Journal of Occupational Rehabilitation

, Volume 28, Issue 4, pp 740–748 | Cite as

Patterns and Predictors of Failed and Sustained Return-to-Work in Transport Injury Insurance Claimants

  • Shannon E. Gray
  • Behrooz Hassani-Mahmooei
  • Ian D. Cameron
  • Elizabeth Kendall
  • Justin Kenardy
  • Alex Collie


Purpose To determine the incidence of employed people who try and fail to return-to-work (RTW) following a transport crash. To identify predictors of RTW failure. Methods: A historical cohort study was conducted in the state of Victoria, Australia. People insured through the state-based compulsory third party transport accident compensation scheme were included. Inclusion criteria included date of crash between 2003 and 2012 (inclusive), age 15–70 years at the time of crash, sustained a non-catastrophic injury and received at least 1 day of income replacement. A matrix was created from an administrative payments dataset that mapped their RTW pattern for each day up to 3 years’ post-crash. A gap of 7 days of no payment followed by resumption of a payment was considered a RTW failure and was flagged. These event flags were then entered into a regression analysis to determine the odds of having a failed RTW attempt. Results: 17% of individuals had a RTW fail, with males having 20% lower odds of experiencing RTW failure. Those who were younger, had minor injuries (sprains, strains, contusions, abrasions, non-limb fractures), or were from more advantaged socio-economic group, were less likely to experience a RTW failure. Most likely to experience a RTW failure were individuals with whiplash, dislocations or particularly those admitted to hospital. Conclusions: Understanding the causes and predictors of failed RTW can help insurers, employers and health systems identify at-risk individuals. This can enable earlier and more targeted support and more effective employment outcomes.


Injuries Return to work Rehabilitation 



This project was funded by the Transport Accident Commission through the Institute for Safety, Compensation and Recovery Research (ISCRR). IC’s salary is supported by an Australian National Health and Medical Research Council Practitioner Fellowship.


This project was funded by the Transport Accident Commission through the Institute for Safety, Compensation and Recovery Research (ISCRR).

Compliance with Ethical Standards

Conflict of interest

Shannon E. Gray, Behrooz Hassani-Mahmooei, Ian D. Cameron, Elizabeth Kendall, Justin Kenardy and Alex Collie declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

Statement not required. This study was performed using a de-identified administrative dataset, with ethics approval granted by Monash University Human Research Ethics Committee (CF09/3150—2009001727).


  1. 1.
    Henley G, Harrison J. Trends in serious injury due to road vehicle traffic crashes, Australia 2001 to 2010. Canberra: Australian Institute of Health and Welfare and Flinders University; 2015.Google Scholar
  2. 2.
    Lilley R, Davie G, Ameratunga S, Derrett S. Factors predicting work status 3 months after injury: results from the Prospective Outcomes of Injury Study. BMJ Open. 2012;2:e000400. Scholar
  3. 3.
    Bureau of Infrastructure Transport and Regional Economics [BITRE]. Road crash costs in Australia 2006. Canberra: Commonwealth of Australia; 2009.Google Scholar
  4. 4.
    The Royal Australasian College of Physicians. Australasian faculty of occupational and environmental medicine position statement on realising the health benefits of work. The Royal Australasian College of Physicians: Sydney; 2011.Google Scholar
  5. 5.
    Canadian Medical Association. The treating physician’s role in helping patients return to work after an illness or injury. 2013. Accessed 23 Mar 2017
  6. 6.
    Pransky G, Gatchel R, Linton SJ, Loisel P. Improving return to work research. J Occup Rehabil. 2005;15(4):453–457.CrossRefGoogle Scholar
  7. 7.
    Fitzharris M, Bowman D, Ludlow K. Factors associated with return-to-work and health outcomes among survivors of road crashes in Victoria. Aust N Z J Public Health. 2010;34(2):153–159.CrossRefGoogle Scholar
  8. 8.
    van Velzen JM, van Bennekom CAM, van Dormolen M, Sluiter JK, Frings-Dresen MHW. Factors influencing return to work experienced by people with acquired brain injury: a qualitative research study. Disabil Rehabil. 2011;33(22–23):2237–2246.CrossRefGoogle Scholar
  9. 9.
    Prang K-H, Bohensky M, Smith P, Collie A. Return to work outcomes for workers with mental health conditions: a retrospective cohort study. Injury. 2016;47(1):257–265.CrossRefGoogle Scholar
  10. 10.
    Smith PM, Black O, Keegel T, Collie A. Are the predictors of work absence following a work-related injury similar for musculoskeletal and mental health claims? J Occup Rehabil. 2014;24(1):79–88.CrossRefGoogle Scholar
  11. 11.
    Berecki-Gisolf J, Clay F, Collie A, McClure R. Predictors of sustained return to work after work-related injury or disease: insights from workers’ compensation claims records. J Occup Rehabil. 2012;22(3):283–291.CrossRefGoogle Scholar
  12. 12.
    Young AE, Roessler RT, Wasiak R, McPherson KM, van Poppel MNM, Anema JR. A developmental conceptualization of return to work. J Occup Rehabil. 2005;15(4):557–568.CrossRefGoogle Scholar
  13. 13.
    Butler RJ, Johnson WG, Baldwin ML. Managing work disability: why first return to work is not a measure of success. ILR Rev. 1995;48(3):452–469.Google Scholar
  14. 14.
    Baldwin ML, Johnson WG, Butler RJ. The error of using returns-to-work to measure the outcomes of health care. Am J Ind Med. 1996;29(6):632–641.CrossRefGoogle Scholar
  15. 15.
    Heron-Delaney M, Warren J, Kenardy JA. Predictors of non-return to work 2 years post-injury in road traffic crash survivors: results from the UQ SuPPORT study. Injury. 2017;48(6):1120–1128.CrossRefGoogle Scholar
  16. 16.
    Transport Accident Commission. TAC Annual Report 2015/16. 2016. Accessed 5 June 2017
  17. 17.
    Prang K-H, Hassani-Mahmooei B, Collie A. Compensation research database: population-based injury data for surveillance, linkage and mining. BMC Res Notes. 2016;9:456. Scholar
  18. 18.
    Gabbe BJ, Simpson PM, Harrison JE, Lyons RA, Ameratunga SA, Ponsford JA, Fitzgerald MA, Judson RA, Collie AA, Cameron PA. Return to work and functional outcomes after major trauma: who recovers, when and how well? Ann Surg. 2016;263(4):623–632.CrossRefGoogle Scholar
  19. 19.
    Australian Bureau of Statistics. Postal Area, Indexes, SEIFA (Socio-Economic Indexes for Areas) 2011. Canberra. 2013.Google Scholar
  20. 20.
    Berecki-Gisolf J, Clay FJ, Collie A, McClure RJ. The impact of aging on work disability and return to work. J Occup Environ Med. 2012;54(3):318–327.CrossRefGoogle Scholar
  21. 21.
    Brijnath B, Bunzli S, Xia T, Singh N, Schattner P, Collie A, Sterling M, Mazza D. General practitioners knowledge and management of whiplash associated disorders and post-traumatic stress disorder: implications for patient care. BMC Fam Pract. 2016;17:82. Scholar
  22. 22.
    Adams H, Ellis T, Stanish WD, Sullivan MJ. Psychosocial factors related to return to work following rehabilitation of whiplash injuries. J Occup Rehabil. 2007;17(2):305–315.CrossRefGoogle Scholar
  23. 23.
    Gozzard C, Bannister G, Langkamer G, Khan S, Gargan M, Foy C. Factors affecting employment after whiplash injury. J Bone Joint Surg. 2001;83-B(4):506–509.CrossRefGoogle Scholar
  24. 24.
    McClune T, Burton AK, Waddell G. Whiplash associated disorders: a review of the literature to guide patient information and advice. Emerg Med J. 2002;19(6):499–506.CrossRefGoogle Scholar
  25. 25.
    Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L, Ouchterlony D, Weegar K. Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms. Brain Inj. 2015;29(6):688–700.CrossRefGoogle Scholar
  26. 26.
    Transport Accident Commission. TAC information for employers. Transport Accident Commission: Geelong; 2014.Google Scholar
  27. 27.
    Nielsen MB, Bultmann U, Madsen IE, Martin M, Christensen U, Diderichsen F, Rugulies R. Health, work, and personal-related predictors of time to return to work among employees with mental health problems. Disabil Rehabil. 2012;34(15):1311–1316.CrossRefGoogle Scholar
  28. 28.
    Cornes P. Return to work of road accident victims claiming compensation for personal injury. Injury. 1992;23(4):256–260.CrossRefGoogle Scholar
  29. 29.
    Knol MJ, Le Cessie S, Algra A, Vandenbroucke JP, Groenwold RHH. Overestimation of risk ratios by odds ratios in trials and cohort studies: alternatives to logistic regression. CMAJ. 2012;184(4):895–899.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Shannon E. Gray
    • 1
    • 5
    • 6
  • Behrooz Hassani-Mahmooei
    • 1
  • Ian D. Cameron
    • 2
    • 5
  • Elizabeth Kendall
    • 3
    • 5
  • Justin Kenardy
    • 4
    • 5
  • Alex Collie
    • 1
    • 5
  1. 1.Insurance Work and Health Group, Faculty of Medicine Nursing and Health SciencesMonash UniversityMelbourneAustralia
  2. 2.John Walsh Centre for Rehabilitation Research, Kolling InstituteUniversity of SydneySt LeonardsAustralia
  3. 3.The Hopkins Centre, Menzies Health Institute QueenslandGriffith UniversityMeadowbrookAustralia
  4. 4.School of PsychologyUniversity of QueenslandSt LuciaAustralia
  5. 5.Centre of Research Excellence in Recovery Following Road Traffic InjuriesHerstonAustralia
  6. 6.MelbourneAustralia

Personalised recommendations