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Background: Many nations have administrative social insurance systems that provide financial support to workers during periods of disability or reduced capacity. These administrative systems provide a means to directly assess the burden of lost working time attributable to work-related musculoskeletal disorders (WRMSD) and other conditions. In Australia, workers’ compensation systems operated by state, territory, and federal governments provide insurance coverage for 94% of of the national labour force.

Objectives: To determine the national burden of working time lost to WRMSD in Australia within workers’ compensation schemes, and to to characterise the distribution of time lost by age, sex, occupation and industry.

Study design: Retrospective population-based study; analysis of National Dataset for Compensation-based Statistics (NDS) data.

Setting, participants: Granted workers’ compensation claims by people aged 15–100 years including payment of wage replacement benefits for time off work lodged in Australia, 1 July 2012–30 June 2017.

Main outcome measures: Working years lost (WYL) per annum (total number of years of wage replacement benefits paid to injured and ill workers), overall and by sex, age, and injury and disease type; WYL per 10 000 fulltime equivalent (FTE) years worked.

Results: A total of 755,330 eligible claims with complete data for analysis variables by people aged 15–100 years were identified, for compensable injuries and disease that led to 41,194 (95% confidence interval [CI], 41,020-41,368) WYL/year. The annual WYL number and rate were each higher for men (25,367 [95% CI, 25,230-25,503] WYL/year; 42.6 [95% CI, 42.1-43.1] WYL/10,000 FTE years) than for women (15,827 [95% CI, 15,720-15,935] WYL/year; 38.8 [95% CI, 38.2-39.4] WYL/10,000 FTE years). Workers aged 45-100 years made 66 742 claims per year (44.1% of all claims) but incurred 21 763 WYL/year (52.8% of all WYL).

Traumatic joint and muscle injuries led to 16,494 WYL/year (40.0% of all WYL) and musculoskeletal disorders to 8,547 WYL/year (20.7%), representing the largest two contributors to WYL nationally. These were followed by work-related mental health conditions at 5,361 WYL/year (13.0%), fractures at 4,276 WYL/year (10.4%), and wounds and lacerations at 3,449 WYL/year (8.4%).

Conclusions: Occupational injury and disease covered by workers’ compensation result in lost working time in Australia equivalent to more than 41,000 fulltime jobs. WRMSDs accounted for >60% of that burden. Distribution of the burden reflects the greater labour force participation of men, slower recovery of older workers, and the impact of common occupational injuries and diseases. Population-based monitoring of lost working time could support effective occupational health surveillance and allocation of resources for protecting the health of Australian workers.