P-591 the Impact of Legislative Amendments on Return to Work. Experiences of a Large Belgian Occupational Health Service

Abstract Introduction In Belgium, 500.000 employees are on long-term sick leave. Legislation recently changed to increase the employment rate. Adapted work must be proposed for all Return To Work (RTW) trajectories without medical contraindications. For the Determination of final incapacity (DFI) a new procedure is introduced. Objectives Comparison of RTW trajectories carried out by a large Occupational Health Service in 2022 (Q1) to those in 2023 (Q1). Methods 815 RTW Trajectories of 2022 (37.5% for mental disorders, 29.7% for musculoskeletal problems) and 143 Trajectories of 2023 (37.5% mental, 29.7% musculoskeletal problems), were analyzed descriptively. Results of 397 DFI trajectories were also analyzed – 28.7% for mental, 28.5% for musculoskeletal problems. Results and discussion In 2022 (Q1), the occupational physician allows RTW after job adjustments for 30.3% of the employees. Re-integration was more successful for musculoskeletal disorders (36% allowed adapted work) compared to mental problems (23.2%) (p=0.001). In 2023 (Q1), after the new legislation, adapted work was possible for 59.4% (65.5% when musculoskeletal problems versus 53.7% when mental reasons) (p=NS). In DFI trajectories, 87.6% was definitively unfit for the job (87.7% when mental and 88.4% when musculoskeletal problems) – 6.5% of the employees asked for adapted work (2.6% when a mental disorder and 8.8% when musculoskeletal problems) (p=0.05). Conclusion The adjustments in the RTW legislation caused a significant decrease in RTW trajectories. There is a higher demand for adapted work in case of musculoskeletal problems versus mental problems. Early guidance to re-employment into a more suitable job is necessary to increase the employment rate in Belgium.