Abstract
PURPOSE: This study aimed to explore if and why the return-to-work (RTW) experiences of various workplace
stakeholders in the Netherlands and Denmark differ between physical and mental health conditions, and to
understand the consequences of potentially different experiences for the RTW process in both health
conditions.
METHODS: We studied 21 cases of long-term sickness absence, and held a total of 61 semi-structured interviews
with the various actors involved in these cases.
RESULTS: Physical cases were seen as ‘‘easy’’ and mental cases as ‘‘difficult’’ to manage, based on the visibility
and predictability of health complaints. On this ground, assessing work ability and following required
RTW actions were perceived as more urgent in mental than in physical cases. Despite these perceptions, in
practice, the assessment of work ability seemed to impair the RTW process in mental cases (but not in
physical ones), and the (non-)uptake of RTW actions appeared to have similar results in both mental and
physical cases.
CONCLUSIONS: With these outcomes, the effectiveness of a differential approach is questioned, and the relevance
of a bidirectional dialog on work ability and a phased RTW plan is highlighted, regardless of the
absence cause. Our study also demonstrates how policymakers need to strike a balance between obligatory
and permissive legislation to better involve workplaces in RTW issues.
