Self-rated work ability predicts return to work after occupational rehabilitation

Work ability assessments are important for planning, targeting, and executing occupational rehabilitation programs. The aim of the study was to examine whether a one-item self-rated Work Ability Score (WAS), assessed before and after rehabilitation, predicts return to work 12 months after occupational rehabilitation.

Data from four institutions in the Norwegian registry for occupational rehabilitation were used. This cohort study included participants with a history of sick leave and complex musculoskeletal and mental health-related challenges who had participated in an occupational rehabilitation program, with a 12-month follow-up period. WAS was self-reported on a scale from 0 to 10 at the start and end of rehabilitation and linked to registry data on health-related social income benefits, as well as self-reported sociodemographic variables. Logistic regression analyses were conducted with "full return to work" (full RTW), defined as receiving no health-related social security benefits for 1 month) at 12 months follow-up as an outcome.

Higher WAS values were positively associated with full RTW. The odds ratio for a one-point increase in WAS at the start of rehabilitation was 1.57 [95% confidence interval (CI): 1.41-1.75], and it was 1.47 (95% CI: 1.33-1.63) for a one-point increase in improvement of WAS from start to end of rehabilitation when controlling for age, sex, education, occupational status and benefits received before rehabilitation.

Even a one-point increase in WAS significantly improved the odds of future work participation. Designing rehabilitation programs to target the workability of participants may initiate a process that leads to work participation.