Effective work reintegration for individuals with SCI is essential because, despite their disability, many of these individuals possess the potential to remain or become productive members of society while deriving positive psychosocial benefits at the same time.Many factors that could facilitate return to work are at a level that is beyond the realm of health care.  These include changing employer and societal perceptions and attitudes, and lobbying for social change that would include improved transportation (Conroy and McKenna 1999). Eliminating policies to reduce financial disincentives are key to eliminating barriers for those who return to work. Policy change requires a strong lobbying voice and a social will to overcome attitudes and arguments from opponents who may otherwise see provision of funding for personal care attendants and/or worksite modification as a poor investment of resources.

• There is level 5 evidence that being male, Caucasian, younger age at time of injury, duration of injury, higher education pre-injury, and having a low-intensity pre-injury job are non-modifiable personal factors that positively influence employment opportunities after SCI.
• There is level 5 evidence that a greater severity of injury is a non-modifiable personal factor that negatively influences employment opportunities after SCI.
• There is level 5 evidence that being married, having education post-injury, having fewer secondary health conditions and higher functional independence, better work related values and a higher internal locus of control, and better wheelchair skills are modifiable personal factors that positively influence employment opportunities after SCI.
• There is level 5 evidence that financial disincentives, ‘disability, discrimination’ and  inaccessibility of workplace are environmental barriers negatively influencing employment after SCI.
• There is level 5 evidence that ability of using transportation independently and technological devices, and having access to work modification are positively influencing employment after SCI.
• There is level 1 evidence (Allen and Blascovich 1996) that suggests a service dog improves integration and participation in school and employment and decrease the number of hours of paid assistance after the first year.
• There is level 5 (Jellinek and  Harvey 1982) and level 4 evidence (Marini et al. 2008) that on-site vocational rehabilitation counselling during inpatient rehabilitation can increase employment rates.
• There is level 4 evidence (Marini et al. 2008) that use of job placement services may help individuals with SCI find employment.
• There is level 4 evidence (Inge et al. 1998) suggesting that person-centred planning tools facilitates employment.
• There is level 4 evidence (King et al. 2004) that case management programs increase return to educational training, but not to work.
• There is level 5 evidence from 4 studies (Wang et al. 2002; Jang et al. 2005; Jongbloed et al. 2007; Hansen 2007;) that receiving vocational training increases the likelihood of employment.