Under the flag of insurance medicine, many physicians seem to do comparable work in different European countries. For a large part, their work has to do with sick leave and work disability, fields with major societal impact and implications. Unlike most clinical disciplines, insurance medicine does not have any distinct property that is valid in all countries. This hampers scientific development in insurance medicine (IM). An important difference between the judgments of treating physicians and insurance physicians and medical experts is the amount of robust evidence available to each group, their ability to access and their skills to use it.