It is common for safety professionals to be involved in decisions related to an employee's ability to work safely and effectively, either because of concerns that he/she could be at work but is not, or because the employee is at work but may be impaired and creating unacceptable risks. Such decisions can be difficult and stressful for all involved, as they are inherently conflictual. In addition to the specialized concerns peculiar to a given workplace, there are general considerations about being aware of Fitness-for-Duty issues, and how to deal with these issues that are applicable to all employment, with particular aspects imparted by details of the specific workplace itself. How do we usually know if an employee is fit for duty or not? In a "routine" work situation, an employee's stated belief is consistent with reality, as to whether the worker is able to work effectively and safely.