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EMUTOM Fitness for work, Return to work

Consequences of (chronic) illness for work, support of return to work

Concise description

This EMUTOM lesson contains educational materials about assessing fitness for work and supporting return to work. Important parts of this lesson are ‘the ICF model’ and ‘the questions every physician should ask his/her patients about fitness for work’.

(Chronic) health problems may be the cause of disabilities, reduced participation and sickness absence. This impact can be evaluated from different perspectives. An employee who is ill will determine for himself whether he or she is able to work. In order to organize the work a manager will evaluate the enterprises’ possibilities when an employee is on sick leave and cannot work. The general practitioner will consider the patient’s circumstances at work in his/her clinical reasoning and treatment plan. The occupational physician will evaluate any problems which might impede returning to work. To what extent a long-term sick employee invokes rightly for a disability insurance will be evaluated by an insurance physician. Of the medical hospital specialists the rehabilitation physician will be the most important to deal with recovery of functioning, also in work. All these doctors use their own definitions and criteria for evaluating disability. Personal values and ethics play a role. And of course, the national contexts with their different laws and regulations are important. (see EMUTOM chapter one) The International Classification of Functioning, disability and health (ICF) model provides a framework for assessing disability in a more objective way and for planning active interventions. This ICF model also enables the communication between different medical specialties.

 If you want to take a look at the self-assessment exercises and the power-point presentation of this lesson, click



English, Spanish

Original Authors:

Dr PBA Smits and Dr F.van Dijk

Original affiliation, ownership:

Public and Occupational Health, University Medical Center Amsterdam, The Netherlands

Year of publication:


Charge for use or free:

Free of charge


Target group(s):

graduate students, non-OSH-expert professionals, OSH experts; or in training

Usefulness for non-OSH-expert professionals:

Fully useful for non-OSH-expert professionals in health care or other sectors; or in training

Time demand to complete the lesson or course:

1 day


This lesson is part of the EMUTOM module. In total the EMUTOM module contains 9 lessons.

Intellectual property and copyright:

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
This license allows reusers to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material. You must give appropriate credit to EMUTOM, provide a link to the license, and indicate if changes were made. You may not use the material for commercial purposes. For details about this license: .

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