The aim of this article is to determine obstacles for return-to-work in disability management of low back pain patients sicklisted for three till four months. A cohort of 467 low back pain patients was recruited. A questionnaire was sent to their occupational physicians (OPs) concerning the medical management, obstacles to return-to-work, and the communication with treating physicians. The OPs of 300 of 467 patients participated in this study. In many cases OPs regarded the clinical waiting period (43%), duration of treatment (41%), and view (25%) of the treating physicians as obstacles for return-to-work. In only 19% of the patients there was communication between OP and treating physician. Surprisingly communication was also limited, when OPs felt that the waiting period (32%), duration of treatment (30%), and view (28%) of treating physicians inhibited return-to-work. Medical management of treating physicians is often an obstacle for return to work regarding low back pain patients sicklisted for three till four months, in the opinion of OPs. Nevertheless communication between OPs and the treating physicians in disability management of these patients is limited.