Introduction Return-to-work (RTW) is a complex process that involves many sectors and stakeholders including worker participation. RTW should consider biopsychosocial aspects of workers and workplace changes with stakeholders’ participation to ensure adaptation and sustainability of the job. Objective to identify RTW challenges from workers’ perspectives after work-related sick leave.

Methods Qualitative research. We interview workers who were victims of occupational diseases or accidents and were treated by a Brazilian public occupational health. We analyzed the speeches considering theoretical and methodological approaches of RTW, Psychodynamics of Work, and Discourse Analysis.

Results RTW is a difficult experience for workers, mainly caused for miscommunication and non-articulation of stakeholders and sectors involved. RTW triggers negative feelings and distress in the workers such as humiliation, revolt, and even feeling of guilt due to sick leave. Besides, workers experience fear of retaliation and stigmatization of their employer or co-workers for their new condition and receive rare or no support in this sense. Discourse analysis shows lacking support from stakeholders and the invisibility of workers during return to work that walks alone in this path. Government sectors (as insurance and healthcare systems) do not mediate RTW and workplace accommodations rely on workers’ demand in an unfair and unbalanced negotiation with the employer.

Conclusion There is an urgent need to review the RTW process in Brazil focusing on a collaborative model between sectors, stakeholders, and the worker looking to a more comprehensive perspective and more effective results.