Underlying determinants for assessing no, partial or complete sick leave The physicians mostly (72%) diagnosed a psychological first cause for the complaints in all case vignettes. Because of this high amount of psychological diagnoses, we dichotomized the outcome of this question in psychological diagnoses and other diagnoses for the analyses. All physicians were significantly more likely to assess partial or complete sick leave when they diagnosed a psychological cause in comparison with other diagnoses (OR 0.19, 95% CI 0.14–0.27). This effect was even stronger for occupational physicians compared to insurance physicians (Table 3). All physicians were also significantly more likely to assess partial or complete sick leave when they considered limitations in personal or social functioning, in static postures, and when they considered a poor overall health status or reduced work ability. For occupational physicians, considering reduced work ability had a stronger effect on the assessment outcome than for insurance physicians (Table 3). If the physicians agreed with the statements “Medical or health-related factors are the main reason for sick listing the worker,”“If the worker is not sick listed, the complaints will worsen or the healing process will be slower” or “His/her private life is the main reason for the worker’s complaints,” they were also more likely to assess partial or complete sick leave. Considering private life issues as the main reason for the worker’s complaints had more influence on the sick leave assessment for occupational physicians than for insurance physicians (Table 3). All physicians were significantly more likely to asses no sick leave, when the physicians agreed with the statement “The worker is not motivated to work,” or when they considered limitations on dynamic movements (Table 3).