The International Social Security Association (ISSA) “Guidelines on Return-to-Work and Reintegration” (the Guidelines) chronicles good practice models, policies and procedures which have successfully been implemented by social security institutions in respect of return-to-work and reintegration. Models have specifically been developed by ISSA in order to identify approaches that will enable decision-makers in social security institutions to benefit from global experience in this area. In particular, the Guidelines are designed to: outline strategic options for social security institutions in order to achieve these outcomes; stimulate discussion around good practice return-to-work programmes for social security institutions; identify critical success design elements; and offer practical implementation tools.

Return-to-work of occupationally injured and diseased workers, and the management of their disabilities, is an area clearly in need of reform in the developing world. The proposed contribution focuses on the recent experiences of two middle-to-high income developing countries, namely Malaysia and South Africa, who are at different stages of introducing and implementing detailed return-to-work measures. The paper considers salient aspects of the seven “Specific Return-to-work Principles and Guidelines” (the Specific Guidelines, contained in Part B of the Guidelines) and matches these against the approaches adopted / being adopted by Malaysia and South Africa respectively. This methodology is designed to provide a comparative, context-specific sample of the application of selected issues emerging from the Specific Guidelines in order to provide some pointers for purposes of extrapolating how return-to-work and reintegration might be introduced and implemented in other (middle-to-high income) countries in the developing world.

The paper acknowledges the tremendous challenges faced by developing countries in introducing and implementing return-to-work and reintegration arrangements, but focuses instead on the application of Specific Guidelines such as “early intervention” and an “individualized approach” in Malaysia and South Africa. The paper draws on constitutional frameworks, draft and existing legislation, policy statements and judicial precedent in order to demonstrate the extent to which the two countries have already been able to integrate selected best practice principles, which are now contained in the Specific Guidelines, in their respective approaches. The paper accordingly holds the potential to demonstrate that the sentiments contained in the Guidelines are practically implementable and ought, therefore, to be carefully considered and analysed by other countries seeking to introduce similar return-to-work and rehabilitation initiatives.

In Germany, people injured in occupational-related accidents are offered comprehensive benefits ranging from medical care to occupational and social reintegration. Statutory accident insurance, funded solely by employers’ contributions, has developed specific structures and practical guidelines for rehabilitation management. This management process involves comprehensive planning, coordination and targeted encouragement and support for those needing rehabilitation. Rehabilitation management must commence promptly, be properly coordinated and achieve long-term effects. The measures deployed aim at restoring health and fitness to work as quickly and comprehensively as possible. In cases involving serious injury, rehabilitation management includes individual counselling and support as a follow-up to the primary medical care and extends beyond medical rehabilitation to include measures that assist occupational and social inclusion. Rehabilitation management demands considerable financial and human resources. To justify this relatively high expenditure, the cases involved need to be identified carefully based on relevant criteria. The accident insurance institutions have investigated how well this works in practice on the basis of their own experience and a wide range of case studies. An extremely important factor is the severity and complexity of the injury. A prognosis of inability to work for more than 112 days determines eligibility as a case needing rehabilitation management because occupational or social integration is at risk. Medical, psychological and social risk factors also need considering, as do the specific occupational requirements. A person's social and professional environment has to be taken into account from the very start. These variables must be examined and analysed as methodically as possible to establish the appropriate course of action.

Background: The length of hospital stay among occupationally injured workers was too long comparing to national health insurance patients in Korea. Also return-to-work rate was low comparing to other countries. The Korea Workers’ Compensation & Welfare (COMWEL) has tried to upgrade the quality of care workers’ compensation contract hospitals since several years. One of the tries was to evaluate the workers’ compensation contract hospitals. However, many hospitals argued the appropriateness of the hospital evaluation.

Objectives: This study was performed to evaluate the appropriateness of the workers’ compensation contract hospital evaluation.

Methods: The total number of 500 hospitals was selected to evaluate among about 5,500 contracts hospitals according to their size or the number of occupationally injured patients. The main evaluation items were hospital facilities and equipment, health personnel, including doctors, record keeping, appropriateness of hospital care, outcomes, including return-to-work, length of hospital stay, satisfaction, etc. Multiple logistic regression was performed to evaluate the appropriateness of the results of this hospital evaluation. The dependent variables were return-to-work rate and length of hospital stay and independent variables were severity of injured workers, disability rate, company size, etc.

Results: The hospitals were classified three categories according to the evaluation score; high, middle, and low quality. The return-to-work rate of high-quality hospitals was significantly higher (odds ratio 1.81; CI 1.27 – 2.58) than others. However, the length of hospital stay was not different among them.

Conclusion: Return-to-work rate is one of the useful indicators for evaluating the occupational health care. Even though these are preliminary results, this evaluation method for the occupational health care hospitals would be appropriate for the purpose. The more specific analysis should be needed.

The Social Security Organisation (SOCSO) of Malaysia introduced the Return to Work (RTW) Program in 2007 which is a comprehensive multidisciplinary biopsychosocial rehabilitation program for its Insured Persons who are experiencing disability due to accidents in the workplace or those claiming for invalidity. This rehabilitation program is unique as it involves the concept of “disability management” in which each Insured Person who is referred to the program, is assigned to a Disability Case Manager who is actively involved throughout the return to work process. Up to date (December 2013), 11,090 workers were motivated to participate in the SOCSO RTW Programme, and this requires many work processes, countless paper-work and massive physical files and document management. Due to this massive information flow, the demand for a more efficient information system is needed. From the beginning, the whole idea was to create an accessible, quick and user-friendly application. The application is now used by the SOCSO RTW Department in managing their information. This application was built on an open source platform which can be access through the internet. It is also a “learning application” where it uses its historical data to assist the case managers to generate standard rehabilitation plans and forecast possible return to work outcomes. The beauty of such application is that it is easily replicated, configurable (email notifications, reminders, etc) to meet the needs of the case managers in various jurisdiction. The scope of the application can also be easily defined to meet the size of an enterprise using the application. With better management of information, this application has contributed in reducing processing time, repetitive paperwork, minimal storage areas and almost real-time flow of information in the SOCSO's RTW Case Management system. Apart from that, the application now stores a wealth of information such as rehabilitation strategies for various disability or illnesses or demographic backgrounds.

Background: Little is known about the overview of legal essences and their enforcement regarding educational provisions for persons with disabilities (PWDs) in Thailand.

Objectives: It aims to 1) comprehensively review, establish and launch model regarding reformation of policy and law, 2) identify results of law enforcement as a past decade, present as a lesson learned on educational provisions for PWDs through consciousness raising of stakeholders.

Methods: This research is participation action research (PAR) and content analysis. As PAR, the two research sites with 13 and 15 participants as private and public education centres for PWDs respectively were voluntarily and purposively selected. Those participants included teachers, administrators, parents of PWDs. As content analysis, the results of two previous research projects were collected. Those data were analyzed by interpretation and analytic induction.

Findings: Even the rights of PWDs were more concerned by society than the past decade, but educational provisions for PWDs have still challenged and should be mainly promoted on 1) positive attitudes toward PWDs, 2) particular skills and knowledge of teachers as IEP, inclusive education and transition services 3) reasonable accommodation and assistive technologies, 4) human resource development. As PAR, inclusive education was mainly concerned by participants. It reflected what participants coped with and how they solved comprehensively.

Discussion: Problems and ineffective law enforcement on educational provisions for PWDs in Thailand existing like previous studies in other developed and developing countries. Positive attitudes of society toward PWDs, collaboration, consciousness raising and patience among stakeholders are the key success of educational provisions for PWDs in which can be enhanced through PAR.

Conclusion: The majority of law enforcement and educational equality of PWDs were still ineffective and discriminated. Thus, role of parents and private centers as well as positive attitudes and collaboration among stakeholders need to be systematically promoted.

Background: Scotland has historically had one of the highest rates of poor health and corresponding work related absence in the developed world. To address this challenge, the Scottish government formed a specialised unit in 2006, the Scottish Centre for Healthy Working Lives (SCHWL). Functioning as an extension of the government funded National Health System (NHS), SCHWL's principle goal was to engage employers and enable them to protect and improve the health of their employees.

Hypothesis: The establishment of disability management services within the National Health Service would create a primary link between medical/health services and employers/employees, resulting in improved timeframes for return to work and reduced absence rates.

Methods: The SCHWL established three pilot projects to deliver Vocational Rehabilitation Services across Scotland. This included the provision of disability management services to enable workers to return to or remain in work, with the intention of creating a necessary bridge between the health care system and employers/employees. SCHWL determined that specialised training of health professional staff working within the NHS would be a critical requirement for success. In 2009, SCHWL engaged KMG Health Partners to begin delivery of the NIDMAR education programme to a cross section of staff working within the NHS. KMG has now trained over 50 health professionals who have achieved their Certified Disability Management Professional (CDMP) designation and who work with the NHS across Scotland. Principle Findings: The CDMP's function as a critical link between the traditional health services accessed at the initial stages of an employee's injury or illness. Their primary role facilitates and supports return to work from the initial onset of medical/health treatment.

Conclusion: The innovative approach implemented by SCHWL has achieved measurable improvements in the communication process between NHS treating health professionals and employers, employer engagement in the return to work process, and reduced employee timeframes for return to work.

This presentation will provide a practical look at the Americans with Disabilities Act (ADA) in the United States. This disability non-discrimination act has undergone recent amendments changing the landscape for employers and changing their responsibilities to stay compliant. We will review how the changes in the ADA differ today for employers in the United States and we will also provide a comparison with other discriminatory acts in the world. The changes to be discussed include issues of “qualification” and “reasonableness” of accommodation and what these changes mean to real employer examples. The example will demonstrate one disability insurance carrier's approach to addressing this change by providing in support of their policyholders’ responsibilities to stay compliant.

Australia's mineral, resource and infrastructure sectors continues to expand as operations in rural and remote locations increasingly rely on fly-in, fly-out or drive-in, drive-out workforces in order to become economically competitive. The issues associated with employing these workforces are becoming more apparent and include a range of physical, mental, psychosocial, safety, and community challenges. Research evaluating the impacts of fly-in, fly-out operations in Australia has been limited, and in February 2013 the Australian House of Representatives Standing Committee on Regional Australia made 21 recommendations aimed at improving these operations. To date, none of the recommendations have been implemented. The Construction and Mining sectors, in which most FIFO workers are employed, represent 12% of the total Australian workforce. Recent evidence from Safe Work Australia (2013) notes that serious injuries incident rates in both these sectors are well above the national injury rate. In addition the median payment and compensation cost for serious injury in these sectors are considerably higher than the Australian average due to higher employees salary, severity of incidents, lengths of absence from work, and medical expenses. These at risk remote site FIFO employees are further challenged post injury by lack of access to well-regarded disability management processes that have traditionally closely involved the workplace in the rehabilitation process. This paper examines the disparate challenges faced by both employers and employees in workplace wellbeing in remote sites, and raises questions as to how best disability management professionals can design, implement, and evaluate effective rehabilitation processes for injured FIFO workers who are a fast growing segment of the workforce but who work in conditions hitherto atypical of mainstream industry.

Measuring return to work outcomes after injury is in itself a challenge for most workers’ compensation schemes. Increasing return to work rates is even more difficult. In Australia, the national return to work measure obtained via an annual survey of injured workers has not risen since its introduction in 1997/98. However, unlike most other Australian jurisdictions, Queensland, Australia's ‘sunshine state’, records return to work outcomes at the end of every time lost claim. More than this, Queensland has increased its overall return to work outcome in recent years from 90% to over 95%. A number of specific strategies were introduced to improve these return to work results. The presentation will outline these strategies which other jurisdictions and countries can hopefully learn from. In addition, WorkCover Queensland, the state's monopoly insurer outside self-insurers, has introduced further return to work measures it successfully uses both internally and externally.

Background: The Healthcare Sector in British Columbia, Canada is comprised of over 110,000 employees covered by four union collective agreements. The overall disability burden for this industry is close to $300M annually. The EDMP was negotiated and developed through employer-union partnership. It is a province-wide program that is a component of the four healthcare collective agreements. Implemented in 2012, EDMP supports employees that are absent from work/struggling at work due to occupational or non-occupational illness/injury.

Objectives: To showcase a leading DM best practice, highlighting effective joint union/employer stewardship of a comprehensive DM program for a major industry in British Columbia, Canada.

Methods: Participation in EDMP is required for regular employees who meet one of the following criteria:

• • shift due to illness or injury resulting from a work-related event

• • consecutive shifts due to a non work-related illness or injury.

Comprehensive policy and process documents developed collaboratively guide the program, with provincial steering joint committee over-site. Union representatives with DM-specific training support the program, working in collaboration with employer's DM professionals to administer a pro-active, comprehensive case management plan with an overarching principle of early intervention and recovery at work. DM-related issues are removed from the labor-relations realm, with a separate dispute resolution process to address disagreements with case management plans.

Findings: The collaborative partnership between EDMP union reps and employer DM professionals facilitates engagement of injured/ill employee and improves the ability to identify and address return to work barriers: medical, workplace, vocational, personal. The mandatory component of the CA language improves engagement from both union and employer, with reductions in both WCB and LTD claim durations as a positive result. Fewer conflicts regarding DM related issues are an additional benefit.

Conclusion: The EDMP should be used a model of effective union-employer partnership in the management of employee illness/injury and should be replicated in other industries/jurisdictions.

Background: The proportion of people with disabilities in the 50 to 64 year age is double that of those aged 35 and 44 years. Economic inactivity rates are almost 40% higher. Disability Management (DM) professionals are in the front line in responding to these challenges.

Objectives: A key issue is the nature and extent that new knowledge and additional skills are required to respond effectively to the needs of older workers. Methods In 2013, the National Institute of Disability Management and Research (NIDMAR), in collaboration with Pacific Coast University for Workplace Health Sciences, brought stakeholders, professionals and researchers together to explore a more integrated approach to older workers. A follow up questionnaire was distributed to participants in order to validate the conclusions.

Findings: The consensus was that DM professionals already had the skills required but that there were a number of areas where it was essential that knowledge be enhanced and attitudes changed. DM professionals required better knowledge of age-related health conditions, the complexities of co-morbidity and human rights issues and to acknowledge longer recovery times, the health benefits of work, the ability to learn new skills and older workers’ added value to teams.

Discussion: In addition to the essential competences, 22 desirable domains of knowledge, skill and attitude were identified. The taxonomy produced has the potential to form the basis of a training needs analysis (TNA) that could be used by organizations to evaluate the competences of DM professionals and to produce age-sensitive continuing professional development modules.

Conclusion: DM professionals are equipped with the necessary skills to respond effectively to older workers. The appropriate application of these skills requires a change in attitudes and a deeper knowledge of age-related health conditions and the human rights implications of the intersectionality of age and disability at work.

The Guidelines on Return to Work and Reintegration of the International Social Security Association (ISSA) in Geneva published 2013 provides key-elements for successful disability management programs worldwide: Early intervention, personal-centred, work-place orientated, holistic-driven and multi-disciplined approach. Lots of tools and good practice from various countries and stakeholders in prevention and rehabilitation support the efforts of retaining and restore the employability of persons with disabilities within societies. The lecture offers an overview of the ISSA Guidelines and how they could be used as standard in social security institutions.

We seek to

• - Found an organisation which represents the interests of the disability manager and disability management (VDIMA e. V.).

• - Advertise campaigns to inform about the general objectives of professional disability management.

• - Build relationships to all the stakeholders especially to decision-makers in politics.

• - Offer further vocational training to the disability manager.

This presentation outlines disparities in the uptake of accident compensation entitlements by indigenous New Zealanders and a programme to prevent injury and improve outcomes/experience for Māori. ACC administers NZ's 24/7 no-fault accident compensation scheme which covers New Zealanders and visitors to NZ injured at work, home, play, in road crashes, or during treatment. Research has shown that disparities persist in injury outcomes/experience for NZ's indigenous population (Māori make-up 15% of the population and experience multiple disadvantage). This is inconsistent with the Government's commitment to Crown-Māori partnership.

Disparities findings persist for Māori included; higher rates of serious/fatal injuries on the roads, lower GP referral rates to medical/surgical specialists, found the claim process more complicated and ACC less helpful in their return to work and lower rates of employment participation following a serious injury.

ACC's 10 year vision of success; improved outcomes/experience for Māori clients and businesses, increased injury prevention effectiveness for Māori and improved ACC culture and capability in relation to Māori.

Over a three year period, the ACC Board considered a series of papers on disparities in the uptake of entitlements by Māori. In early 2013, the Board considered advice on the Scheme's and organisation's responsiveness to Māori and endorsed the need for significant improvements. We shall explore two phases. Phase 1 of ACC's Māori Programme aims to reduce disparities, build organisational capability and establish relationships. Initiatives include innovative solutions to improve employment participation of seriously injured Māori. Phase 2 builds new partnerships with indigenous organisations and embeds cultural-responsiveness into the organisation/system. Challenges include building genuine partnerships and sustaining the Programme in a changing organisational, social, political and economic context. Improving injury outcomes/experience for Māori is a long-term commitment. Programme success includes fewer fatal/serious injuries to Maori, better employment participation after injury, and new partnerships.

Background: There is ample evidence that returning to suitable work is good for an injured worker's health and wellbeing. Evidence from the 2013 National Return to Work Survey shows a positive relationship between employers’ treatment of injured workers and return to work outcomes.

Objectives: The case studies project aims to provide:

• • employers with examples of practical solutions, practices or systems to improve return to work outcomes, and

• • policy makers with a summary of key themes and best practice approaches to inform the development of policy and programs.

Methods: Organisations for the case studies will be shortlisted from recent Australian national return to work award winners and finalists. Key players within the organisations, including managers, supervisors, rehabilitation co-ordinators and recovered injured workers, will be interviewed to obtain information and attitudes on the early intervention and return to work approaches. An analysis of the case studies and a literature review on current best practice for early intervention and return to work will be conducted from which key themes and practices will be identified.

Findings: The project will produce two reports: case studies of six organisations’ practices, and an analytical report on key findings and best practice for early intervention and return to work. The case studies will provide employers and workers published examples of practical approaches to improving return to work outcomes. The case studies also explore the roles and views of management, supervisors and injured workers. The analytical report will examine the case studies and report on key themes and best practice, providing policy makers and employers with an analysis of findings. The 2013 National Return to Work survey provides supporting evidence of the positive relationship between return to work outcomes and a range of variables related to the role of the employer and the workplace.

Conclusion: It is anticipated the case studies project will provide examples of practical approaches to improving early intervention and return to work outcomes, which other organisations may consider implementing.

Maximising independence through community rehabilitation. Community rehabilitation is now recognized as an integral part of the rehabilitation process. The provision of such community rehabilitation within a person's home or community enables their clinicians to focus on meaningful functional activities and independence needs of a person. Providing rehabilitation in the environment where a person normally functions, whether it is for physical, cognitive or behavioural needs, maximizes outcomes as it ensures the person's learning is occurring in a contextual environment. It also maximizes independence as it enables practice of new skills to occur frequently across the day; consequently skill development is based on regular practice. As skills are acquired these can be progressed within the home or the community environment. Integral to this process is the development of functional goals. Goals must be person centered and aligned with underlying functional needs, thus goal achievement is underpinned by a rehabilitation process where all members of the rehabilitation team are working towards the same functional outcome. Carers can be trained to assist with practice of the program, this allows autonomy as clinicians don't need to be present at all times while practicing tasks or exercises. Consequently the ability to select and train carers are vital skills required by clinicians managing injured people in the community. Allowing the injured person to have a role in carer selection can facilitate a more fruitful relationship. It is expected that as the person's skills develop and evolve there will be an understanding from all involved that the person's need for carers will reduce. At times independence can be limited if clinicians and carers continue therapy and restrict a person's ability to develop confidence in their independence; best practice would indicate treatment plans are reviewed regularly so this doesn't occur. To maximize independence, all these components should be considered.

Background: Medical certification of injured workers is a routine occurrence in most General Practitioners (GPs) offices. GPs play an important role in return-to-employment after a work-related injury.

Objectives: To examine patterns of healthcare service utilisation (HSU) in injured workers by condition and type of medical certificate issued by the GP at the initial consultation.

Methods: Zero-inflated negative binomial regression (ZINB) was conducted for major healthcare services accessed by injured workers over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation, psychology and others. Logistic regression was conducted for hospital and occupational therapy services. All models were adjusted for the injured worker's gender, age, injury type, certification type, occupation and residential location.

Findings: HSU differed according to the type of initial medical certificate and worker condition. Compared to other conditions, for unfit for work (UFW) and alternate duties (ALT) certificates, the average number of physiotherapy services was greater in workers with musculoskeletal disorders (MSD), back pains and strains and fractures. In contrast, for both UFW and ALT certificates, the mean number of psychological services was greater in mental health conditions (MHC). Workers suffering from MHCs were more likely to access pharmacy and psychological services. Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services. They were less likely to access occupational rehabilitation, psychology or other services.

Discussion: HSU in the 12 months post-initial medical certification varied substantially according to the worker's medical condition, certificate type, occupation, age, gender and residential location.

Conclusion: Understanding these socio-demographic characteristics that influence HSU can facilitate more appropriate resource allocation, strategic thinking on optimal use of particular health services and enable better targeting of particular provider groups for more education on the health benefits of RTW and safe work.

Background: Returning to work following a workplace injury or illness is a complex, multi-faceted and continuously evolving issue that involves a range of challenges and complexities. Very little, however, is known about the stages individual injured worker's progress through, from their personal perspective, in returning to work.

Objectives: The objectives of this research were to provide Comcare with greater insights and a better understanding about how to positively engage with injured/unwell workers in the federal jurisdiction, and to encourage more positive return to work (RTW) and recovery outcomes.

Methods: A total of 47 in-depth interviews were conducted with injured workers from both premium paying and self-insured organisations in four Australian States and Territories. An independent research company conducted the interviews on behalf of Comcare between December 2012 and February 2013. A purposeful sampling approach was employed, however, this was influenced by the willingness of people to participate. Principle Findings:- Six stages were identified in the RTW journey, with each stage representing a distinct dynamic. The mind-set and needs of an individual were found to shift through each of these stages, thereby influencing the likelihood of them achieving a successful RTW outcome.

Discussion: The RTW experience of injured and unwell workers was found to be a very personal journey that encompasses a range of experiences which can be completed in a few weeks, or continue for years. It is very emotionally charged, challenging, and tends to result in changes to personal and professional identity, life and work expectations.

Conclusion: The insights gained by Comcare into an individual's RTW journey have reaffirmed our commitment to having the injured/unwell worker at the centre of what we do, and to continuing to tailor our claims management strategies to meet their individual needs. le: Key factors influencing an organisation's approach to return to work.

The Motor Vehicle Accident Fund (MVA Fund) started operations on 1 January 1987 to service third party cover from funds earned from a levy on fuel. Originally called the Motor Vehicle Insurance Fund, the MVA Fund has been going through profound change in order to deliver services that meet the expectations of its stakeholders. Over the years, the governing Act underwent reviews as a response to feedback from both the public and stakeholders. Currently the Fund is governed by the Motor Vehicle Accident Fund Act No. 15 of 2007, which is a hybrid of both a fault-based and a no fault compensation system. Severe Injuries MVA Fund has a total of 1 589 claimants who suffered severe injuries during road crashes.. Role of MVA Fund in management of the severely injured The Act has put emphasis on medical treatment and rehabilitation as one of its core mandates. The timeliness of medical attention and rehabilitation results in improved claimants’ outcomes. Some of the objectives of the Fund in managing these claimants include among others:

• • Restoring claimants to highest possible level of functionality

• • Vocational rehabilitation

• • Return to work

• • Social rehabilitation Achievements by Botswana MVA Fund

Despite the challenges faced by developing countries, the Fund managed to:

• • Remain sustainable hence continuing to deliver on its mandate

• • Support the severely injured by:

  • ○ medical and rehabilitation cover

  • ○ loss of income o enhancement of quality of life e.g. house/workplace modification o providing social and welfare care

  • ○ advocacy role

• • Build capacity in both government and non-governmental organisations as a long-term investment in the management of the severely injured.

The Fund continues collaborating with relevant stakeholders and international bodies for best practice in managing these claimants.

Objective: We investigate labour-market earnings of workers’ compensation claimants from three distinctly different workers’ compensation insurance support programs for claimants with permanent impairments. These three programs, which existed in Ontario, Canada in different periods over the last 25 years, are the Permanent Disability (PD) program, the Future Economic Loss (FEL) program, and the Loss of Earnings (LOE) program. The nature of benefit determination and the return to work supports provided by three programs are very different. The focus of the study is on evidence of programmatic impact on labour-market earnings recovery trajectories over nine years post injury.

Methods: The study included claimants sampled from each of the three programs who sustained a permanent impairment from a work injury. Claimants were identified in a Revenue Canada tax file database known as the Longitudinal Administrative Databank (LAD), which is a longitudinal 20% simple random sample of all Canadian tax filers. Each claimant was matched with similar uninjured controls that were also in the LAD, based on sex, age, labour-market earnings amounts and trajectories in the four years prior to injury, and a propensity score. Statistical modeling analysis was undertaken to compare the labour-market earnings trajectories of claimants relative to their matched controls using data on earnings over the nine years post injury. Analyses focused on sub-strata defined by program, sex, age, permanent impairment level, and pre-injury earnings. A key issue of interest was to determine which program of supports resulted in the best labour-market earnings recovery.

Results: Five distinct earnings recovery trajectories were identified. Claimants in various demographic and pre-injury earnings sub-strata from the LOE program cohort had a statistically significant lower probability of the lowest earnings recovery trajectory, and higher probability of the second highest trajectory compared to the PD cohort. Results for the LOE program were similar to the FEL program.

Conclusions: Injured workers from the LOE program appear to fare better than claimants from the PD program and similarly to those from the FEL program in terms of labour-market earnings recovery over the nine years post injury. Across all programs, older claimants fare more poorly, and women fare worse than men in terms of labour-market earnings recovery.