This article uses data f r o m The Survey of Ontario Workers With Permanent Impairments, the Hwld's largest nirvt'y of injured workers, to show that. as currently used, return-to-work is a misleading ineasiire cf the effectiveness of health cure. The article discusses examples o f two serious lintitutions on the use of return-to-wqork to measure the outcomes cf health care, where heiilth care rcfers to all the medical and rehabilitative services provided to a nwrker ,following a workplace injuy. The ,first limitation is that return-to-work, like muny other outcomes of health cure, is injlueitced by ,factors that are not directlv related to health care. Using LI loxi1 model to estimate the determinants qffirst obsence.sf,-om work a f k r uii injuiy, we find that .sni,ioec.onomic characteristics, economic incentives, and job charclcteristics have a significant injluence on return-to-nvork. The second limitation on return-to-fivrk as an outcome measure is thnt the first return-to-work qfter an injury, like a hospital discharge, ,frequentlv marks the end of only the first of several episodes of work disability caused by the original iizjuiy. Using first post-injury returns-to-work as a proxy f o r recovey, we would assume that 85% of the Onturia workers recovered.from their injury when, in .firer, 61 % had .suh.seqiient .spells of work disabilitv. We identified ,four mutually exclusive patterns (f postirijuv work and work disabilio. Multinomial logit estimates qf the detcrininunts of the patterns .shonv that health care is only one of several influences on return-to-work. The results also demonstrate that retuin-to-work is used to measure outcomes, it must be evaluated over N time horizon that permits multiple spells of work disability.