Return to Work Is Becoming a Bigger Part of the OT Conversation August 12 2026
For a long time, return-to-work rehabilitation has lived in a somewhat unusual space in healthcare.
Everyone agrees that work matters. Employers want people back. Patients often want to get back to their jobs. Insurers want injured workers to recover and return to productive activity. Physicians write restrictions and clearances. And occupational and physical therapists are frequently the professionals who have the best understanding of what a person can actually do.
Yet the question of how someone functions at work has not always received the attention it deserves.
That may be changing.
In April 2026, the American Occupational Therapy Association participated in a U.S. Department of Labor policy forum focused specifically on Stay-at-Work and Return-to-Work programs. The discussion included the role of occupational therapy in addressing physical, cognitive, psychosocial, environmental, and ergonomic barriers to employment.
That is an important conversation for rehabilitation professionals.
"Can They Work?" Is Usually the Wrong Question
One of the problems with return-to-work decisions is that they are often reduced to a yes-or-no question:
Can this person work?
In reality, the more useful questions are:
- What does the job actually require?
- Which essential functions can the person perform?
- Which tasks are difficult?
- How much lifting, carrying, reaching, standing, sitting, or walking is required?
- Can the person sustain those activities over an entire workday?
- Are there cognitive or attention demands?
- What happens when multiple demands occur at the same time?
- Could reasonable modifications allow the person to remain productive?
Those are functional questions.
And functional questions are where rehabilitation professionals have something important to contribute.
The Workplace Is More Than a List of Restrictions
A traditional restriction might say:
No lifting over 20 pounds.
That sounds objective. But it doesn't tell us much about the actual job.
Does the worker lift 20 pounds once an hour or 20 times every five minutes?
Does the lifting occur from floor level, waist level, or overhead?
Does the worker carry the object 50 feet?
Are they simultaneously required to reach, twist, climb stairs, or maintain balance?
Does the job require sustained hand use?
Does the worker have to remember a sequence of instructions while performing the physical task?
The difference between a medical restriction and an actual job demand can be enormous.
This is one reason functional assessment remains so valuable.
OT Has a Particularly Broad View of Work
One of the things that makes occupational therapy particularly well suited to return-to-work rehabilitation is the profession's focus on the interaction between the person, the task, and the environment.
A worker may have adequate strength but struggle with the pace of the job.
Another person may demonstrate excellent physical capacity but have difficulty managing divided attention following a brain injury.
Someone else may physically be able to perform a task but need a workstation modification to do it safely and consistently.
And sometimes the solution isn't additional treatment.
Sometimes the solution is changing the task.
That distinction matters.
Where Objective Testing Fits
Functional Capacity Evaluations can provide objective information about physical performance, while tools such as the Hand Function Sort, Spinal Function Sort, and Multidimensional Task Ability Profile can help quantify perceived functional ability in everyday and work-related activities.
The goal isn't to replace clinical judgment with a score.
The goal is to give clinical judgment better information.
When objective performance, self-reported function, job demands, and clinical observations all point in the same direction, the return-to-work recommendation becomes much easier to explain.
And when they don't agree, that discrepancy may actually be the most important finding.
The Future of Return-to-Work Rehabilitation
The Department of Labor's recent attention to Stay-at-Work and Return-to-Work programs is a reminder that rehabilitation does not end when pain decreases or range of motion improves.
The ultimate question is participation.
Can the person safely and sustainably participate in the activities that matter to them—including work?
That is a question occupational and physical therapists have been answering for decades.
It may simply be getting more attention now.
At Matheson Development, we believe good functional assessment starts with that same principle: measure what matters in the real world.
Explore our Functional Capacity Evaluation and work rehabilitation equipment and resources at Matheson Development.