Effects of COVID-19 on Enrollment and Discharge for Veterans (With Substance and Alcohol Use Disorders) Referred for Vocational Rehabilitation Within the VA Health Care System

The objective of this study was to investigate the impact of COVID-19 on vocational rehabilitation (VR) program enrollment rates and employment rates at discharge for those with substance or alcohol use disorders (SUDs or AUDs) within the Veterans Affairs (VA) health care system. An outcome-based, summative program evaluation design (retrospective, secondary analysis) was used to measure quality assurance/quality improvement of a VR program located in Veterans Integrated Services Network (VISN) 12 between 2016 and 2021. After participants were excluded, 923 veterans (population) were analyzed. Veterans with AUDs had reduced post-COVID era employment rates, and these rates were significantly lower for veterans with active or inactive (in-remission) AUDs. Rise in post-COVID era Veteran Health Administration (VHA) VR program enrollment was disproportionately higher for veterans with SUDs than AUDs (overall). The lack of a significant interaction between SUD, AUD, and COVID-19 suggests that while SUDs play a vital role in employment outcomes, the impact remained consistent regardless of the pandemic, emphasizing the persistent struggle faced by veterans with substance-related disorders.