Occupational categories and return to work after traumatic brain injury: A multicenter study

Authors: Wallace, C. J., & Tauber, R.
Year Published 2006
Publication Archives of Physical Medicine and Rehabilitation
Volume 87
Number 12
Pages 1576-1582
Publisher Elsevier

A number of researchers have indicated that postinjury return to work rates are a function of pre-injury job classifications. However, these and other job category studies have conflicting findings, differing methodology and small sample sizes. This makes it difficult to determine if this is a significant and unique predictor that impacts return to work rates. Due to poor post injury employment rates for individuals with TBI knowing the relation between pre-injury occupational category and return to work could improve employment outcomes.


The purpose of the study was to find out if pre-employment occupation was a significant and unique predictor of return to work for individuals with TBI.


The setting was 17 NIDILRR funded TBI Model Systems Projects (TBIMS) located across the United States.


The sample size was 1,341 individuals with TBI who had data in the TBIMS national database including one year follow up data. The majority of the sample were males (77%) and white (69%). Most had sustained an injury that would be considered moderate to severe.

Data Collection

Data was collected at TBIMS rehabilitation centers that include a wide array of services. Hospital records and admission and discharge FIM instrument used to evaluate level of independence were used to collect medical information. Annual telephone interviews were attempted to collect follow up information at month 10 and 14 post-injury. If this was not successful, a questionnaire via mail and/or an interview with significant other was completed.


There was no control or comparison condition.


Individuals who held professional and managerial jobs were more likely to be working during the one year follow up. Approximately, 33% of those who had worked in manual labor jobs were working at follow up with a slightly improved rate among those in skilled labor positions.Severity of injury was not predictive. However, the following variables: preinjury job category, education level, hospital LOS and discharge FIM total score were predictors. Additional analysis, clearly supported that job category predicts return to work outcomes beyond using educational level obtained prior to injury alone.


Preinjury occupational factors influence return to work post injury for individuals with TBI. Given that individuals, who were worked as manual laborers prior to injury had the poorest return to work rate, this group may have a greater need for vocational services. More research is needed to better understand return to work rates and evaluate possible strategies to improve employment outcomes.

URL http://www.msktc.org/publications/detail/1732
Disabilities Traumatic brain injury (TBI)
Populations Male
Outcomes Return to work
NIDILRR Funded Yes
Research Design Single group, Quasi-experimental
Peer Reviewed Yes