This chapter focuses on the developments following the implementation of the German legislation for preventing and managing disability that was amended in 2004. In the 1990s, the National Institute of Disability Management Research (NIDMAR), Canada, began to develop occupational standards for professionals. Managing disability aims to secure the participation of people with illnesses and disabilities in the labour market, and thereby meets a fundamental political and societal duty. The necessary tasks in managing disability are not only determined by the change of legislation and the new framework of disability allowing for empowerment and participation, but also by a change of workers within the group of persons with health problems and disabilities. Franche et al. show that effective return to work (RTW) interventions in the workplace require the support of a professional disability manager or RTW counsellor. The qualifications the actors who manage disability have become a special issue for German companies in connection with rehabilitation providers/insurances.