8287478 Investigating differences in return-to-work for workers with work-related chronic pain and concurrent psychological injuries in British Columbia

<h3>Objectives</h3> To investigate differences in time for return-to-work (RTW) among psychological, chronic pain, and concurrent psychological with chronic pain injuries and to identify the most influential factors affecting the likelihood of RTW for each injury type. <h3>Methods</h3> Workers’ compensation claims data were used to identify workers (n=414,507) with an accepted time-loss claim due to work-related psychological, chronic pain, concurrent psychological with chronic pain injuries, or other injury types occurring between 2012 and 2019, with up to 3 years (1095 days) of follow-up. Descriptive statistics were used to analyze differences in time to RTW. Multivariate logistic regression was used to assess the role of socio-demographic and work characteristics in determining the likelihood of RTW for each injury type. <h3>Results</h3> Descriptive statistics reveal substantial differences in days to RTW after injury, with concurrent psychological with chronic pain having the longest durations (median=1095 days [IQR:1095 – 1095 days]), followed by chronic pain (median=1095 days [IQR:327 – 1095 days]) and psychological (median=422.5 days [IQR:74 – 1095 days]). All other injuries had a median of 21 days [IQR:7 – 83 days]. Variables such as older age and smaller firm size reduced the likelihood of RTW across all injury types, while other variables had injury-specific effects. For example, men were less likely to RTW compared to women (OR:0.86 [95% CI:0.77 – 0.96]) for psychological injury; workers with lower wages were less likely to RTW compared to those with higher wages (OR:0.58 [95% CI:0.52 – 0.64]) for chronic pain; and, health occupations were less likely to RTW for concurrent psychological injury with chronic pain (OR:0.49 [95% CI:0.25 – 0.94]). <h3>Conclusion</h3> There were large differences in RTW across injury types, and various characteristics impacted the likelihood of RTW differently across injury types. The small proportion of workers who had RTW after 3 years for concurrent psychological injury with chronic pain injuries warrants further research. <h3>Funding</h3> WorkSafeBC Research Training Award