gms | German Medical Science

Background: Researchers in work disability prevention (WDP) often fail to examine regulatory contexts in which their research takes place [1]). Policy-makers may draw on research from other jurisdictions without making the necessary adjustments for their own regulatory context.

Aim: This presentation is derived from a chapter in The Science and Politics of Work Disability Prevention addressing social, political and economic contexts driving state work disability reform in 13 countries [2].

Method: Using classic legal analysis of regulatory frameworks in Quebec and Ontario, we compare regulatory provisions governing rehabilitation in four compensation systems (work, motor vehicle accidents, crimes or domestic accidents). Results are linked to the literature on WDP [3].

Results/findings: Within Canada, provincial regulatory frameworks will differentially affect behaviour of workplace parties, health care providers and insurers. Employers will have incentives to reintegrate a worker if disability is caused by work, but not if it is caused by crime. Comparing workers' compensation regimes, the nature of these incentives is different depending on the province. Compensation regimes provide differential access to rehabilitation supports and incentives for return to work.

Discussion and conclusions: Cause of disability and geographic location will determine the nature and level of supports made available to the worker and the workplace in the return to work process. Studies compare administrative data between provinces as if the contexts were identical, yet behaviour of health care providers, compensation authorities, workers and employers are driven by different incentives in different provinces. We will conclude with a summary of key messages for policy makers and researchers in designing studies and policies aimed at WDP.