An intricate balance of health care and administrative decision-making is necessary to ensure the accurate confirmation of an employee's disability and appropriate accommodation of his/her work limitations. In this article, an occupational health consult process is presented describing the interplay between the health care team, the disabled employee's supervisor, and human resource specialists-each having a categorical interest in the status of the employee. The occupational health nurse plays a central role in the administrative coordination of this interaction which requires effective yet careful communication between members of the health care team and the employee's supervisor. He/she should work closely with the disability specialist to reach common objectives. When conducted properly, occupational health consultation facilitates early and successful return to work for many employees who have incurred physical disabilities while employed. The significance of occupational health consultation is evident in light of current legislation that places greater expectations on employers to make reasonable accommodations for employees with disabilities.