In this context, systems refer to the set of legislation, policy and regulations which govern the services provided to people who have become absent from work, especially on a long-term basis. In essence, it refers to provisions on the field of employment, rehabilitation, equality and social insurance or social welfare.

The guidelines published by the International Social Security Association, ISSA Guidelines: Return to Work and Reintegration, provide a policy imperative towards early intervention for people with nonoccupational health conditions at risk of exiting the workforce and moving to disability dependency. Socioeconomic and fiscal imperatives have been demonstrated by the Organisation for Economic Co-operation and Development's (OECD) review on sickness, disability and work (OECD, 2010), and by an accumulating evidence base for effectiveness. This study explored how social protection agencies are responding in terms of employment rehabilitation services for employed people with acquired disabilities. Specifically, this study reviewed job retention and return processes for workers with nonoccupational health conditions from the perspective of the ISSA guidelines in four jurisdictions with differing system frameworks. The methods used included a review of relevant literature and web resources and gathering detailed system descriptions from national respondents. Although the jurisdictions differed in the concepts used, service context, the structure of welfare systems and eligibility criteria, there was evidence of an acknowledgement of the needs of employed people with disabilities. This was not, however, consistently reflected in procedures, processes or outcome measurements. While some promising characteristics were identified, there was substantial room for improvement in the job retention and return to work strategies of the relevant agencies in all four jurisdictions. It was concluded that the deployment of the ISSA Guidelines: Return to Work and Reintegration, published in 2013, had yet to make a substantial impact on services and approaches in the domain of nonoccupational health conditions in these jurisdictions.

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Adebate is emerging regarding the best way to ensure the timely and efficient return to work (RTW) of workers who have become long term absent (LTA) for health reasons. Elements of this debate center on the roles of the individual, the rehabilitation agent, the employing organisation and the rehabilitation and reintegration system. Recent years have seen the emergence of new approaches to managing LTA, mostly focusing on disability management and on amendments to welfare and rehabilitation systems. This paper discusses these trends in the light of a 6-year research programme carried out in Ireland, involving both national and transnational studies which have sought to identify the key elements of successful LTA policies and practices. It also reviews recent international work in the area in order to assess the relative importance of systemic, organisational and individual factors in ensuring timely and effective LTA policies and practices.

Internalising disability management (DM) processes into an organisation needs careful planning and preparation particularly where the existing practice is to outsource DM services and supports to third-party providers. By using an action research methodology, the implementation process of an early intervention and rehabilitation pilot project in a large North American multisite health provider was tracked and monitored. An action researcher, who was the staff member responsible for line managing the DM pilot, kept an action research journal in which the actions taken, outcomes achieved, issues arising, insight gained and successful responses were regularly recorded over the initial phase of the pilot project. Organisational impact indicators for the pilot project were very positive. A content analysis of the action research journal revealed key components in a successful company DM program, the challenges faced when introducing a new program where pre-existing programs and policies exist, challenges arising from project implementation and mechanisms and strategies that worked well. The action research approach provided a useful insight into the day-to-day issues to be addressed when internalising DM into a large multisite organisation.