Factors affecting return to work following musculoskeletal injuries in income disability insurance claimants

Abstract

Introduction: Absenteeism related to disability is a financial burden on society and insurance companies. Many of the factors affecting return to work have not been explored sufficiently in South Africa. Therefore, the aim of this study was to describe the prevalence of musculoskeletal injuries, and the factors that predicted a return to work in insurance claimants. Methods: A retrospective chart audit of one of the largest insurance companies in the Republic of South Africa was performed. Claims that were paid between 01 January 2011 and 31 December 2014 were analysed. Factors associated with return to work was analysed using a multivariate Cox proportional hazard regression model. Results: The most common musculoskeletal claims were for conditions and injuries of the lumbar region (29.0%). Waiting periods of one and three months (HR 0.46; 95% CI 0.32 - 0.66 and HR 0.12; 95% CI 0.05 - 0.24; p<0.01) respectively and lower education (HR 0.64; 95% CI 0.45 - 0.91; p=0.01) were associated with a delayed return to work and monthly income of R5 000 to R10 000 (HR 3.26; 95% CI 2.00 - 5.32; p<0.01) was associated with a faster return to work. Conclusion: In conclusion, lumbar injuries were prevalent in this group of claimants and this research showed that policies with longer waiting periods, and lower education level cause relatively longer delays in return to work. Therefore, insurance companies should intervene sooner in at risk individuals. Further research is required to explore how return to work is affected by insurance and claims handling procedures.