Return to Work Plan

The Return to Work Plan Template is a comprehensive document designed to facilitate the smooth reintegration of employees recovering from work-related injuries or illnesses back into the workplace. This template provides a structured approach to managing the return-to-work process, ensuring that the employee’s health and safety are prioritized while maintaining productivity. The plan includes sections for documenting the nature of the injury, treatment and rehabilitation requirements, suitable duties during the recovery period, and ongoing reviews. It also ensures that all stakeholders, including the employee, supervisor, and treating doctor, are involved in the planning and approval process.

What’s Included:

1. Employee and Injury Details:
   • Fields for the employee’s name, occupation, contact details, nature of the injury, and date of the injury.
   • Space to indicate whether the injury is work-related and to provide the Workers Compensation Claim number if applicable.
2. Employer Details:
   • Sections for the employer’s name, occupation, supervisor’s name, and contact information.
3. Return-to-Work Objectives:
   • Clearly defined objectives for the return-to-work process, such as the estimated date to return to pre-injury duties, preventing aggravation of the condition, and promoting recovery.
4. Rehabilitation and Treatment:
   • Detailed description of the rehabilitation or treatment required, such as physiotherapy, functional capacity evaluations, and work conditioning.
   • Space to track the dates of rehabilitation activities and their completion.
5. Nominated Treating Doctor’s Details:
   • Sections to document the treating doctor’s practice name, practitioner’s name, contact details, and address.
6. Restrictions and Suitable Duties:
   • Documentation of any medical restrictions or capabilities provided by the treating doctor, along with specific duties to be avoided.
   • Outline of suitable duties during rehabilitation, including the dates for these duties and specific work schedules (days, start/finish times, breaks).
7. Review and Monitoring:
   • Planned and actual review dates, along with the methods used for reviews (e.g., site visits, weekly reviews by the Return-to-Work Coordinator).
   • Space for comments regarding changes in shifts, required training, or other relevant notes.
8. Sign-Off/Agreement:
   • Sections for the signatures of the injured worker, supervisor, treating doctor, and Return-to-Work Coordinator, indicating acceptance of the plan.
   • Instructions for distributing copies of the signed plan to all relevant parties.