Introduction The construction industry experiences severe injuries. When an employee is injured, the goal is to minimise long-term disability and efficiently return the employee to work. The Union Construction Workers Compensation Program (UCWCP) of Minnesota provides an alternative, collectively-bargained system administered by workers’ compensation insurance providers. The program includes exclusive provider network for medical care and access to alternative dispute resolution process. The goal of this study is to determine injury outcome differences for UCWCP members.

Methods Workers’ compensation claims were examined over a ten year period. UCWCP membership and date of enrollment were determined. Claims were stratified by medical or lost-time status. Multiple measures of severity and outcome were examined, including claim rate and duration, time to return-to-work, and permanent partial disability status. We calculated rates and comparative risk based on UCWCP. A logistic model will estimate rate ratios (RR) and 95% confidence intervals (CI) as a function of claim rate. Time-to-event models will assess differences in duration of disability based on UCWCP. Proportional hazards regression estimated hazard ratios (HR) and 95% CI.

Results UCWCP employers had a lower rate of lost-time claims. Compared to non-UCWCP employers, UCWCP-membership was associated with a 9% increased likelihood of claim closure for both medical and lost-time claims (HR=1.09, CI=1.05–1.13; HR=1.09, CI=1.02–1.17). Most differences occurred in the first 90 days. Return-to-work likelihood and reduced permanent disability appeared to be related to UCWCP.

Conclusions Alternative workers’ compensation arrangements may include elements that collectively protect workers’ interests, reduce injury severity, and are cost-effective for insurers.