Objective: This study investigates the participation trends in return-to-work programs among patients with work-related injuries or illnesses, following recent revisions to industrial accident insurance policies. Methods: A retrospective cohort study was conducted using electronic medical records from hospitals under the Korea Workers' Compensation and Welfare Service. A total of 3,852 patients with work-related injuries or illnesses who participated in return-to-work programs between January 2018 and December 2023 were included. Following the implementation of revised industrial accident insurance policies, the participants were categorized into two groups. Changes in the participants' demographics, occupational injuries, return-to-work programs, and job-related characteristics were analyzed. Results: The proportion of individuals aged 60 years and older increased, accompanied by an increase in upper-limb injuries. Furthermore, the incidence of lower back pain, musculoskeletal disorders, and occupational diseases increased. In terms of the return-to-work program characteristics, the average training duration decreased, whereas the proportion of participants with regular employment increased. Conclusion: This study emphasizes the significance of industrial-accident prevention policies and highlights the necessity for institutional improvements and customized return-to-work programs to enhance return-to-work outcomes.