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paradoxical adverse associations with OPA and CVD should be investigated further. This study investigates if gradual return to work (GRTW) is associated with full sustainable return to work (RTW) for seriously injured workers with a musculoskeletal disorder (MSD), in British Columbia, Canada. This is an effectiveness study using a retrospective cohort study design. Accepted workers' compensation lost-time claims were extracted for workers with an MSD who were on full work disability for at least 30 days, between 2010 and 2015 (n=37 356).