They usually say that what goes up must come down, but in the case of OT salaries following the rehab "recession" of 1998-2000, what went down had to come up.

And it did. In fact, the ADVANCE 2003 salary survey-the first in three years-shows an average rise of some $9,000 for full-time occupational therapists across the nation in the past four years! The new annual average for OTs is $51,352.

If you have not experienced this phenomenon, however, don't go out and start picketing your workplace. The annual average takes into account professionals in all work settings and with all degrees of experience and education. A look at the breakdown by job title across all 50 states shows that staff therapists in many places are still making salaries in the upper 40s. That's still high ground, considering that the downturn, that began in the summer of 1998, had pushed the average OT salary down to about $41,000 by 1999.

View OT and OTA salaries by state.

In fact, about 45 percent of OTs got raises over the past 12 months averaging about 1-3 percent, and only 16 people reported losing their jobs or not working.

A whopping 3,303 OTs and OTAs answered the ADVANCE salary survey that appeared in print during March and early April and was on the Web site until late May. Respondents came from all 50 states, plus U.S. territories such as Guam and Puerto Rico. The new online option even drew responses from Canada, Saudi Arabia, Germany, Ireland and other nations around the world, though those numbers had to be deleted from the database in order to maintain a representative sample of American pay scales.

Occupational therapy assistants have bounced back just as well as their counterparts, showing an average national salary of $35,635 in the past year. That's $8,000 more than the $27,626 average they were making in 1999. Again, however, that represents the pay of OTAs working in all settings, and even outside OT. Statewise, staff OTAs seem to be running an average closer to about $32,000, though in some states they are making in the high 30s. In others, however, salaries are still in the mid to high 20s.

In our 2000 salary survey, 21 percent of respondents had changed jobs due to the double-edged sword of prospective payment and the therapy cap that had hit the industry. This time around, 70 percent of respondents reported no changes in job status in the past year, and about 50 percent of those who answered the survey have been in their current jobs for no more than five years, an indicator that people who changed jobs during the recession are doing well in them.

So where are your colleagues working, and who's making the big bucks? Well, most OTs reported that they are employed in the schools or in skilled nursing facilities (20 percent and 18 percent of respondents, respectively). Outpatient rehab is now third on the list. Only 13 percent said they worked in that setting.

View OT and OTA salaries by setting.

And although it may be hard to believe, people in SNFs drew the highest reported salaries, drawing an annual average of $52,776. School therapists, on the other hand, were only making an average of $45,716. Payscales in acute and subacute care settings averaged over $50,000. Outpatient rehab came in at $48,484.

Respondents who worked in mental health settings reported good wages, though few OTs ( less than 2 percent) worked in those settings. The salaries they reported, however, ran between $48,000 and $50,000.

Hospitals are still the primary employers of OTs. Twenty-six percent of respondents worked for hospitals, indicating that hospitals are providing care in more settings. School systems and private schools employed about 17 percent of people who answered the survey. Large rehab companies are still in the game; they employed about 13 percent of respondents.

Interestingly, SNFs actually employed only about 11 percent of OTs who responded, and agencies came in fifth, with 10 percent. This indicates that many SNFs still outsource their therapy departments.

The salary survey drew a young crop of therapists. Fifty-one percent said they have worked in OT for five years or less. Another 20 percent have been in the field for up to 10 years. Eleven percent have worked in the profession for more than 20 years.

The "typical" OT survey respondent, nationally, is a fairly new professional with a bachelor's degree, no special credentialing, and employed as a staff therapist in a school system, skilled nursing facility, or outpatient rehab unit.

Among occupational therapists, salaries are somewhat tied to degree level, although in many cases, people with bachelors' degrees are making nearly as much as those with entry-level masters' degrees. Salary rises incrementally as the degree level goes up, ostensibly because people with higher degrees get jobs in higher-paying fields.

OTs with bachelors' degrees were making an average of $48,342 nationally in our survey. Those with entry-level masters' degrees were making only $194 a year more. But with the advanced master's degree, the salary jumped to $53,773. Doctoral-level people were averaging only about $2,000 higher a year.

Specialty credentials seemed to have a measurable effect on salary, for the first time. OTs without them were averaging just over $48,000 a year. Those with them were making literally $5,000 to $10,000 more. The highest salaries were for those who had AOTA board certifications in any of the three categories: neurology, geriatrics or pediatrics. They ranked in the $60,000s. Therapists with CHT (hand certifications) had were making just over $59,000 a year. Other certification-related payscales were in the mid 50s.

Unfortunately, the vast majority of respondents had no specialty credentials.

Paid continuing education was still the most widely-offered benefit (other than medical benefits, which were not part of the survey), for both levels of the profession, along with profit-sharing and 401K options. Very few employers paid professional association dues.

And guess what. Though women still greatly outnumber men in occupational therapy -- 78 percent of the respondents were women -- men are still making more money. Our male survey respondents reported average salaries of $55,216 for OTs and $37,425 for OTAs; women reported average salaries of $48,763 and $32,927.

E.J. Brown is ADVANCE editor.