Adverse Childhood Experiences: Antecedents to Occupational Disability and Lost Time

Vocational disability and lost time can be a consequence of psychosocial and biological dynamics that pre-existed a specific accident, injury, or illness. More specifically, Adverse Childhood Experience (ACE) can predispose employees to being disability prone and lead to long-term absence from work following claimed injury or illness. For the vulnerable employee, the reported injury or illness can serve as an “explanatory event,” which can be transformed into an “acceptable disability.” A case study depicts how ACEs can be risk factors for occupational disability and lost time. Vocational evaluators, rehabilitation professionals, and medical personnel must be willing to take thorough histories as part of comprehensive rehabilitation evaluations so that these dynamics can be explored and their impact on medical and vocational recoveries can be better understood.