Objectives Although research on disability and RTW outcome has led to significant advances in understanding about these outcomes, limited studies focus on the quality of the RTW process, that is, if the RTW process is designed effectively, the activities undertaken by employee, employer and other stakeholders optimised the chances of RTW, and if the RTW outcome is achieved in accordance with health status and work ability of the sick-listed employee. The focus of this study is to explore factors essential to reach sufficient efforts in the RTW trajectory in cases of sick-listed employees in receipt of disability benefits.

Methods Information about the efforts undertaken during the RTW trajectory by employee and employer of 415 cases were gathered by means of a questionnaire. Multilevel regression analyses were performed.

Results Univariate analyses showed five potential determinants (P<0.20): reason for absence, tenure, work-relatedness of absence, employer-employee relationship, and employer-employee conflict. Using multiple regression analysis, only employer-employee relationship had a significant relationship to a higher chance of achieving sufficient efforts (OR 5.47, 95% CI 2.00 to 14.98, P<0.01).

Conclusions The employer-employee relationship is a relevant factor in determining if RTW efforts are sufficient. This implies that the quality and quantity of communication between employer and employee is relevant in the RTW trajectory to increase the chance of RTW. Issues regarding relationships might be improved by mediation; early detection by external parties (eg, physician or rehabilitation expert) is needed.