Background: In Germany operational integration management (OIM) and gradual reintegration (GR) are intended to help employees return to work after a long period of incapacity to work. The aim of this study was to update the state of research on the utilization of these procedures and to supplement possible indications of their benefit. Method: Information collected between October 2019 and May 2022 from 187 OIM-eligible participants of the Gutenberg Health Study was cross-sectionally analyzed. Logistic regression models were used to examine whether (the possibility of) OIM/GR participation is associated with the chance of (1) being employed at the time of measurement (ToM) with at least moderate ability to work or (2) feeling retrospectively supported by the employer regarding return to work (RTW). Possible confounding effects of termination of employment immediately following sick leave were investigated in sensitivity analyses. Results: Of the respondents 45% (n = 85) received an OIM offer from the employer, which 58% (n = 49) accepted. At the ToM 68% (n = 128) of the participants were employed with at least a moderate ability to work. Regarding the RTW, 61% (n = 115) of the participants felt (somewhat) adequately supported by the employer. In contrast to the participants who accepted the OIM/GR option, (former) employees without an OIM/GR option have a lower chance of being employed at the ToM with at least moderate ability to work (odds ratio, OR = 0.35; 95% confidence interval, CI: 0.13–0.91) or of feeling supported by the employer regarding RTW (OR = 0.30; 95% CI: 0.12–0.74). Taking into account whether the employment relationship was terminated immediately after sick leave, the weakened associations did not reach the 5% significance level. There are no corresponding differences between those who rejected the OIM/GR and the OIM/GR participants. Discussion: The study points out again that employers do not consistently offer OIM after long periods of inability to work; however, the possibility of utilizing the OIM after a longer period of incapacity to work should be given, particularly if the termination of the employment relationship is specifically being considered.