[Denial of disability versus inability to meet essential job functions].

The return to work process following a prolonged medical leave includes an assessment of both work capacity and ability to meet essential job functions. We present the case of an administrative assistant with a congenital vocal cord injury who was denied total permanent disability. The initial fitness for duty examination after her prolonged absence resulted in a determination of fitness, but with limitations. After performing a risk assessment and review of the essential job functions of her occupation, she was dismissed based on inability to meet the essential demands of the job. Assessments of work capacity/disability must be multidisciplinary, integrating the diagnosis, treatment, course of the illness, and conducted from both a preventive and work perspective.