Abstract

Abstract In 2011, the American Medical Association published the AMA Guides to the Evaluation of Work Ability and Return to Work (AMA's Return to Work), Second Edition, which began with a review of consensus statements attesting that, in general, work is good for a person's health and well-being. Since publication of AMA's Return to Work, the Australian Royal College of Physicians has issued a consensus statement about the negative health consequences of becoming unemployed and the health benefits of returning to work. Key points include: for most individuals, working improves general health and well-being and reduces psychological distress; even musculoskeletal and mental health conditions attributed to work can benefit from activity-based rehabilitation and an early return to suitable work; long-term work absence is harmful to physical and mental health and well-being; the negative effects of remaining away from work include stress on the worker's families, including children. Of the potential consequences of unemployment in mid-adult life, the worst is premature death. In causation research, unlike medical treatment studies, individuals cannot be randomly assigned to a group that is forced to remain at work and a group that is forced to be unemployed. Even so, causation research has found strong evidence for a protective effect of employment on depression and general mental health. In performing evaluations, physicians must accurately assess work ability and recognize the healthy benefits of work.

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