Original research| Volume 100, ISSUE 10, P1932-1938, October 2019

Employment and Job Benefits Among Those With Spinal Cord Dysfunction: A Comparison of People With Spinal Cord Injury and Multiple Sclerosis



      (1) Identify the proportion of participants with spinal cord dysfunction (SCD) reporting each of 10 job benefits and compare the proportions between participants with spinal cord injury (SCI) and multiple sclerosis (MS); and (2) examine if diagnostic criteria, demographics, education level, and functional limitations are associated with the number of job benefits received.


      Econometric modeling of cross-sectional data using a 2-step data analytic model of employment and job benefits.


      Medical university in the southeastern United States.


      Participants (N=2624) were identified from the southeastern United States. After eliminating those age 65 and older, there were 2624 adult participants with SCD; 1234 had MS and 1390 had SCI.


      Not applicable.

      Main Outcome Measures

      Current employment status; number of benefits received and specific benefits received.


      A greater proportion of participants with MS received benefits, with significant differences observed on all but 1 type of benefit. Among those who were employed, a greater number of benefits was associated with having MS, greater education, younger age, married or in an unmarried couple, and not having functional restrictions with cognition, doing errands, or shopping alone in the community, and walking.


      Employed participants with MS were more likely to receive job benefits, indicative of a higher quality of employment, compared to participants with SCI. Employment without benefits is a form of underemployment that disproportionately affects individuals with many of the same characteristics that initially lead to disparities in probability of gainful employment.


      List of abbreviations:

      CI (confidence interval), MS (multiple sclerosis), OR (odds ratio), SCD (spinal cord dysfunction), SCI (spinal cord injury)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bureau of Labor Statistics
        Persons with a disability: labor force characteristics summary.
        (Available at:) (Accessed November 13, 2018)
        • Krause J.S.
        • Kewman D.
        • DeVivo M.J.
        • et al.
        Employment after spinal cord injury: An analysis of cases from the Model Spinal Cord Injury Systems.
        Arch Phys Med Rehabil. 1999; 80: 1492-1500
        • Krause J.S.
        • Rumrill P.
        • Dismuke-Greer C.E.
        • Jarnecke M.
        Quality employment outcomes after multiple sclerosis: a comparison of participants from a specialty hospital and the National MS Society.
        J Voc Rehab. 2018; 48: 177-186
        • Rumrill P.D.
        • Roessler R.T.
        • Li J.
        • Daly K.
        • Leslie M.
        The employment concerns of Americans with multiple sclerosis: perspectives from a national sample.
        Work. 2015; 52: 735-748
        • Meade M.A.
        • Reed K.S.
        • Saunders L.L.
        • Krause J.S.
        It’s all of the above: benefits of working for individuals after spinal cord injury.
        Top Spinal Cord Inj Rehabil. 2015; 21: 1-9
        • Lustig D.C.
        • Strauser D.R.
        • Donnell C.
        Quality employment outcomes: benefits for individuals with disabilities.
        Rehabil Counsel Bull. 2003; 47: 5-14
        • United States Census Bureau
        Current population survey (CPS).
        (Available at:) (Accessed November 13, 2018)
        • Centers for Medicare and Medicaid Services
        Medicare Health Outcomes Survey (HOS).
        (Available at:) (Accessed November 13, 2018)
        • U.S. Department of Heath and Human Services
        Medical Expenditure Panel Survey (MEPS).
        (Available at:) (Accessed November 13, 2018)
        • Belotti F.
        • Deb P.
        • Manning W.G.
        • Norton E.C.
        Twopm: two-part models.
        Stata J. 2015; 15: 3-20
        • Livermore G.A.
        • Honeycutt T.C.
        Employment and economic well-being of people with and without disabilities before and after the great recession.
        J Disabil Pol Stud. 2015; 26: 70-79
        • Altman B.M.
        • Bernstein A.
        Disability and health in the United States, 2001-2005.
        National Center for Health Statistics, Hyattsville, MD2008
        • Kennedy J.
        • Wood E.G.
        • Frieden L.
        Disparities in insurance coverage, health services use, and access following implementation of the Affordable Care Act: a comparison of disabled and nondisabled working-age adults.
        Inquiry. 2017; 5446958017734031
        • Rumrill P.D.
        Return to work and job retention strategies for people with multiple sclerosis.
        in: Schultz I.Z. Gatchel R.J. Handbook of return to work: from research to practice. Springer, New York2016: 545-561
        • Krause J.S.
        • Terza J.V.
        • Erten M.
        • Focht K.L.
        • Dismuke C.E.
        Prediction of postinjury employment and percentage of time worked after spinal cord injury.
        Arch Phys Med Rehabil. 2012; 93: 373-375
        • Krause J.S.
        • Terza J.V.
        • Saunders L.L.
        • Dismuke C.E.
        Delayed entry into employment after spinal cord injury: factors related to time to first job.
        Spinal Cord. 2010; 48: 487-491
        • Houtenville A.J.
        • Brucker D.L.
        Participation in safety-net programs and the utilization of employment services among working-age persons with disabilities.
        J Disabil Pol Stud. 2013; 25: 91-105
        • Mamun A.
        • O'Leary P.
        • Wittenburg D.C.
        • Gregory J.
        Employment among Social Security disability program beneficiaries, 1996-2007.
        Soc Secur Bull. 2011; 71: 11-34
        • Stapleton D.C.
        • Erickson W.A.
        Characteristics or incentives: why do employment outcomes for the SSA beneficiary clients of VR agencies differ, on average, from those of other clients?.
        (Available at:) (Accessed November 13, 2018)
        • Olney M.F.
        Caught in a social safety net: perspectives of recipients of social security disability programs on employment.
        J App Rehabil Counsel. 2007; 38: 5-13
        • Strauser D.
        Career development, employment, and disability in rehabilitation.
        Springer Publishing Company, New York2014