Patterns and Predictors of Failed and Sustained Return-to-Work in Transport Injury Insurance Claimants

• Published in: Journal of occupational rehabilitation 2018-12, Vol.28 (4), p.740-748
• Main Authors: Gray, Shannon E., Hassani-Mahmooei, Behrooz, Cameron, Ian D., Kendall, Elizabeth, Kenardy, Justin, Collie, Alex
• Format: Article
• Language: English
• Subjects: Analysis; Catastrophic failure analysis; Clinical Psychology; Compensation; Datasets; Dislocations; Economic conditions; Employment; Environmental Health; Fractures; Health Psychology; Hospitals; Injuries; Medicine; Medicine & Public Health; Occupational Medicine/Industrial Medicine; Orthopedics; Payments; Personal injuries; Regression analysis; Rehabilitation; Transport; Whiplash injuries
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-018-9761-2

Purpose To determine the incidence of employed people who try and fail to return-to-work (RTW) following a transport crash. To identify predictors of RTW failure. Methods : A historical cohort study was conducted in the state of Victoria, Australia. People insured through the state-based compulsory third party transport accident compensation scheme were included. Inclusion criteria included date of crash between 2003 and 2012 (inclusive), age 15–70 years at the time of crash, sustained a non-catastrophic injury and received at least 1 day of income replacement. A matrix was created from an administrative payments dataset that mapped their RTW pattern for each day up to 3 years’ post-crash. A gap of 7 days of no payment followed by resumption of a payment was considered a RTW failure and was flagged. These event flags were then entered into a regression analysis to determine the odds of having a failed RTW attempt. Results : 17% of individuals had a RTW fail, with males having 20% lower odds of experiencing RTW failure. Those who were younger, had minor injuries (sprains, strains, contusions, abrasions, non-limb fractures), or were from more advantaged socio-economic group, were less likely to experience a RTW failure. Most likely to experience a RTW failure were individuals with whiplash, dislocations or particularly those admitted to hospital. Conclusions : Understanding the causes and predictors of failed RTW can help insurers, employers and health systems identify at-risk individuals. This can enable earlier and more targeted support and more effective employment outcomes.