Are the Predictors of Work Absence Following a Work-Related Injury Similar for Musculoskeletal and Mental Health Claims?

Understanding what determines the length of absence from work for someone with a work-related injury has evolved over the last two decades, moving from a bio-medical model, to models that incorporates individual, workplace, health care provider and system level influences. However, much of what we know about return-to-work has been generated from studies focused on musculoskeletal conditions. A recent publication from the Monash Centre for Occupational and Environmental Health (MonCOEH) led by Associate Professor Peter Smith examined if the predictors of absence from work were the same for mental health injuries compared to musculoskeletal injuries. Workplaces and compensation authorities are increasingly interested in work-related mental health injuries as the proportion of these claims has increased from 7.4 % of all claims in 2000/2001 to 9.1 % of claims in 2008/2009.To do this the research group used data from the Compensation Research Database, which is housed by the Institute for Safety, Compensation and Recovery Research (ISCRR), a joint collaboration between WorkSafe Victoria, the Transport Accident Commission and Monash University.

The researchers found important differences in the relationship between occupation and workplace-level variables on days of wage replacement for mental health and musculoskeletal injuries. For example, employment in the agriculture, forestry, fishing and mining industries and employment in small organisations were more strongly associated with the number days of wage replacement among MSK compared to mental health claims. Conversely, employment in the public administration and safety, or education and training industries, and being employed in an occupation with higher time pressure was associated with greater days of wage-replacement among mental health compared to MSK claims. These findings highlight that the predictors of duration of absence at the occupation and workplace variables differ for injury types and are suggestive of the need for occupation and industry specific secondary prevention strategies to identify workers who might be more likely to have extended absences from work following injury.