Objective This study aims to evaluate whether performance-based tests have additional prognostic value over self-reported work ability for sustainable return to work (RTW) in physically demanding work.

Methods A one-year prospective cohort study was performed among 72 construction workers on sick leave for six weeks due to musculoskeletal disorders. The Work Ability Index (WAI) question regarding “current work ability” was used. Three dynamic lifting tests were used from a Functional Capacity Evaluation (FCE). Sustainable RTW was the number of days on sick leave until the first day of returning fully to work for a period of ≥4 weeks. Regression models were built to calculate the prognostic values.

Results Self-reported work ability alone predicted sustainable RTW (R=0.31, R²=0.09, P=0.009). In combination with one lifting test, the explained variance (R²) increased to 0.16 (P=0.001).

Conclusion Combining self-reported work ability and a lifting test nearly doubled the explained variance for sustainable RTW in physically demanding work, although the strength remained modest.

Key terms construction worker; disability assessment; FCE; functional capacity evaluation; high demand job; performance-based lifting test; return to work; RTW; self-reported work ability; sustainable return to work; WAI; work ability; work ability index