Determining return to work in a compensation setting: A review of New South Wales workplace rehabilitation service provider referrals over 5 years

BACKGROUND: Australian workers' compensation data reports a reduction in injury rates and claim incidence but no improvement in Return to Work (RTW) rates. OBJECTIVE: To identify factors associated with a positive RTW outcome and describe those referred to Workplace Rehabilitation Providers (WRPs) in the New South Wales (NSW) Australian workers' compensation scheme. METHODS: A retrospective review of 65,762 de-identified WRP case records over a 5 year period. 9,262 cases specifically referred for RTW assistance were analysed to identify factors associated with a positive RTW outcome RESULTS: Overall 47% of those referred for RTW services were able to upgrade their work status whilst 30% maintained their Stay at Work or pre-referral work status. The significant independent predictors associated with a positive RTW outcome were a shorter duration of disability (p < 0.001) (0R, 0.971; 95% CI, 0.964-0.977) and a higher socio economic index score (p = 0.002) (OR, 1.131; 95% CI, 1.045-1.223). CONCLUSIONS: The study suggests that WRPs are seeing an increased focus on management of workers with increasing disability, with socio-economic disadvantage, increasing age, from blue collar backgrounds. The duration of disability is a significant determinant in achieving positive RTW outcomes suggesting that injured workers should be referred earlier for RTW services.