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Graduated Return to Work Agreement Please refer to the notes on page 8 where you see this symbol. Also see the additional information about the form on page 8. Please complete in dark blue or black ink. What do I use this form for If you are facilitating a return to work program for an ill or injured employee you should complete the necessary sections of this form before providing it to your employee who should complete the Employee declaration i...
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How to fill out graduated return to work

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How to fill out graduated return to work:

01
Consult with your healthcare provider: Before starting the graduated return to work plan, it is important to consult with your healthcare provider who can provide guidance and make sure it is safe for you to return to work gradually.
02
Assess your current abilities: Evaluate your current physical and mental health abilities to determine what tasks and activities you are capable of doing without causing harm or setbacks. This will help in creating a plan tailored to your specific needs.
03
Collaborate with your employer: Communicate with your employer about your intention to return to work gradually and discuss any accommodations or adjustments that may be needed during this process. It is important to have their support and understanding.
04
Create a plan: With the help of your healthcare provider and employer, develop a detailed plan outlining the steps you will take to gradually increase your workload and responsibilities. This may include starting with part-time work or modified tasks initially.
05
Set realistic goals: Establish achievable goals that you can work towards during each phase of the graduated return to work plan. This will help you track your progress and ensure that you are not pushing yourself too hard or too quickly.
06
Monitor and adjust: Regularly monitor your progress and adjust the plan as needed. Listen to your body and mind, and communicate any difficulties or concerns with your healthcare provider and employer.

Who needs graduated return to work:

01
Individuals recovering from an illness or injury: Graduated return to work is commonly used for individuals who are recovering from an illness, injury, or surgery. It allows them to gradually build up their strength and stamina before fully resuming their regular work responsibilities.
02
Individuals with chronic conditions or disabilities: People living with chronic conditions or disabilities may benefit from a graduated return to work plan to accommodate their unique needs. It can help them ease back into the workforce while managing their health effectively.
03
Employees returning after a long absence: If an employee has been away from work for an extended period, such as maternity or paternity leave, sabbatical, or extended break, a phased return plan can help them readjust to their work environment and duties gradually.
04
Individuals facing mental health challenges: Graduated return to work can be beneficial for individuals dealing with mental health challenges, such as anxiety or depression. It provides a structured approach that allows them to manage their workload and reduce stress levels as they transition back to work.
05
Employers implementing return-to-work programs: Employers who value employee well-being and support a smooth transition back to work often implement graduated return to work programs. These programs help ensure the physical and mental health of their employees while maintaining productivity.
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A return-to-work policy allows your employees to return to a light-duty job while they recover from an illness or injury at work. A return-to-work policy is designed to help injured or sick employees get back to work in a safe and timely manner.
A Graduated Return to Work (GRTW) is recommended for most people returning to work after a serious illness/injury. A GRTW involves developing a plan with your family doctor to gradually build up your work hours and job demands over several days or weeks. A GRTW allows you to build your activity tolerance for work.
Examples of Return-to-Work programs Return-to-Work programs entail assigning light or alternative duties to workers recuperating from illness or injury. For example, supervisors can allow employees to work at a slower pace or do less physically demanding tasks as part of their regular duties.
8 keys to developing a successful return to work program Support from company leadership. Have a written policy and process. Establish a return to work culture. Train your team members. Establish a RTW coordinator. Create detailed job descriptions. Create modified duty options. Establish evaluation metrics.
How to write a return-to-work letter Address the letter to the correct person. Thank them for authorizing your work leave. Attach the proper documentation. Mention how you plan to get reacclimated. Close the letter with gratitude.
By implementing a comprehensive RTW program, a business can: Reduce costs. By offering injured employees the opportunity to assume a modified role – when it's medically feasible – employers can minimize their workers' compensation costs, including their temporary total disability payments.

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Graduated return to work is a program that allows employees who have been on leave due to illness or injury to return to their job in a phased manner, gradually increasing their work hours and responsibilities.
Typically, employees who are returning to work after a significant medical leave or injury and wish to utilize a graduated return to work program must file this documentation.
To fill out a graduated return to work form, an employee should provide details such as their expected return date, the gradual increase in hours, and any specific accommodations needed during the transition.
The purpose of graduated return to work is to support employees in their transition back to full duty, ensuring their health and well-being while allowing employers to manage workload effectively.
The information that must be reported includes the employee's name, the date of their planned return, the schedule of working hours, the duration of the graduated phase, and any specific adjustments or support needed.
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