scholarly journals O2C.2 Does region of residence matter for return-to-work after work-related injury? A comparative analysis of six canadian workers’ compensation jurisdictions

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A16.1-A16
Author(s):  
Robert Macpherson ◽  
Hui Shen ◽  
Mieke Koehoorn ◽  
Benjamin Amick ◽  
Alex Collie ◽  
...  
Keyword(s):  
Return To Work ◽  
Rural Areas ◽  
Urban Areas ◽  
Work Disability ◽  
Injured Workers ◽  
Workers Compensation ◽  
Disability Benefits ◽  
Work Related ◽  
Work Related Injury ◽  
Urban Rural

ObjectivesTo investigate regional differences in return-to-work following work-related injury and whether these differences persist after adjusting for individual characteristics.MethodsWorkers’ compensation claims from six Canadian provinces were used to create comparable cohorts of workers aged 15–80 with a work-related injury resulting in at least one disability day from 2011 to 2015. Workers’ residential postal codes were mapped to Census standard geographic units to categorize workers into six regions representing decreasing urban density and metropolitan influence (ranging from large urban areas of 100,000+people to rural areas of <10 000 people with no metropolitan influence). Cox regression models were used to estimate the effect of urban-rural residence on the likelihood of injured workers transitioning off work disability benefits within one-year post-injury, adjusting for confounders, including provincial compensation jurisdiction. Models were stratified by industry sectors.ResultsThe cohort included 7 46 029 work disability claims, of which the majority resided in large urban areas (69%). Unadjusted models showed that workers residing in smaller urban and rural areas had a lower likelihood of transitioning off work disability benefits compared to those in large urban areas. Urban-rural differences persisted in adjusted models (e.g. HR=0.91 95% CI 0.89, 0.94 for workers in rural areas with no metropolitan influence). Industry-stratified models showed that greater differences existed between urban and rural places of residence for workers in the transportation and construction sectors, and smaller differences for workers in the health care and manufacturing sectors.ConclusionsThe main finding suggests that injured workers in more rural areas face barriers in returning to work and that workers’ compensation resources may need to be allocated to address these regional disparities. Future research will incorporate both individual and regional-level variables in a multilevel model framework to identify the characteristics that are the most important in explaining variability in work disability duration.

scholarly journals Data linkage to build detailed return-to-work trajectories for work disability research

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Esther Maas ◽  
Wei Zhang ◽  
Mieke Koehoorn ◽  
Chris McLeod
Keyword(s):  
Health Services ◽  
Return To Work ◽  
Work Disability ◽  
Population Based ◽  
Economic Benefits ◽  
Injured Workers ◽  
Workers Compensation ◽  
Prescription Data ◽  
Cost Benefits ◽  
The Cost

IntroductionMusculoskeletal disorders (MSDs) are the most prevalent chronic condition in Canada, and account for the highest disability costs. Gradual-return-to-work (GRTW) can improve health and labour market outcomes in an aging workforce at risk of MSDs. Linked longitudinal data enables us to generate evidence of GRTW to inform policy needs. Objectives and ApproachThe objective of this study was to investigate the effectiveness and cost-benefits of GRTW for workers with a work-acquired MSD in British Columbia, Canada. We linked workers’ compensation data, health services data, and prescription data from three governing bodies to 1) identify injured workers with an accepted MSD lost-time injury between 2010 and 2015; 2) identify trajectories of RTW states (injury, sickness absence, GRTW, RTW, and non-RTW) and the probability of transitioning between states; and 3) assess the association between workers characteristics and RTW trajectories, and analyze the cost-benefits of GRTW. ResultsFinal results are expected early 2019. To our knowledge, this will be the first study linking workers’ compensation data (in particular detailed RTW data), health services data and prescription data from three different governing bodies for a comprehensive, population-based investigation of work disability experiences over a longitudinal time period and within the Canadian context. Also, using this data for the purpose of assessing the cost-benefits is new, and will help to prioritize prevention resources and strategies to limit the health and economic impact of work-related MSDs on employers, workers’ compensation boards and society. Conclusion/ImplicationsEvaluating the effects of GRTW on work disability is essential to maximize the health and economic benefits for injured workers. The innovation of this project is that is links three population-based databases to capture multiple indicators of health and work status to build RTW trajectories over time.

More than Meets the Eye: Social, Economic, and Emotional Impacts of Work-Related Injury and Illness

2008 ◽  
Vol 18 (3) ◽  
pp. 343-360 ◽  
Author(s):  
Michael B. Lax ◽  
Rosemary Klein
Keyword(s):  
Access To Health Care ◽  
Health Condition ◽  
Injured Workers ◽  
Workers Compensation ◽  
Occupational Illness ◽  
Work Related ◽  
Work Related Injury ◽  
Retirement Funds ◽  
Financial Impacts ◽  
The Impact

The impact of an occupational illness or injury on an injured worker can be severe. This study assessed several dimensions of the impact on a group of 50 injured workers, all patients at an Occupational Health Center. The dimensions assessed included aspects of access to health care, support from treating physicians in obtaining Workers' Compensation benefits, financial impacts, the role of attorneys and “Independent Medical Examiners,” and the impact on mental health. The results showed almost two-thirds of respondents lost their health insurance after diagnosis with a work-related illness or injury, most for more than a year. Many reported that their treating physician did not want to become involved in Workers' Compensation, despite indicating a belief that the health condition was work-related. The financial impacts of a work-related diagnosis were particularly striking, with respondents reporting that they were burdened with both costs directly related to the medical care of their condition, and with coping with ongoing general expenses on a reduced income. Many respondents reported depleting savings, borrowing money, taking out retirement funds, and declaring bankruptcy in efforts to cope. Emotionally, respondents almost universally reported their diagnosis and related issues were associated with depression, anxiety, and loss of identity and self-worth. This study demonstrates how a work-related injury or illness can extend far beyond the physical impact for injured workers. Existing systems fail to adequately compensate or rehabilitate injured workers, leaving them to their own devices to deal with their losses, medical or otherwise.

Literature Review

1997 ◽  
Vol 2 (1) ◽  
pp. 4-8
Author(s):  
James B. Talmage
Keyword(s):  
Workers Compensation ◽  
Body Parts ◽  
Injured Worker ◽  
Disability Benefits ◽  
Fourth Edition ◽  
Permanent Disability ◽  
Work Related ◽  
Work Related Injury ◽  
Whole Person ◽  
Compensation Law

Abstract Evaluating physicians should understand how their impairment evaluations are used, and to these ends Section 1.5 of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, discusses impairment and workers’ compensation. Permanent disability rewards may be paid according to a schedule that associates impairments of certain body parts, functions, or systems (eg, amputation or loss of sight or hearing) with specific awards. Typically, a schedule in the workers’ compensation law equates disability and a maximum number of weeks of benefits, but what occurs when an injured worker has both scheduled and unscheduled injuries? Under Colorado statute, scheduled injuries involve those to the neck, head, torso, and any injury not specifically enumerated in the statutory schedule. Because schedules usually do not cover all conditions following injuries, nonscheduled awards are available and are based on the extent of impairment, the nature of the injury, and the employee's occupation, experience, training, and age. The Colorado Supreme Court ruled that when a work-related injury results in both a scheduled and a nonscheduled injury, the scheduled injury must be converted to a whole person impairment rating and combined with the nonscheduled injury's whole person impairment when calculating permanent disability benefits. In its decision, the court relied heavily on and cited provisions in the AMA Guides.

scholarly journals Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS)

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048143
Author(s):  
Cameron Mustard ◽  
Victoria Nadalin ◽  
Nancy Carnide ◽  
Emile Tompa ◽  
Peter Smith
Keyword(s):  
Return To Work ◽  
Labour Market ◽  
Work Disability ◽  
Prescription Opioid ◽  
Workplace Injury ◽  
Market Outcomes ◽  
Work Related ◽  
Work Related Injury ◽  
Labour Market Outcomes

PurposeThe substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery requires a period of absence from work, with the majority of costs arising from the minority of workers with the longest duration absences. The objective of the Ontario Life After Workplace Injury Study is to describe the long-term health and labour market outcomes of workers disabled by work injury or illness after they are no longer receiving benefits or services from the work disability insurance authority.ParticipantsWorkers disabled by a work-related injury or illness were recruited from a sample frame of disability benefit claimants with oversampling of claimants with longer benefit durations. Characteristics of workers, their employers and claimant benefits were obtained from baseline administrative data. Interviews completed at 18 months post injury (T1) and to be completed at 36 months (T2) measure return-to-work and work status; income; physical and mental health; case manager and healthcare provider interactions and employer accommodations supporting return-to-work and sociodemographic characteristics. Of eligible claimants, 40% (1132) participated in the T1 interview, with 96% consenting to participate in the T2 interview.Findings to datePreliminary descriptive analyses of T1 data have been completed. The median age was 50 years and 56% were male. At 18 months following injury, 61% were employed by their at-injury employer, 16% had changed employment and 23% were not working. Past-year prescription opioid use was prevalent (34%), as was past-year cannabis use (31%). Longer duration claimants had poorer function, recovery and health and more adverse labour market outcomes.Future plansMultivariate analyses to identify modifiable predictors of adverse health and labour market outcomes and a follow-up survey of 96% of participants consenting to follow-up at 36 months are planned.

scholarly journals Differences in Work Disability Duration for Immigrants and Canadian-Born Workers in British Columbia, Canada

2021 ◽  
Vol 18 (22) ◽  
pp. 11794
Author(s):  
Sonja Senthanar ◽  
Mieke Koehoorn ◽  
Lillian Tamburic ◽  
Stephanie Premji ◽  
Ute Bültmann ◽  
...  
Keyword(s):  
British Columbia ◽  
Work Disability ◽  
Mitigation Strategies ◽  
Workers Compensation ◽  
Disability Benefits ◽  
Severe Injuries ◽  
Work Related ◽  
Fracture Cohort ◽  
Compensation Claims ◽  
The Relationship

This study aimed to investigate differences in work disability duration among immigrants (categorized as economic, family member or refugee/other classification upon arrival to Canada) compared to Canadian-born workers with a work-related injury in British Columbia. Immigrants and Canadian-born workers were identified from linked immigration records with workers’ compensation claims for work-related back strain, connective tissue, concussion and fracture injuries requiring at least one paid day of work disability benefits between 2009 to 2015. Quantile regression investigated the relationship between immigration classification and predicted work disability days (defined from injury date to end of compensation claim, up to 365 days) and modeled at the 25th, 50th and 75th percentile of the distribution of the disability days. With a few exceptions, immigrants experienced greater predicted disability days compared to Canadian-born workers within the same injury cohort. The largest differences were observed for family and refugee/other immigrant classification workers, and, in particular, for women within these classifications, compared to Canadian-born workers. For example, at the 50th percentile of the distribution of disability days, we observed a difference of 34.1 days longer for refugee/other women in the concussion cohort and a difference of 27.5 days longer for family classification women in the fracture cohort. Economic immigrants had comparable disability days with Canadian-born workers, especially at the 25th and 50th percentiles of the distribution. Immigrant workers’ longer disability durations may be a result of more severe injuries or challenges navigating the workers’ compensation system with delays in seeking disability benefits and rehabilitation services. Differences by immigrant classification speak to vulnerabilities or inequities upon arrival in Canada that persist after entry to the workforce and warrant further investigation for early mitigation strategies.

Impairment Tutorial: Rating Facial Disfigurement After an Injury

1998 ◽  
Vol 3 (4) ◽  
pp. 6-6
Author(s):  
Marc T. Taylor
Keyword(s):  
Current Work ◽  
Workers Compensation ◽  
Loss Of Function ◽  
Facial Disfigurement ◽  
Work Related ◽  
Work Related Injury ◽  
Compensation Claim ◽  
Impairment Ratings

Abstract This article discusses two important cases that involve the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). First, in Vargas v Industrial Com’n of Arizona, a claimant had a pre-existing non–work-related injury to his right knee as well as a work-related injury, and the issue was apportionment of the pre-existing injury. The court held that, under Arizona's statute, the impairment from the pre-existing injury should be subtracted from the current work-related impairment. In the second case, Colorado courts addressed the issue of apportionment in a workers’ compensation claim in which the pre-existing injury was asymptomatic at the time of the work-related injury (Askey v Industrial Claim Appeals Office). In this case, the court held that the worker's benefits should not be reduced to account for an asymptomatic pre-existing condition that could not be rated accurately using the AMA Guides. The AMA Guides bases impairment ratings on anatomic or physiologic loss of function, and if an examinee presents with two or more sequential injuries and calculable impairments, the AMA Guides can be used to apportion between pre-existing and subsequent impairments. Courts often use the AMA Guides to decide statutorily determined benefits and are subject to interpretation by courts and administrative bodies whose interpretations may vary from state to state.

Urban–Rural Dichotomy in Planning: Review of Legal Framework in Four States of India

2021 ◽  
pp. 001955612110016
Author(s):  
Anurima Mukherjee Basu ◽  
Rutool Sharma
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Planning Process ◽  
Legal Framework ◽  
Quantum Jump ◽  
Class 1 ◽  
Urban Settlements ◽  
Urban Rural ◽  
Territorial Approach ◽  
Sizeable Number

Current urbanisation trends in India show a quantum jump in number of ‘census towns’, which are not statutorily declared as urban areas, but have acquired all characteristics of urban settlements. Sizeable number of such census towns are not located near any Class 1 city. Lack of proper and timely planning has led to unplanned growth of these settlements. This article is based on a review of planning legislations, institutional framework and planning process of four states in India. The present article analyses the scope and limitations of the planning process adopted in the rapidly urbanising rural areas of these states. The findings reveal that states are still following a conventional approach to planning that treats ‘urban’ and ‘rural’ as separate categories and highlights the need for adopting an integrated territorial approach to planning of settlements.

scholarly journals Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie
Keyword(s):  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
Incidence Rates ◽  
Cancer Type ◽  
Anatomic Site ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

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