with pre-injury employers. For them, retraining and the pursuit of new employment will likely prove more successful.
  • For those in the oldest age groups, post-injury employment is almost exclusively associated with a return to the pre-injury employer, magnifying the importance of working with pre-injury employers to help accommodate individuals with SCI, whenever possible. Overcoming architectural and logistical barriers to the access of these individuals to their pre-injury workplace is the key here, as the likelihood of them being able to successfully accomplish the duties of their pre-injury jobs is high.

Thus, post-injury employment follows two different tracks:  The first is the job transition model and the second is the job retention/return-to-work model. Each of these has a different relationship with age at injury onset, which needs to be considered when developing the most appropriate strategies to promote employment.

For more information about returning to work, visit Shepherd Center's educational website,

Written by Lesley Hudson, MA
SCIMS Project Director

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.