Workers with COVID-19 had better return-to-work rates than others during the pandemic

During the COVID-19 pandemic, workers who contracted the infection from work could submit a workers’ compensation claim. As a new category of illness, these claims had the potential to pose new challenges for those managing return-to-work and could make the return-to-work process different for those with COVID-19 and those with other types of injuries or illnesses.

The researchers set out to compare return-to-work rates between those with absences due to work-related COVID-19, and those with absences due to other work-related injuries or illnesses. They also wanted to understand whether different factors in the return-to-work process might explain any differences.

To do this, they conducted phone interviews with 1,000 workers who had a lost-time workers’ compensation claim accepted 18 months prior by the Workplace Safety and Insurance Board (WSIB). All participants had submitted their claim in 2021. The team excluded a small number of claims where injuries needed specialized or long-term management, as well as claims for mental health injuries.

They asked workers if they had returned to their jobs in the 18 months after experiencing their injury or illness. They also asked:

• how they rated their general health and mental health,
• if they experienced financial difficulties during the work absence,
• if their workplace offered supports or accommodations for their condition to help them return to work,
• if they received health-care for their condition and/or were provided a return-to-work date by their provider,
• if they were in contact with WSIB staff, and
• if they disagreed with the WSIB about their condition, the return-to-work process or their healthcare entitlements.

They then conducted analyses to determine the degree to which each factor might have explained any differences in return-to work rates between the groups.

Of those interviewed, 607 had work-related COVID-19, and 393 had other work-related conditions. 

Ninety per cent of those with work-related COVID-19 were back at work 18 months after their compensation claim was accepted, compared to 77 per cent of those with other work-related conditions. That’s 13 more workers back at work in the COVID-19 group for every 100 people.

Compared to those with other conditions, those with a COVID-19 claim were more likely to report:

• better self-rated health,
• good support from a workplace contact,
• low stress when interacting with a return-to-work coordinator, or not having coordinator, and
• not having a disagreement with the compensation agency about their claim.

What factors explain better return-to-work rates for those with COVID-19?

Of the return-to-work factors the survey asked about, only two contributed significantly to the differences in return-to-work rates: self-rated health and disagreements with the worker’s compensation agency. The better self-rated health of participants and the fewer disagreements with the worker’s compensation agency were significantly related to more workers with COVID-19 returning to work within 18 months. However, these two variables only explained about a third of the differences.

These results were also adjusted for other potential differences between claim types including: age; sex; race; pre-injury chronic conditions: job satisfaction: union membership; perceptions of COVID-19 protections at work; and their workplace’s industry, gender split and size.

Some factors affected return-to-work rates differently between groups

Differences in other return-to-work factors explained relatively little of the difference in return-to-work rates. But notably, some of the factors affected each group’s return-to-work rates differently:

Financial difficulties

Both groups reported similar levels of financial difficulties (just under half of each group). However, for those with non-COVID-19 injuries or illnesses, experiencing financial difficulties lowered the likelihood that they had returned to work 18 months later. Financial difficulties did not affect return-to-work rates for those with COVID-19.

Claim ownership

Having someone at the compensation agency who was responsible for a worker’s claim was linked to better return-to-work rates among workers with non‑COVID-19 conditions. It made no difference for those with COVID-19.

Offers for accommodations or alternative duties

Being offered accommodations at work was linked to better return-to-work rates among those with non-COVID-19 conditions but it made no difference for workers with COVID-19.

Return-to-work rates 18 months after an injury or illness were better for those who had work-related COVID-19 than those with other work-related conditions, during the pandemic. Established return-to-work factors only explained small portions of this difference. This suggests that the importance of these factors for facilitating return-to-work for other conditions may not apply to those with COVID-19 within the context of the pandemic.

Traditional return-to-work supports may have mattered less for COVID‑19 if the compensation claims were more about meeting isolation requirements during the pandemic than an inability to work.

A strength of the study included that the results were adjusted for a large number of factors at the individual, occupation, and workplace level. This made it possible to pinpoint how return-to-work was affected by certain factors. 

A limitation of the study was the retrospective study design, where workers reflected on the return-to-work process 18 months after their injury or illness, rather than multiple times during the process. This design could mean that some workers who had not returned to work reported more negative experiences than those who had. 

As isolation requirements are no longer in place for COVID-19, it will be important going forward to monitor return-to-work experiences for those with longer or more complex COVID-19 symptoms that may impact their ability to work.