Absence of conflict of interest.
Citation
Greenberg, G. A., & Rosenheck, R. A. (2007). Compensation of veterans with psychiatric or substance abuse disorders and employment and earnings. Military Medicine, 172(2), 162-168.
Highlights
- The study’s objective was to examine the impact of the Veterans Affairs (VA) Compensation Program on employment for veterans with service-connected disabilities.
- This study compared employment outcomes for two groups of veterans: (1) disabled veterans receiving VA compensation and (2) nondisabled veterans not receiving disability compensation. To do this, the study team combined data from two national surveys: the Survey of Disabled Veterans and the National Survey of Veterans.
- Veterans receiving benefits of more than $800 per month from the VA Compensation Program were significantly less likely to be employed than were nondisabled veterans.
- The quality of causal evidence presented in this report is low because the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to the VA Compensation Program; other factors likely contributed to the findings.
Intervention Examined
The VA Compensation Program
Features of the Intervention
The VA Compensation Program provides benefits to disabled veterans whose injuries or illnesses occurred or worsened as a result of their military service. The amount of benefits received is based on the severity of the condition, described by the percentage “service connected” (for example, a veteran who is totally disabled would be considered 100 percent service connected). The level of benefits can differ if the condition changes or if the veteran has dependents. The Veterans Health Administration assesses disability severity and benefit level.
Unlike other disability compensation programs, veterans may return to work without automatically reducing their benefits from the VA Compensation Program. In 1990, the average VA monthly compensation for all veterans in the program was $352.
Features of the Study
This study compared the employment outcomes for (1) a treatment group of disabled veterans receiving benefits from the VA Compensation Program and (2) a comparison group of nondisabled veterans who did not receive disability compensation. The study team drew its data from a sample of 18,625 veterans. Treatment group data came from the Survey of Disabled Veterans, conducted from August 1988 through May 1989, and the comparison group data came from the National Survey of Veterans, conducted in 1987. The team estimated statistical models to examine the relationship between employment and VA compensation, accounting for sociodemographic characteristics, health status, and other sources of income.
Of the 18,625 veterans in the sample, 98 percent were male, 10 percent were African American, 5 percent were Hispanic, 48 percent were employed, 24 percent completed high school, 19 percent were ages 35 to 44, 16 percent were ages 45 to 54, 27 percent were ages 55 to 64, and 32 percent were older than age 64.
Findings
Employment
- Veterans receiving more than $800 per month from the VA Compensation Program were significantly less likely to be employed than were nondisabled veterans. However, veterans who received <$800 per month from the program were as likely to be employed than nondisabled veterans were.
Considerations for Interpreting the Findings
The authors did not account for preexisting differences between the groups before they took part in the VA Compensation Program. Such differences—and not the program itself—could explain the observed differences in outcomes.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to the VA Compensation Program; other factors likely contributed to the findings.