IntroductionWorkers moving between states or provinces to find employment are reported to take longer to return to work after the injury.MethodsThe Alberta Workers Compensation Board (WCB) identified all workers from four Canadian Atlantic provinces who sustained a work injury in Alberta resulting in greater than 5 total temporary disability days (TTDDays) from January 2015 to June 2017. Each was matched on sex, age, and injury date with an Alberta claimant also with greater than 5 TTDDays. WCB information extracted included employment, injury, cost and place of treatment, and modified work. Cox regression identified factors associated with TTDDays. Semi‐structured interviews were also undertaken.ResultsTwo‐hundred forty pairs were identified and 60 interviews completed. Those from the Atlantic provinces had more TTDDays (median 63 days) than Alberta (median 22 days) with an unadjusted hazard ratio (HR) 0.50 (95% confidence interval [CI], 0.42‐0.61). When adjusted for all factors, the HR moved closer to unity (HR = 0.62; 95% CI, 0.50‐0.76). Total health care costs were the strongest predictor, with modified work, injury type, and claim status also explanatory factors. Among the Atlantic workers, leaving Alberta for treatment was strongly related to a lower likelihood of ending wage replacement (HR = 0.45; 95% CI, 0.32‐0.62). Participants in the interview study emphasized the importance of returning to the family after injury and the financial difficulties of maintaining a second home with reduced income after the injury.ConclusionThe higher costs of wage replacement associated with extended time off work may be inherent to the practice of employing out‐of‐province workers for jobs for which there is a shortage of local labor.

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Objectives To identify the factors that infl uence a family physician's assessment of causation for compensation purposes in suspected work-related injury or illness. Methods Four groups of family physicians with differing levels of prior reporting to the Workers' Compensation Board (zero, low, medium, and high) in Alberta, Canada, were sent four case scenarios and a series of questions related to these. For each scenario there were four different versions (SS, SW, WS, WW) with either strong or weak features suggesting work was an important cause or contributor, and either strong or weak features suggesting non-work causes or contributors. Responses to questions about causation were made on visual analogue scales. Results The nature of the condition and the scenario type (ie, the information about workplace and non-workplace factors) were both associated with the physicians' opinions on causation. The physicians' understanding of the nature of work. the timing of symptoms, and the patients' implied opinion about work relatedness all appeared important in reaching a decision that a condition was work related, while the presence of other potential causes outside work seemed important in reaching a decision that a condition was not work-related. Prior reporting history of the physician was not strongly associated with opinions on work-relatedness. Conclusions The characteristics of the scenario were more important in determining physicians' opinion about workrelatedness than the prior reporting characteristics of the physician, suggesting that it may be the case mix, rather than physician interest, that determines high or low rates of reporting.

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