Comparing disability and return to work outcomes between alternative and traditional workers' compensation programs

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Background: The Union Construction Workers' Compensation Program (UCWCP) was developed in 1996 as an alternative workers' compensation arrangement. The program includes use of a preapproved medical and rehabilitation network and alternative dispute resolution (ADR), and prioritizes a quick and safe return-to-work. The aim of this study is to determine if differences in recovery-related outcomes exist between UCWCP and the statutory workers' compensation system (SWCS). Methods: Claims data from 2003 to 2016 were classified as processed through UCWCP or SWCS. Outcomes included: temporary total disability (TTD), vocational rehabilitation (VR), claim duration and costs, and permanent partial disability (PPD). The relative risk of incurring TTD, VR, and PPD in UCWCP vs SWCS was calculated using log-binomial regression. Linear regression examined the relationship between programs and continuous outcomes including costs and duration. Estimates were adjusted for age, sex, wage, and severity. Results: The UCWCP processed 15.8% of claims; higher percentages of UCWCP claimants were older and earned higher wages. Results point to positive findings of decreased TTD incidence and cost, lower risk of TTD extending over time, higher likelihood of VR participation, and less attorney involvement and stipulation agreements associated with UCWCP membership. Differences were more apparent in workers who suffered permanent physical impairment. Conclusion: Findings suggest that the defining programmatic elements of the UCWCP, including its medical provider and rehabilitation network and access to ADR, have been successful in their aims. Claims with increased severity exhibited more pronounced differences vs SWCS, potentially due, in part, to greater use of programmatic elements.

Original languageEnglish (US)
Pages (from-to)755-765
Number of pages11
JournalAmerican Journal of Industrial Medicine
Issue number9
StatePublished - Sep 2019

Bibliographical note

Funding Information:
The authors appreciate the support of the Union Construction Workers' Compensation Program in providing access to program data and the Minnesota Department of Labor & Industry and Brian Zaidman, Senior Research Analyst. Institution at which the work was performed: University of Minnesota Duluth. Grant sponsor: Pilot Project Grant through the Midwest Center for Occupational Health and Safety (MCOHS) Education and Research Center, University of Minnesota, NIOSH; Grant number: T42OH008434.

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Comparative Study


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