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Purpose: Research indicates that the implementation of work-related medical rehabilitation (WMR) is characterized by pronounced heterogeneity and that the requirements defined by the German Pension Insurance are not consistently met. The study aimed to investigate the implementation of the WMR guideline in patients with musculoskeletal disorders with regard to the identification of a need for WMR as well as the assessment of the individual demands of work., Methods: 317 rehabilitation facilities authorized for WMR in patients with musculoskeletal disorders were invited to participate in a nationwide survey. 86 of 317 facilities responded to the self-developed questionnaire and met the inclusion criteria., Results: Although most facilities reported that nearly all patients receive WMR if they have a need for it, the proportion of WMR measures provided was below ten percent in the majority of cases. With regard to work demands, respondents demanded greater involvement of employers in order to strengthen validity., Conclusion: The findings indicate that WMR is largely implemented in accordance with the WMR guideline. The main challenges include meeting the need for WMR and strengthening the involvement of employers in the assessment of work requirements., Competing Interests: Die Autoren sind für das Institut für Qualitätssicherung in Prävention und Rehabilitation GmbH an der Deutschen Sporthochschule Köln tätig., (Thieme. All rights reserved.)