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Long-term sickness absence can have negative consequences for individuals, their employers and the organisations that they are working in. In such cases occupational health has an important role in assisting workplace rehabilitation. This study investigates long-term sickness absence referrals in the Irish Civil Service in terms of epidemiological profile, illness categories and eventual outcomes.A retrospective review was carried out of consecutive new long-term sickness absence cases referred between April and June 2014 inclusive. Cases were followed up for 2 years. Case outcomes were established by reviewing both electronic and paper records, and liaising with the relevant human resources department where necessary.Two hundred and fifty two cases were available for analysis. Referral for long-term sickness absence was more common among older employees and female employees. Clerical Officer grades accounted for over one third of all referrals.The principal diagnostic groups were mental health issues (25%) and musculoskeletal disorders (20.6%). The category that followed, accounting for 11.9% of all illnesses was ‘physical other’. This category was comprised of a wide range of illnesses that were not elsewhere categorised. Cancer and cardiac and circulatory disease were the next common at 8.7% and 7.9% respectively.The eventual outcomes at two years were 88% of employees having returned to work, 8% were retired by their employer on grounds of ill health, 1.6% retired on age grounds, 0.8% were deceased and 0.8% remained on sick leave.74% of cases were found fit for work at time of review. Of these 40% had already returned to work in the interval between their referral to the CMO and their first appointment.The final outcome in a large majority of case referrals was to resume work, with only a small proportion retiring on ill-health grounds. The results suggest, with 40% of employees resuming work between the time of referral and their first appointment, that referral to the CMO may have prompted a return to work. The principal reasons for absence remain mental health disorders and musculoskeletal disease.