Return To Work Letter


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How to write a Return to Work Letter? Who fills out return to work form? Are you looking for a professional Return To Work Letter? Download this template now!

A Return to Work Letter is a file created by HR and  used to keep a record of information about employees coming from a prolonged leave of absence (e.g. due to injury or sickness) and registers their ability to return to work and fulfill their job duties. Such a form is either used as a tool during return to work interviews or for self-certification. This Return To Work Letter template can help you find inspiration and motivation. This Return To Work Letter covers the most important topics that you are looking for and will help you to structure and communicate in a professional manner with those involved. 

The RTWC will:
  • Maintain the RTW program, and related records and forms, up-to-date 
  • Make sure the First Report of Injury forms are completed and sent to the appropriate parties
  • Locate and use members of Hanover’s Workers’ Compensation Medical Provider Network (or recommend their use if state law does not allow requiring their use) 

Give the medical provider information on the physical requirements of the employee’s job, and potential alternate or modified transitional duty assignments 
  • Maintain contact with the injured employee on a regular basis
  • Work with the physician to develop a transitional duty work plan
  • Communicate frequently with the medical provider and Hanover Insurance
  • Train employees on Our Company’s RTW program Employee Responsibilities Supervisors employed at Our Company are responsible for assuring that: 

  • Anyone who is injured receives prompt medical attention 
  • They contact the injured employee on a regular basis 
  • The RTWC is made aware of all injuries and illnesses 
  • The RTWC has assistance needed to develop a list of transitional duty jobs that employees with medical work restrictions can perform 
  • There is a positive work atmosphere and environment where the returning employee feels welcome • Anyone returning to work does their job (or an alternate job) within limitations established by the physician All employees play a critical role in the success of the RTW program.. 
  • Handover Examples: “Sit-In-Place” Tasks — Sitting with occasional walking and light lifting 
  • Working at computer
  • Opening mail 
  • Ordering supplies 
  • Processing invoices and payments
  • Answering telephone 
  • Updating manuals and best practices “On-Your-Feet” Tasks — Walking and standing, moderate lifting, up to physician restrictions 
  • Filing 
  • Taking inventory
  • Vacuuming or sweeping 
  • Light assembly or manufacturing tasks “One-Arm” Tasks — Can be performed with one hand or arm
  •  Phone with he

Return-to-Work Program:

Dear [Name of Physician]:
We have implemented a Return-to-Work program at our company, designed to bring employees
back to work as soon as they are physically able, to perform work that is meaningful, without
aggravating their injury or illness.
Please complete the attached “Attending Physician’s Report: Return-to-Work Recommendations”
form and fax it to [RTWC’s fax number].
To assist you in completing the Return-to-Work form, attached is a list of transitional duty tasks
that are currently available.
If you have questions, please call me at [RTWC’s phone number].
Sincerely,
[Name of Return-to-Work Coordinator]


Feel free to download this intuitive template that is available in several kinds of formats, or try any other of our basic or advanced templates, forms or documents. Download this Return To Work Letter template and save yourself time and effort! You will see completing your task has never been simpler!


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