This study is a follow-on to prior DOD funded work Efficacy of a Driving Intervention Program on Safe Community Mobility for Combat Veterans. Funding for the Effectiveness current study was activated in October 2015. In the 2018-2019 cycle, we added staffing with four additional personnel, all completing their VA credentialing. As of April 2019 we have 20 Veterans enrolled in the five session protocol, half randomized to the occupational therapy driving intervention OT-DI and half to the control arm, traffic safety education TSE. Seven Veterans have completed the protocol and 12 are active in testing. In addition to on-going recruitment and testing, our team has been able to disseminate findings from the efficacy study on a state and national level. This includes 7 journal articles, 1 book chapter, 9 honors theses, and over 20 state and national level presentations. Our examination of real-world driving through analysis of driver license records to determine the level of violations, citations, and crashes in the years pre and post intervention is complete and findings regarding reductions in citations post-intervention are under peer review for potential publication. Overall, both arms of the study, occupational therapy driving intervention and traffic safety education demonstrate benefits according to our interim analysis by reducing Veterans driving errors as measured in simulator. Preliminary findings on real-world outcomes also indicate a benefit through reduced traffic violations and citations. In the no cost extension period we will continue testing to confirm these findings with a larger sample of Veteran drivers.