Who Returns to Work and Why?: A Six Country Study on Work Incapacity and Reintegration, Vol. 5 Book

	Foreword	xvii
	Preface	xix
	Note to Readers	xxv
1.	Work Incapacity and Reintegration: History and Aim of the WIR Project	1
	Background and Central Research Goals	1
	Participating Countries and Institutions	2
	Common Core Research Design	3
	Interventions, Incentives, and Disincentives	4
	Measurement of Outcomes	5
	Organization of the Project	5
	Implementation of the Project	5
	Presentation of Data and Results	6
	References	8
2.	Social Security, Work Incapacity, and Reintegration	9
	Background of the Problem	9
	Labor Market Considerations	9
	The Health Perspective	10
	Social Security Concerns	11
	Sickness and Disability Benefit Schemes: Similarities and Differences	12
	Eligibility	16
	Payment Levels and Replacement Rates	16
	Administration and Determination of Eligibility	17
	Rehabilitation Services	18
	Job Protection	20
	Selected Incentives and Disincentives: A Comparative Overview	21
	Placing the Project's Research Questions in Context	23
	Notes	25
	References	25
3.	Work Incapacity and Reintegration: A Literature Review	27
	Introduction	27
	Clinical Studies	28
	Return to Work in Chronic Low-back Pain Patients	29
	Effects of Interventions	31
	Economic Studies	33
	Economic Incentives and Return to Work	33
	Effects of Vocational Rehabilitation	36
	Public Policy Studies	37
	The Importance of Benefit Schemes	38
	Sociological Studies	42
	The Micro Approach	42
	The Macro Approach	43
	A Theoretical Model of Work Incapacity and Work Resumption	47
	Summary and Conclusions	49
Appendix 3.1	Selected Literature from the Review	51
4.	Research Design and Methodology	55
	Background and Aim of Research Design	55
	Operationalizing the Research Design	57
	Inclusion Criteria and Cohort Creation	57
	Cohort Characteristics, Interventions, and Outcomes	58
	Observation Period and Measurement Points	60
	Standardized Measurements	60
	The National Cohorts	61
	Non Response at T1	61
	Cohort Sizes	61
	Data Collection Methods	61
	Data Analysis Methods	63
	International Database	63
5.	Cohorts Compared: Cross-national Similarities and Differences	65
	Introduction	65
	Demographic Characteristics	66
	Work Characteristics	70
	Subjective Health Status	71
	Subjective Work Prognosis	73
	Non-response Analysis	74
	Comparison with Working Population	75
	Comparability of Cohorts	77
	Summary and Conclusions	84
	Reference	84
6.	Work Status and Benefit Status	85
	Work Status and Benefit Status after One and Two Years	86
	Work Status	86
	Benefit Status	88
	Work Status at T3 and Demographic, Health, and Work Characteristics	91
	Conclusions	95
7.	The Role of Medical Interventions	99
	Introduction	99
	National Health Care Systems and the Back Patient	101
	Denmark	101
	Germany	102
	Israel	102
	The Netherlands	102
	Sweden	102
	The United States	103
	Medical Interventions and their Providers	103
	Caregivers	103
	Imaging Techniques	104
	Hospitalization, Surgery, and Bed Rest	105
	Treatments	106
	Medication and Injections	107
	Braces and Supports	107
	Back-related Health within the National Cohorts	108
	Medical Interventions	111
	Consultation with Physician	111
	Consultation with a Physiotherapist or Other Caregivers	113
	Imaging the Lumbar Spine	115
	Treatments	117
	Health Indicators and Return to Work	124
	Back Function	124
	General Health	125
	Social Functioning	125
	Vitality	126
	Mental Health	128
	Pain Intensity	129
	Summary and Conclusions	131
	Note	132
	References	132
8.	Vocational and Other Non-medical Interventions	135
	Scope and Provision of Interventions	136
	Repertoire of Vocational and Other Non-medical Interventions	136
	Actors, Timing and Procedures in the Work Incapacity Process	137
	Conclusions	143
	Training and Education	143
	Training and Education Measures	144
	When Training and Education Started	145
	Relationship to Work Resumption	145
	Work Accommodations and Employer Motivators	147
	Work Accommodations	148
	When Work Accommodations were Applied	150
	Transportation to Workplace and Sheltered Workshops	151
	Employer Motivators: Wage Subsidy and Exemption of Wage Payment	151
	Combinations of Training, Education, and Work Accommodations	152
	Relationship to Work	154
	Employee Motivators: Disciplinary Actions and Labor Relationships	155
	Warning of Dismissal and Dismissal	155
	Contacts With Colleagues/Employer	157
	Relationship to Work Resumption	158
	Work Incapacity Assessment, Benefit Withdrawal, and Rehabilitation	159
	Medical Examinations for Sickness Benefit Eligibility	159
	Threat and Actual Withdrawal of Sickness Benefit	160
	Rehabilitation Inquiry and Plan	161
	Test of Vocational Capacity	162
	Assessment of Eligibility for Disability Benefit	163
	Capitalization of Benefit	165
	Relationship to Work Resumption	165
	Job Services and Other Services	166
	Job Counseling	167
	Job Search	167
	Job Offer	168
	Job Club	169
	Change in Day Care Arrangements for Children	170
	Counseling	170
	Reduction of Waiting Periods for Health Care	171
	Relationship to Work Resumption	172
	Summary and Conclusions	173
	Rehabilitation Inquiry and Plan	173
	Education and Training	173
	Work Accommodations	174
	Threat and Actual Loss of Work, and Job Services	174
	Return to Former Work	175
	Disability Benefit	175
	Relevance of Policy Context and Timing of Interventions	177
	Reference	178
Appendix 8.1	Vocational and Other Non-medical Interventions in the Six Cohorts	179
Appendix 8.2	Summary of Work Incapacity Procedures	186
9.	A Closer Look at Work Resumption	193
	Characteristics of Work Resumption	193
	Type of Employer	194
	Occupation	195
	Changes in Hours Worked, Wages, and Occupation	198
	Work Resumption and Vocational and Other Non-medical Interventions	199
	Work Resumption and Medical Interventions	201
	Type of Medical Provider	201
	Medical Treatments	203
	Work Resumption Patterns	204
	"Continuous" Versus "Late Resumers"	204
	"Continuous Resumers" Versus "Relapse"	206
	Late Resumers" Versus "Non-resumers"	206
	Work Resumption and Selected Baseline Characteristics	209
	Reasons Reported for Not Working	211
	Summary and Conclusions	211
	Employer and Occupation	211
	Vocational and Other Non-medical Interventions	212
	Reasons for Non-resumption	212
	Medical Providers and Treatments	212
	Patterns of Work Resumption	213
	Indications of Successful Interventions	213
	Technical Note	214
Appendix 9.1	Additional Data on Work Resumption Patterns	215
10.	Work Resumption and the Role of Interventions
	Introduction	223
	Work Capacity	225
	Overview of the Model and Strategy for Analysis	228
	Medical Interventions and Health in the First Year	229
	Baseline Characteristics, Vocational and Other Non-medical Interventions, and Work Status in the First Year	234
	Baseline Characteristics	235
	Vocational and Other Non-medical Interventions	239
	Baseline Characteristics, Vocational and Other Non-medical Interventions, and Work Status in the Second Year	240
	Work Status at T2	243
	Baseline Characteristics	244
	Vocational and Other Non-medical Interventions	245
	The Cohorts Compared	247
	Conclusions: Major Determinants of Work Resumption	250
	Personal and Work Characteristics ("Baseline Characteristics")	251
	Medical Interventions	252
	Vocational and Other Non-medical Interventions	253
	Interventions, Incentives, and Disincentives	253
	Notes	255
	References	256
	Description of the Statistical Analysis Used	257
Appendix 10.1	Full Results of Statistical Analysis	258
11.	Factors Influencing Work Resumption: A Summary of Major Findings	273
	Aim and Background of the Study	273
	Ambitions and Restrictions	274
	Striking Differences in Work Resumption Rates and Patterns	275
	The Role of Demographic, Health and Vocational Factors	276
	Health Condition, Medical Treatments and Work Resumption	277
	Vocational and Other Non-medical Interventions	279
	Resumers, Non-resumers and Benefit Receipt	280
	Health Condition, Interventions and Work Resumption Reconsidered	281
	Additional Conclusions from National Studies	282
	Denmark	282
	Germany	283
	Israel	283
	The Netherlands	283
	Sweden	284
	United States	284
	Outlook for Future Research	284
	References	285
Addendum A	Overview of Variables	287
Addendum B	List of Project Publications	296
	Contributors	305