Stay-at-Work/Return-to-Work Policy Collaborative-S@W/R2W


SAW/RTW Policy Papers and Tools

The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) established the Stay-at-Work/Return-to-Work (SAW/RTW) Policy Collaborative to support the development of policies, programs, and practices that encourage continued employment of workers likely to leave the workforce due to injury, serious illness, or disability. The ODEP SAW/RTW Policy Collaborative includes a SAW/RTW Community of Practice, webinars and online discussions, and expert-led Policy Working Groups (PWGs). This year the SAW/RTW Policy Collaborative included three PWGs:

Replicating and Adapting the Washington State COHE Model
Musculoskeletal Conditions and
Pain Management
Transition Back to Work

Washington’s Centers of Occupational Health and Education (COHE) is a community-based occupational healthcare program for injured workers in the state’s workers’ compensation program which has proven effective across a range of outcomes. The PWG considered core elements of COHE and other coordination of care programs, as well as issues in adapting, adopting, and replicating COHE in states across the country.

This PWG considered various methods of addressing musculoskeletal (MSK) conditions and managing pain, use of opioids and other medications in pain management, and policies to help workers with MSK conditions to remain at work or return to work in a safe and timely manner.

This PWG discussed strategies to promote the transition back to work for injured workers or workers affected by the onset of a health condition. Policy recommendations addressed by the group include partial disability income support, partial RTW, and employer incentives and subsidies.

SAW/RTW Policy Action Papers

These PWGs produced three policy action papers that describe their work and present policy recommendations: 1) Improving Occupational Healthcare Delivery to Support Workers’ Compensation Return to Work: Building on Evidence-Based Practice from Washington’s Centers of Occupational Health and Education (COHE) Experience; 2) Improving Pain Management and Support for Workers with Musculoskeletal Disorders: Policies to Prevent Work Disability and Job Loss; and 3) Transition Back to Work: Policies to Support Return to Work after Illness or Injury.

The PWGs and the SAW/RTW Policy Collaborative Community of Practice developed additional products that discuss ideas and address SAW and RTW issues, and are designed to support key stakeholders’ efforts to make and implement policy changes, including:

Centers of Occupational Health and Education Policy Brief

Designed for healthcare providers, state and federal policymakers, insurers, and employers, this document provides a concise introduction to and summary of the key issues in the COHE PWG’s policy action paper and summarizes recommendations for states to implement or adapt the model.
Available at /sites/default/files/files/COHE%20Policy%20Brief.pdf.

Guide to Conducting State Pilot Programs to Improve SAW/RTW Outcomes in Occupational Health

This product offers states a coordinated set of materials they can use to launch a pilot project for a COHE-type model of occupational healthcare delivery that will improve workers’ compensation RTW outcomes. It is based on the pilot projects that led to the launch of COHE in Washington State, as well as on current efforts in Colorado.
Available at /sites/default/files/files/Product%20_2%20Pilot%20-FINAL_Pages1-3-COMPLIANT%20pages%204-24%20not%20yet.pdf

Preventing Work Disability after Musculoskeletal Injuries: Underlying Issues Surrounding Policies and Guidance

This document includes an infographic and explanation of the many mechanisms by which an MSK condition might lead to permanent work disability or job loss. Intended for state and federal policymakers, insurers, and employers, the document shows how a seemingly simple MSK condition such as low back pain may lead to job loss and work disability and highlights the importance of psychological, social, lifestyle, and workplace factors influencing RTW.
Available at /sites/default/files/files/Product%203%20How%20MSK%20Conditions%20Lead%20to%20Disability.pdf.

How to Mitigate Risk Factors for Long-Term Musculoskeletal Work Disability

This document includes an infographic and explanation of key nonmedical issues for workers who develop MSK pain that can lead to a poor outcome unless addressed in a timely and appropriate manner. It presents ways that frontline professionals including healthcare providers, insurers, and employers can help address the work-related challenges that workers with MSK conditions may face and ways to support workers in returning to work.
Available at /sites/default/files/files/Product%204%20-%20How%20to%20Mitigate%20Risk%20Factors.pdf.

Can Work Disability Be Prevented after Musculoskeletal Injuries? Three Successful, Cost-effective Pilot Intervention Programs

Designed for state and federal policymakers, this resource presents three clinical trials—in the United States, the United Kingdom, and Australia—of screening and intervention to keep MSK disorders from leading to work disability. The document highlights the rationale behind each intervention strategy, how each study was implemented, the policy factors that led to study design and funding, and key findings.
Available at /sites/default/files/files/Product%205%20DisabilityPreventionCaseStudies.pdf.

Musculoskeletal Disorders and Pain Management Resource Compendium

A companion volume to the MSK Conditions and Pain Management PWG’s policy action paper, this document provides interested stakeholders with detailed information about policies, interventions, and evidence of effectiveness in improving pain management and support for workers with MSK disorders. The compendium features an annotated collection of articles, documents, and online resources. Available at /sites/default/files/files/MSK%20Pain%20Policy%20Paper%20Vol%202.pdf.

What States Can Do to Engage Employers in SAW/RTW Programs

This guide presents strategies and materials that states can use to educate businesses about the value of RTW programs and to promote their adoption by employers. It includes information on the key components of an RTW program that an employer might implement, as well as best practices for employers across sectors.
Available at /sites/default/files/files/Product%20_7%20Guide%20to%20engaging%20employers%20final.pdf

For materials developed by the ODEP SAW/RTW Policy Collaborative in previous years, go to



The U.S. Department of Labor's Office of Disability Employment Policy (ODEP) established the SAW/RTW Policy Collaborative to support the development of policies, programs, and practices that encourage the continued employment of workers likely to leave the workforce due to injury, serious illness, or disability. Through the SAW/RTW Community of Practice (CoP), the expert-led virtual Policy Work Groups (PWGs), online platforms that include ePolicyWorks, ODEP resource centers, and other related resources, the SAW/RTW Policy Collaborative shares informational materials and other resources among a large and varied group of stakeholders, and produces recommendations for retention and re-employment programs and policies that promote not only the workforce participation, but also the workforce attachment of individuals with disabilities.

In its fourth year, the SAW/RTW Policy Collaborative is taking the work of the SAW/RTW Collaborative to the next step by convening experts and identifying and developing policy products to help states and other key stakeholders take action in several key policy focus areas. Building on previous years’ work, the PWGs are addressing important issues in improving stay at work and return to work outcomes for individuals experiencing disabilities resulting in work limitations. Through a collaborative effort with the State Exchange Employment and Disability (SEED) initiative, working with the National Council of State Legislators (NCSL), the Council of State Governments (CSG), and the National Governors Association (NGA), as well as through collaboration with other federal agencies, ODEP has identified policy areas for us to focus on this year, including:

  • Best practices for working with injured workers to coordinate care and return to work,
  • State-of-the art methods of addressing musculoskeletal injuries and pain management (particularly in relation to the use of opioids), and
  • Strategies to promote the transition back to work such as partial disability, partial return-to-work, and employer subsidies.