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J Health Econ. 2019 May;65:189-209. doi: 10.1016/j.jhealeco.2019.03.009. Epub 2019 Apr 6.

Graded return-to-work as a stepping stone to full work resumption.

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Universiteit Leiden, P.O. Box 9500, 2300 RA Leiden, The Netherlands; Netspar, The Netherlands. Electronic address:
Universiteit Leiden, P.O. Box 9500, 2300 RA Leiden, The Netherlands; Vrije Universiteit Amsterdam, The Netherlands; Tinbergen Institute, The Netherlands; IZA Germany. Electronic address:


While there is increasing evidence that graded return-to-work is an effective tool for the rehabilitation of sick-listed workers, little is known on the optimal timing and level of grading in return-to-work trajectories. We use administrative data from a Dutch private workplace reintegration provider to fill this gap. In order to correct for the selection bias inherent to the evaluation of activation strategies, we exploit the discretionary room of the case managers in setting up treatment plans. We find that graded return-to-work has the potential to speed up the recovery process, but does not necessarily help rehabilitate workers who would otherwise have not rehabilitated. Work resumption can be achieved faster when graded return-to-work is started earlier and may permanently increase when started at a higher rate of work resumption. These findings however do not hold for individuals who have problems related to mental health.


Activation; Graded return-to-work; Long-term sickness absence

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