Building Smarter Stay-at-Work and Return-to-Work Strategies 

After more than two decades in the leave and accommodation management space, one thing has become increasingly clear: the conversation around stay-at-work and return-to-work (SAW/RTW) strategies is evolving in meaningful and productive ways. For many years, these conversations were largely focused on claims management and regulatory compliance. Today, they have evolved into broader, more strategic discussions that carry significant implications for workforce participation, employee retention, and organizational performance. 

This shift was especially evident during a recent panel discussion I moderated at the U.S. Department of Labor’s SAW/RTW Policy Forum in Washington, DC, focused on the impact of SAW/RTW strategies for both employers and employees. It was clear from the conversation that this is no longer a niche issue, and that attention is growing at both the federal and state levels on how employers can better support employees’ health while simultaneously strengthening workforce participation and retention.

Employers, policymakers, healthcare leaders, and workforce experts increasingly recognize that helping employees remain connected to work during illness, injury, or mental health and substance use challenges is not only beneficial for workers, but also essential to workforce stability, productivity, and long-term economic and business success. 

As organizations often serve on the front lines of these challenges, employers have a unique perspective on where employees struggle, where systems break down, and what approaches are most effective. Bringing that real-world experience into broader SAW/RTW and policy conversations is critical to shaping strategies that are coordinated and effective. 

Why This Matters Right Now

The reality is, the need has never been greater.

Nearly 4 million workers were completely absent from work in 2024 due to illness, injury, or other health-related reasons, and the longer employees remain disconnected from work, the harder it becomes to successfully return. Research also shows the likelihood of returning to work drops significantly after 12 weeks of leave.

That’s why proactive SAW/RTW strategies matter. The employers seeing the strongest outcomes are moving away from a “leave-first” mindset and focusing more on workforce continuity and early intervention. Sometimes that looks like temporary accommodations, flexible scheduling, modified duties, transitional work assignments, or simply having earlier conversations with employees before challenges escalate.

These programs are not just about reducing costs, although they absolutely can help reduce turnover, training expenses, and long-term absence durations. They are also about helping employees maintain stability, connection, purpose, and confidence during difficult periods in their lives. At their best, SAW/RTW strategies help people stay connected to work while navigating some of life’s most challenging moments. 

Where Employers Still Face Challenges 

One of the biggest challenges I continue to see is fragmentation. Employees are often trying to navigate leave, accommodations, healthcare providers, disability benefits, and workplace policies all at once, usually while dealing with a medical or mental health issue. Even organizations with the strongest, most comprehensive programs can struggle if communication and coordination break down.

That’s why SAW/RTW efforts need to be practical, connected, and employee-centered. In many cases, employers don’t need entirely new programs. They need better coordination, clearer communication, and managers who feel equipped to support employees through these conversations.

There is also an important mindset shift happening. Too often, work and health are treated as separate conversations. In reality, they are deeply connected. Work can provide structure, routine, social connection, financial stability, and purpose, all things that can positively impact recovery and well-being when the right supports are in place.

We also need to consider changing how we think about employees during these situations. I often say we need to think about employees as fragile, not fraudulent. Most people want to work. Most people want to stay connected to their teams. When organizations create environments where employees feel supported and safe speaking up early, we are much more likely to see positive outcomes for everyone involved.

Turning Insight Into Action 

As SAW/RTW strategies continue to evolve, so does the need for professionals with the skills and knowledge to effectively support employees through return-to-work, accommodations, and workforce reintegration efforts. Yet while the role has become increasingly important, there has been limited consistency around the competencies and training needed to perform it effectively. To help address that gap, DMEC is launching the Stay-at-Work / Return-to-Work Specialist Core Competency Program, a role-based education program designed to establish a professional baseline for the field. By building expertise in both behavioral and technical competencies, the program aims to better equip professionals to navigate today’s increasingly complex workplace landscape while helping organizations strengthen workforce participation, retention, and productivity. 

At the same time, strengthening SAW/RTW outcomes requires progress beyond individual organizations. Earlier this year, DMEC released a SAW/RTW policy brief that brings the employer perspective into broader policy discussions and highlights practical recommendations grounded in real-world workforce challenges. Efforts like these help advance more connected approaches that support employees in remaining engaged in work while giving employers the flexibility and tools needed to respond effectively.

It is also important to recognize the broader transformation underway across leave and accommodation management as technology and AI become increasingly integrated into workplace processes. These tools hold significant potential to improve coordination, reduce administrative burdens, and make support systems easier to navigate. However, technology is not a replacement for the human element. Employees navigating illness, injury, or mental health challenges still need empathy, clear communication, flexibility, and genuine support. As the field continues to evolve, the greatest opportunity lies in combining better policies, stronger professional expertise, and innovative tools to create more effective and employee-centered SAW/RTW strategies.

The Future of SAW/RTW 

At its core, SAW/RTW is not just about helping employees return after an absence. It’s about creating workplaces where employees feel supported enough to stay connected throughout challenges and transitions. The organizations leading in this area are not waiting until someone goes out on leave to start the conversation. They are building cultures, policies, and support systems that prioritize early intervention, flexibility, communication, and trust.

That’s where I see the biggest opportunity ahead for employers, policymakers, and industry leaders alike: building more connected and proactive workforce support systems that make it easier for employees to remain engaged in work, while helping organizations create healthier, more resilient workforces for the long term.

Ultimately, the future of SAW/RTW is not just about helping employees return to work. It’s about helping more people remain connected, supported, and engaged throughout the workforce experience.