This study’s purpose was to assess the agreement between management and employee ratings of organizational policies and practices (OPP) involved in the return to work process following carpal tunnel surgery. As a part of the prospective community-based Maine Carpal Tunnel II Study, 65 manager and employee pairs completed a questionnaire tapping four OPP dimensions: people oriented culture, safety climate, ergonomic practices, and disability management. It was hypothesized that managers and employees would agree on their assessment of the four OPPs and a composite organizational support index. Agreement was assessed using Lin’s concordance correlation coefficient. Employee and manager ratings were similar for the organizational support index (rhoc = 0.14, p = 0.08), and people oriented culture (rhoc = 0.25, p = 0.01) but not the other three OPPs. In larger companies (> 450 employees), ratings were also similar for safety climate (rhoc = 0.24, p = 0.09), disability management (rhoc = 0.22, p = 0.07) and ergonomic practices (rhoc = 0.35, p = 0.02). In unionized companies there was agreement for safety climate (rho = 0.44, p = 0.02), disability management (rhoc = 0.41, p = 0.01) and ergonomic practices (rhoc = 0.40, p = 0.06). These preliminary results suggest employees can report on certain OPPs and that an employee questionnaire can be used to assess organizational support. Given recent evidence that employee ratings of OPPs are predictive of injury/illness incidence, work disability and return-to-work outcomes, further research is needed to confirm these findings.