Table 2 Algorithm to assess work instability, indications for workplace visits, and intervention levels, modified from [24]

Level 0

Shoulder function is adequate to perform all work activities, pain is under control, work activities do not imply a risk to the shoulder (job colour code: green), and the patient does not worry that this is the case.

No

Level 1

As above, but from time to time pain is a problem, work activities do not imply a risk to the shoulder (job colour code: green), but the patient worries that this may be the case, and/or the patient experiences that the employer hesitates to let the patient do his or her ordinary work activities in order to protect the shoulder.

Maybe – the indication is relative. Reassure the patient (and the employer) that work can be continued/resumed.

Level 2

Work activities do not imply a risk to the shoulder (job colour code: green), but pain is aggravated to an unacceptable level, and/or shoulder function does not match all work activities. The shoulder problems are expected to resolve within 6–12 months.

Yes, temporary solutions have to be established at the workplace.

Level 3

Some work activities imply a risk of worsening the shoulder condition (job colour code: yellow or red), pain is aggravated to an unacceptable level, and/or shoulder function does not match all work activities. The shoulder problems are not expected to resolve within 6–12 months.

Yes, permanent solutions have to be established at the workplace.

Level 4

Major work activities imply a risk of worsening the shoulder condition (job colour code: yellow or red), pain is aggravated to an unacceptable level, and/or shoulder function does not match the work demands. The shoulder problems are not expected to resolve within twelve months.

Yes, a permanent shift to another job may be necessary.

Undetermined

A workplace visit is necessary to assess work instability.

Yes, shoulder load has to be assessed.