By Gage Koeller, MPH, CPH, Senior Research Analyst & Kerri Wizner, MPH, CPH, Head of Epidemiology
Full article here: Are Return-to-Work Durations Changing Over Time?
Publication date: Sept 2026
Return-to-work (RTW) durations are a measure of how long employees need to recover from an illness, injury, or medical procedure before returning to their jobs. However, these durations reflect much more than recovery time alone. They are shaped by a variety of factors, including healthcare access, job demands, workplace accommodations, socioeconomic factors, and broader policy reforms. This is why it is important to not only examine evidence-based guidelines set by clinicians but also to explore the influences on duration changes over time.
Recent years have seen a rise in the number of employees taking a leave of absence, with 57% of organizations reporting increased leave requests, especially for mental health conditions.1 However, an important question remains: Are leave times longer than they were in the past? To answer this, we examined average RTW durations for common conditions across 29 million claims in the MDGuidelines database over the past decade.
Although there were year-to-year differences in the 2014 to 2023 reporting period, RTW durations generally decreased over time despite an increased number of leave requests for both workers’ compensation and short-term disability claims. In this dataset, durations for low back pain and carpal tunnel syndrome decreased, whereas durations for herniated lumbar discs and torn knee cartilage were longer.
The period beginning in 2020 stands out. For several conditions, average durations increased during and immediately after the COVID-19 pandemic. Particularly, mental health conditions such as anxiety disorders and recurrent depression reflected longer durations during this time. These trends likely reflect pandemic-related disruptions, including reduced access to medical care, delayed care, increased stress, and more complex recovery environments. However, the COVID-19 pandemic also resulted in a shift toward flexible schedules and remote access work, which may have resulted in some employees experiencing a more effective transition back to work after an injury or illness.
There are many factors that play a role in how quickly an employee returns to work. Recovery time is not simply a result of access to best-practice care, but is also influenced by patient expectations, demographics, and sociopolitical stressors. Certain conditions, like herniated discs and knee tears, are more prevalent in an aging workforce, whereas mental health conditions like depression and anxiety are becoming more prevalent due to a reduced stigma in younger generations. Additional factors that enhance an employee’s ability to RTW quickly include adherence to evidence-based guidelines, improved treatments, readily available online medical information, and more effective medications and over-the-counter remedies.
Understanding the changing nature of RTW durations can be important for both employers and clinicians. The factors affecting recovery time are incredibly complex, but durations are overall getting shorter despite employers reporting an increased number of leaves. Using evidence-based guidelines, providing employee support programs, and regularly checking in with employees during their leave of absence is essential in helping them recover more quickly and RTW safely.
References
1. Agovino T. Employee leave requests rise for the third consecutive year. HR Brew, Inc. www.hr-brew.com/stories/2025/01/31/employee-leave-requests-rise-for-the-third-consecutive-year.
2. Coole C, Nouri F, Narayanasamy M, Baker P, Drummond A. Total hip and knee replacement and return to work: Clinicians’ perspectives. Disabil Rehabil. 2021;43(9): 1247–1254. doi.org/10.1080/09638288.2019.1654000.
3. Carpenter BD, Gatz M, Smyer MA. Mental health and aging in the 2020s. Am Psychol. 2022;77(4): 538–550. doi.org/10.1037/amp0000873.
