Predictors of sustained return to work after work-related injury or disease: insights from workers' compensation claims records

Abstract

Aim: After work-related injury or disease, multiple spells of work absences and unsuccessful return to work (RTW) are common. The purpose of this study was to identify predictors of sustained RTW and work disability recurrences.

Methods: Australian WorkSafe Victoria claims containing income compensation payments starting between January 1st, 2001 and December 31st, 2004 (n = 59,526) were analysed over a 2-year observation window. Time until first RTW and final RTW, and 'recurrences' (cessations of payments of >7 days), were derived from claims payments data. Regression models were used relating demographic, occupational, workplace and injury characteristics to RTW outcomes.

Results: Although 94% of claimants had at least one RTW, only 79% achieved sustained RTW during follow-up. Median time until first RTW was 50 days; median time until final RTW was 91 days. Independent predictors of delayed final RTW were older age, afflictions involving the neck or multiple locations, and working in manufacturing. Of those who returned to work, 37% had at least one recurrence: risk factors were ages 35-55, female sex, working as a labourer, working in manufacturing, traumatic joint/ligament or muscle/tendon injury and musculoskeletal and connective tissue diseases, and afflictions involving the neck or multiple locations.

Conclusions: Work disability recurrences are common and have considerable impact on sustained RTW outcomes. A policy focus on education about secondary prevention may help improve long-term RTW outcomes, particularly for persons with musculoskeletal disorders and those working in manufacturing.