Factors associated with graduated return to work following injury in a road traffic crash

Return-to-work (RTW) after road traffic crash is an important rehabilitation and recovery step. A possible RTW pathway is to gradually return-to-work (GRTW), or return in a partial capacity before reaching full RTW goals. This study sought to identify those likely to follow a GRTW pathway, and identify factors associated with successful GRTW. Administrative claims data from a state-based compulsory third party transport injury insurer were used. Individuals whose crash occurred from 2003–2012 were included if aged 15–70 years at time of crash, sustained a non-catastrophic injury, had complete data for all variables and attempted a RTW in the three years follow-up. A matrix was created using income payments data, which were used as a proxy for RTW, to map their RTW pattern for up to three years post-crash. Individuals were flagged as attempting GRTW if patterns were detected for receiving full income payments, followed by partial payments, then none. Individuals who resumed full payments after a period of partial payments or resumed any payments after a period of no payments were flagged as having relapsed. In the three years follow-up, 9.6% of individuals followed a GRTW pathway. Of those that attempted GRTW for their first full-time RTW, 55.1% relapsed. Least likely to attempt GRTW were males, individuals with contusions, abrasions, sprains, strains, non-limb fractures and those from the most advantaged socioeconomic group. Conversely, those admitted to hospital were 88% more likely to relapse. Of those that followed a GRTW pathway, those aged 15–24 years were most likely to succeed. Those with whiplash, internal injuries and those admitted to hospital were least likely to succeed. This study may assist regulators, insurers, employers and healthcare professionals to identify opportunities for GRTW (such as using RTW as a recovery tool), and identifies groups that may require additional support to achieve successful employment outcomes