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Abstract

Work-related chronic pain injuries in British Columbia, Canada, have been on the rise, with a 48% increase in accepted workers’ compensation claims from 2017 to 2022. Similarly, psychological health claims have also risen, with a 51% increase in the number of claims submitted from 2019 to 2023. This growth is expected to continue in the coming years due to changes in workplace dynamics and an aging population. Previous research has shown that these injury types have a bidirectional relationship whereby having one increases an individual’s susceptibility to having the other. This study aims to investigate differences in time to return-to-work (RTW) among psychological, chronic pain, and psychological with chronic pain injuries and to identify the most influential factors affecting the likelihood of RTW for each injury type. Workers’ compensation claims data were used in this study to identify workers (n=414,507) with an accepted time-loss claim due to work-related psychological, chronic pain, psychological with chronic pain, or other injury types occurring between 2012 and 2019, with up to 3 years of follow-up. Descriptive statistics were used to analyze differences in time to RTW. Multivariable logistic regression was used to assess the role of workplace/organizational, socio-demographic, and injury-specific characteristics in determining the likelihood of RTW for each injury type. Results indicate substantial differences in days to RTW events after injury, with psychological with chronic pain injuries having the longest RTW durations (median=1095 days [Interquartile Range (IQR):1095 – 1095 days]), followed by chronic pain (median=1095 days [IQR:327 – 1095 days]) and psychological (median=399 days [IQR:67 – 1095 days]). All other injuries had a median RTW duration of 21 days [IQR:7 – 83 days]. Characteristics such as younger age, larger firm size, and having modified RTW increased the likelihood of RTW across injury types, while other variables had varying injury-specific effects. These findings suggest the need to modify current RTW programs to include better mental health and chronic pain management systems. Additionally, workers with concurrent psychological and chronic pain injuries warrant further investigation into how they can be further supported to promote earlier RTW outcomes, as over 75% of the cohort did not RTW within three years.