<p>Coronavirus disease 2019 (COVID-19) can threaten the long-term ability to work. Findings on the influence of long COVID and post COVID on the ability to work are limited and heterogeneous. This article uses qualitative data to show the changes of work ability after COVID-19 rehabilitation and examine the COVID-19 patients’ characteristics and discuss related challenges for rehabilitation and employment. We conducted interviews with COVID-19 patients (<i>n</i> = 15) 12&#xa0;months after their stay in medical rehabilitation (cardiological, pneumological, neurological). Recruitment was carried out using “maximum variation sampling”. In addition, interviews (<i>n</i> = 5) and group discussions (<i>n</i> = 3) were held with rehabilitation staff. All interviews were audio-recorded, transcribed and analysed. Clinic staff and rehabilitants pursue the work ability as a main rehabilitation goal. They are motivated by regaining self-esteem, social integration, financial worries and existential fears. Sometimes, maintaining the ability to work is achieved at the expense of nonoccupational activities. Compensation strategies are developed in order to be able to work despite impairments. The sociomedical assessment of performance is described as inadequate and currently does not allow any long-term prognoses regarding the work ability. Although many return to work after rehabilitation, some still have a long-term threat of work ability. Recording and monitoring the ability to work and the employment situation are important in order to enable accurate sociomedical prognoses.</p>