Factors Influencing Return to Work for Injured Workers: Lessons from Pennsylvania and Wisconsin

Identifying the features of workers’ compensation systems that promote timely, safe, and sustainable return to work and those that create barriers to return to work can lead to win-win opportunities for both injured workers and employers. Using a case study approach and semi-structured interviews with more than 75 experts in the Pennsylvania and Wisconsin workers’ compensation systems, including employers, insurers, labor representatives, attorneys, medical providers, vocational rehabilitation counselors, and state government officials, this analysis addresses the following questions:

• Which workers' compensation system features facilitate return to work for longer-term unemployed injured workers? Which serve as barriers to return to work for these workers?

• Which workers' compensation system features facilitate return to work for longer-term unemployed injured workers?

• How has the recent economic downturn magnified or diminished the impact these system features have on return to work for these workers?

• What are the policy implications of these system features on return to work for longer-term unemployed injured workers affected by the recent economic downturn? 

For this study, we focused our state expert interviews on the return-to-work process for injured workers who have been out of work for three months or more—whom we define as longer-term unemployed injured workers. Most of the system experts interviewed for this study indicated that, in their experience, the vast majority of injured workers are highly motivated to return to work after an injury and experience little difficulty in returning to work. However, longer-term unemployed injured workers face particular challenges in returning to work—challenges that are even greater in the context of the economic downturn.  

Sample of Major Findings:  

While recognizing that employers and injured workers play a central role in the return-to-work process, the study identifies the features of the Pennsylvania and Wisconsin workers’ compensation systems that promote timely, safe, and sustainable return to work as well as those that create barriers.

• Wisconsin's clear standards and processes for terminating TD benefits—when effectively communicated by employers and insurers and well-understood by injured workers and their medical providers—establish early, upstream expectations about benefit termination. These expectations prompt workers to focus on their recovery and return to work rather than on benefit continuation. In Pennsylvania, however, unilateral termination is generally not permitted; instead, there is an “agreement” approach, which is intended to ensure due process. While such an approach creates strong financial incentives for employers to return injured workers to work, it also may delay return to work for some workers if a dispute arises, because workers do not typically return to work during the litigation process.

• Statutory standards and processes for TD benefit termination can encourage employers to offer injured workers safe and suitable light, modified, or transitional duty work during the healing period. If injured workers accept such offers, it may minimize their detachment from the workforce and reduce the likelihood of a longer-term absence from work—also reducing indemnity benefit costs for employers. 

• Medical providers play a key role in facilitating return to work. Public policy decisions regarding the delivery of workers’ compensation medical care can also directly or indirectly impact indemnity benefits by influencing the return-to-work process.

• Public policy decisions about the transition from TD to PPD benefits represent key opportunities to impact return to work for longer-term unemployed injured workers. Workers with permanent restrictions are especially vulnerable to difficulties and delays in return to work. The difficulties these workers face are magnified further in the economic downturn and put a public policy spotlight on how workers’ compensation systems address workers who are unable to return to work with the pre-injury employer – particularly in the areas of lump sum settlement practices and the availability of vocational rehabilitation and retraining benefits.