Introduction Changes in the workplace environment, precarization and flexibilization of employment, loss of labor rights, and the big economy have had an impact, increasing work accidents, harms, and occupational diseases as well sick leaves. In Brazil, Vocational Rehabilitation (VR) is provided by the National Institute of Social Security system and includes educational, adjustment, and re-adjustment support to facilitate return to work among workers who receive benefits due disease or accidents. However, its scope is quite limited and does not offer a follow-up to workers after discharge.

Objective To understand the return to work after discharge of the VR.

Methods Qualitative study developed in a VR program from Sao Paulo state and carried out in two phases: (i) documental analysis to identify potential participants who were assisted by VR; (ii) individual interviews by telephone following an open questions script and analyzed through Thematic Content Analysis. This research was approved by the Ethical Committee of Federal University of Sao Carlos; all ethical concerns were addressed.

Results From 2009 to 2020, 263 workers returned to work after discharge of VR: 84 (32%) women and 179 (68%) men received support predominantly due to musculoskeletal disorders (35%) and external causes of injuries (33%). Of these, 71 (27%) returned to the same task and 192 (73%) to different ones. 33 workers discharged from VR during 2019–2020 were invited to participate in the interviews and 11 workers were interviewed. Three categories emerged from interviews: difficulties in the return to work process; limits of VR to return to work; necessary advances to VR regard to return to work.

Conclusion Results showed the need for reorganization of VR including review of criteria of inclusion, interprofessional team analysis of potential participants, discharge mechanisms, follow-up of the worker after discharge, and negotiating with employers accommodation to the rehabilitated worker.