Modified Work and Return to Work: A Review of the Literature

Workplace injuries which result in lost time from work can have considerable financial repercussions for employer and employee alike, not to mention their physical and emotional impact on the employee. In order to lessen workers' compensation costs and facilitate the rehabilitation process, some employers offer modified work to their injured employees in order to allow an earlier return to work than would ordinarily be possible. Although modified work is regarded by many as a cornerstone in the job rehabilitation process, little is known about the structure, effectiveness, and efficiency of such programs. This report is a systematic review of the scientific literature on modified work published since 1975. Its objective is to synthesize and critically appraise the research on modified work, and, specifically, to assess the effectiveness of modified work programs. Using a systematic keyword search in three online libraries, 29 empirical studies of modified work programs were selected for review. The studies were evaluated for methodological quality, from which 13 higher quality studies were identified. On the basis of these 13 studies, the effectiveness of modified work programs was evaluated. The main finding of this review is that modified work programs facilitate return to work for temporarily and permanently disabled workers. Injured workers who are offered modified work return to work about twice as often as those who are not. Similarly, modified work programs cut the number of lost work days in half. The available evidence also suggests that modified work programs are cost-effective. Comprehensive cost-benefit analyses are needed to confirm this finding.