RF-326 Does participation in modified return to work differ for immigrant compared to Canadian-born workers in British Columbia, Canada?

Introduction The longer workers are off work, the less likely they are to successfully return to work. Modified return-to-work (MRTW) provides earlier work reintegration after an injury with the goal of full recovery and shorter work disability durations. Objective This study examined differences in MRTW participation for immigrant compared to Canadian-born workers with a work-related injury in British Columbia. Methods Workers’ compensation claims data linked with immigration records were used to identify immigrant (economic, family or refugees/other classifications) and Canadian-born workers with an accepted short-term disability claim between 2009–2015 for acute (fracture and concussion) and chronic injuries (back strain and connective tissue). Injury cohorts were restricted to 30 days on claim for a common disability window to measure MRTW participation. The outcome of MRTW was measured as never offered MRTW or an offer of MRTW within the first 30 days on benefits. Individuals with an offer beyond 30 days were excluded. Results In adjusted logistic regression models, immigrant classification was associated with a decreased odds ratio (OR) of receiving an offer of MRTW within 30 days across injury cohorts. For example, for workers with back strain injuries: OR=0.97 [95%CI 0.88, 1.07] for economic immigrants, OR=0.72 [95%CI 0.66, 0.79] for family class immigrants, and OR=0.74 [95% CI 0.64, 0.86] for refugee/other classifications. Similarly, for workers with a fracture injury: OR=0.94 [95%CI 0.72, 1.22] for economic immigrants, OR=0.84 [95%CI 0.64, 1.11] for family class immigrants, and OR=0.42 [95%CI 0.24, 0.76] for refugee/other classifications. Conclusion Understanding why immigrant workers are less likely to be offered MRTW compared to Canadian-born workers for the same injuries is worthy of further investigation, and in particular for workers who arrived to Canada as refugees. A focus on increasing earlier provision of MRTW for longer term claims has the potential to reduce work disability duration among immigrant workers.