The authors explored the relationship among childhood sexual abuse (CSA), physical and mental health work barriers, and employment outcomes using a large panel study of current and former welfare recipients. Controlling for human capital and demographic characteristics, they found CSA was associated with significantly fewer months worked over the 33-month period immediately following the 1996 welfare reform legislation. CSA was also strongly associated with presence of a mental or physical health work barrier during that same time period, and those variables mediated the relationship between CSA and employment. The data suggest that human capital variables alone do not account for women's work outcomes and that intervention is needed in the welfare system to address women's work barriers, including the long-term consequences of CSA.