Disability and return to work outcomes after traumatic brain injury: Results from the Washington State Industrial Insurance Fund

Introduction. This article contains a description of community traumatic brain injury (TBI) treatment patterns and outcomes based solely on workers' compensation administrative records for Washington State. Methods. Administrative records available from the Washington State Department of Labor and Industries data warehouse of administrative records are used to describe medical rehabilitation services and return to work (RTW) referrals for cases of TBI between 1 January 1998 and 31 December 2002. These data represent official records for disability determination and referral for vocational rehabilitation (VR) services. Results. At total of 797 cases were identified all of which had identifiable treatment trajectories. No disability was the outcome in 9.0% of cases; temporary disability in 53.5% of cases, permanent disability in 31.1% of cases. Only 48% of surviving cases include a medical rehabilitation phase. This phase included only inpatient services in 26.5% of referred cases, only ambulatory services in 59.6% and both inpatient and ambulatory services in 13.9%. Only about half of surviving cases were referred for RTW services. Employment rates were similar to those published from other state rehabilitation programs. Conclusions. State/community treatment and disability outcome patterns are more diverse than the expected sequence of acute treatment, medical rehabilitation and VR. Employment rates after referral for VR were 65%.