Impact of Workers' Compensation Benefits on Health-Related Quality of Life for Working Adults: A Burn Model System Investigation.

Abstract

Workers' compensation (WC) includes wage replacement, medical cost coverage, and vocational rehabilitation services. We aimed to examine the impact of WC on health-related quality of life (HRQOL) scores among working adults with burn injury. The Burn Model System National Database was queried for self-reported working adult participants who answered the Veterans RAND 12-Item Health Survey (VR-12) at discharge (pre-injury recall) and 6-, 12-, and 24-months post-injury. Participants were stratified into those with and without WC. HRQOL scores were calculated by transforming VR-12 responses to Short Form-6D (SF-12). Mixed-effects linear regression modeling was used to assess impact of WC on HRQOL scores over 2-years post-injury. 495 participants were analyzed (94 with WC, 401 without WC). Males accounted for 87% of WC beneficiaries and 72% of those without WC. Mean pre-injury HRQOL scores were 0.72 for WC beneficiaries and 0.73 for those without WC (p=.99) and decreased significantly in both groups at each study timepoint post-injury. Greater HRQOL loss was seen in WC beneficiaries compared to those without WC at 6-months (p=.07), 12-months (p=.02), and 24-months (p=.03) post-injury. All workers experienced a drop in HRQOL scores post-injury. WC beneficiaries experienced greater HRQOL loss than non-WC participants. These findings align with investigations among working adults with non-burn upper extremity and back injuries, suggesting there is opportunity to improve the delivery of WC benefits for all injured workers. To enhance vocational rehabilitation service delivery, the intensity of interventions should be tailored to person-specific needs, risks of complicated return-to-work, and unique recovery journeys.