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Medicina y Seguridad del Trabajo

On-line version ISSN 1989-7790Print version ISSN 0465-546X


LOPEZ-GUILLEN GARCIA, Araceli  and  VICENTE PARDO, José Manuel. Return to Work Policies after Long-Term Incapacity for Work Needed, in Terms of Social Security. Med. segur. trab. [online]. 2018, vol.64, n.253, pp.379-401. ISSN 1989-7790.

Long-term incapacities mean a prolonged work absence, and beyond the significant economic repercussion for the productive system, the companies, the social and health protection system and the costs for the worker, they mean an intrinsic difficulty to the healthy, effective and permanent return. That is, the establishment of return-to-work policies for preventing work-related illness, both in its genesis and in its relapses is required; to manage a health condition situation at work and to make worker’s return stable and continued in time after extended periods of sick leave. Long-term disability implies not only a deterioration in the worker’s quality of life but a risk of becoming permanently disabled and a risk of losing employment. A social protection system such as the social security system requires policies that encourage the return to work, especially in this group that has suffered a long disabling process, acquiring a new disease risk situation due to work and for the work due to the disease developed. It implies a higher risk of not having a healthy nor lasting return.

Material and method:

The following bibliographic databases were reviewed until November 2018: SciELO, PUBMED, and other sources reviewed in bibliography.


To emphasize the need for establishing policies for the return of workers after incapacity for work, for the integral and integrative management of the service and the improvement of occupational health with economic protection criteria and preventive occupational protection criteria.


The policies of returning to work after long-term incapacity for work require, in matters of social security, to improve the registration systems, to prepare an Incapacity or Disability Planning in Spain, to implement changes in order to improve the decision-making process, to facilitate the communication of occupational health information among the healthcare area, the benefit area and the occupational area, to improve the company-worker relationship and the protection system, to facilitate partial discharge, to enable the sick leave and medical discharge situations according with different work requirements, to achieve a balance between work and personal life, to implement flexible schedules, to make use of an Occupational File in order to have full concrete knowledge of the work requirements by the care and benefit area, to avoid the controversy between not fit and medical discharge or no disability, to guarantee occupational biosecurity, to promote environment healthy work, to ensure the greatest rigor in determining the causal of work as a source of disease, to implement specific return to work programs for workers with musculoskeletal disorders and minor psychiatric disorders and to implement a cancer strategy implementation plan for workers with cancer. Changes in the management paradigm that incorporate preventive criteria and assess work disability (“non-return to work”) as an indicator of health management and an indicator of occupational health are needed. Changes in the norm are needed to make all of this possible.

Keywords : Social Security; return to work policies; return to work; occupational disability; work capacity assessment; occupational risk.

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