{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:54Z","timestamp":1792786014970,"version":"4.5.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","funder":[{"name":"Defense Health Agency Research and Engineering Military Health System Research Program","award":["HT9402-22-1-0008"],"award-info":[{"award-number":["HT9402-22-1-0008"]}],"id":[{"id":"https:\/\/ror.org\/03b7pda13","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Premature loss of enlisted active component personnel is costly and challenges force readiness. Enlisted personnel who experience serious illness or injury during their first contract may be especially vulnerable to negative military outcomes, despite access to additional medical support provided by temporary limited duty (LIMDU) programs. This study is the first to examine post-LIMDU military career outcomes among enlisted Sailors and Marines assigned to LIMDU during their initial military contract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Archival data included comprehensive records from the Sailor and Marine Readiness Tracker (SMART) as well as military personnel data for personnel who entered LIMDU during their first contract and were in active LIMDU status between fiscal years 2017 and 2022 (N\u2009=\u200922,500). The post-LIMDU military career outcomes examined included the timing of and reason for release or discharge from active duty service. Loss timing was categorized as first-term attrition (before completing first contract), later discharge (after completing first contract but before fulfilling the full 8-year military service obligation [MSO]), or continued MSO (fulfilled MSO or still on track to meet MSO). Loss type was characterized as met requirements, disability, poor performance, or misconduct. Multinomial logistic regression analyses examined demographic, military, medical, and LIMDU-related factors as potential predictors of both loss timing and loss type; interaction effects were included to explore service differences in predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The military prematurely terminated enlistment contracts with more than 60% of the sample, 38.04% through first-term attrition and 22.68% through later discharge. The most common reasons for post-LIMDU active duty losses were medical disability (43.30%) and met requirements (39.85%). Poor performance and misconduct losses were most frequently associated with first-term attrition; later discharges were most often because of disability. Although predictors varied across the outcomes considered, being in the Marine Corps and starting LIMDU during a later contract year were strong and consistent predictors of positive outcomes, whereas entering LIMDU for mental and behavioral health or \u201cother\u201d medical conditions (vs. injury, musculoskeletal, or pain issues) were among the strongest and most consistent predictors of negative outcomes. Service differences were observed in both predictors and outcomes, and service moderated the impact of several predictors on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides novel information about patterns and predictors of service loss among Sailors and Marines who enter LIMDU during their first term of service, including findings regarding the timing and causes of military attrition, predictors of positive military career outcomes, and service-specific differences in both predictors and outcomes. These results raise important questions about the frequency with which service members in the LIMDU program can return to full duty; by incorporating additional data regarding the duty status of service members upon release from LIMDU, future investigations may provide critical information to inform policy and practice to maximize the effectiveness and efficiency of the LIMDU program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag453","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:34:56Z","timestamp":1790076896000},"source":"Crossref","is-referenced-by-count":0,"title":["Military Career Outcomes of Enlisted Sailors and Marines Who Entered Temporary Limited Duty During Their First Active Component Contract"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0210-5394","authenticated-orcid":false,"given":"Stephanie","family":"McWhorter","sequence":"first","affiliation":[{"name":"Naval Health Research Center , San Diego, CA 92106,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia J","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Naval Health Research Center , San Diego, CA 92106,","place":["United States"]},{"name":"Leidos Inc. , San Diego, CA 92121,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"2026100112061349100_usag453-B1","author":"Office of the Under Secretary of Defense for Personnel and Readiness: Department of Defense Instruction (DODI) 1304.25: Fulfilling the Military Service Obligation"},{"key":"2026100112061349100_usag453-B2","author":"Office of the Under Secretary of Defense for Personnel and Readiness: DODI 1300.04: Inter-Service and Inter-Component Transfers of Service Members"},{"key":"2026100112061349100_usag453-B3","author":"Office of the Under Secretary of Defense for Personnel 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