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

Lieke Kools*, Pierre Koning

*Corresponding author for this work

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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.

Original languageEnglish
Pages (from-to)189-209
Number of pages21
JournalJournal of Health Economics
Early online date6 Apr 2019
Publication statusPublished - May 2019


The authors gratefully acknowledge the financial support from Instituut Gak for this research project. They also thank the referees to this paper, Bénédicte Rouland, Rob Euwals and Bertjan Teunissen for detailed comments and suggestions on earlier versions of the paper, as well as seminar participants that gave feedback at the EALE conference in St. Gallen in 2017 and the research seminars at CPB Netherlands Bureau for Economic Policy Analysis, the University of Antwerp and RWI in Essen.

FundersFunder number
Instituut Gak


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


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