The present longitudinal survey among 201 telecom managers supports the Job Demands-Resources (JD-R) model that postulates a health impairment process and a motivational process. As hypothesized, results of structural equation modeling analyses revealed that: (1) increases in job demands (i.e., overload, emotional demands, and work-home interference) and decreases in job resources (i.e., social support, autonomy, opportunities to learn, and feedback) predict burnout, (2) increases in job resources predict work engagement, and (3) burnout (positively) and engagement (negatively) predict registered sickness duration (“involuntary” absence) and frequency (“involuntary” absence), respectively. Finally, consistent with predictions results suggest a positive gain spiral: initial work engagement predicts an increase in job resources, which, in its turn, further increases work engagement. Copyright © 2009 John Wiley & Sons, Ltd.