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Return To Work Medical Form

Return To Work Medical Form Template for Australia

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Key Requirements PROMPT example:

Return To Work Medical Form

"I need a Return to Work Medical Form for a manufacturing company in Queensland, with specific focus on heavy machinery operation and physical capacity assessment, including additional sections for shift work considerations and safety-critical tasks."

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Document background
The Return To Work Medical Form is a crucial document required under Australian workplace health and safety legislation when an employee is returning to work following an injury, illness, or medical condition. It is designed to protect both employer and employee interests by ensuring a safe and appropriate return to work process. The form must be completed by a qualified medical practitioner and includes detailed assessments of work capacity, physical restrictions, and recommended workplace modifications. This document is essential for compliance with state-specific workers' compensation requirements and federal workplace safety regulations. It helps organizations manage their duty of care obligations while facilitating effective communication between all stakeholders involved in the return-to-work process.
Suggested Sections

1. Employee Information: Essential personal and employment details including name, date of birth, employee ID, position, and department

2. Injury/Illness Details: Information about the condition, including date of injury/illness, whether it's work-related, and brief description of the condition

3. Current Work Capacity Assessment: Medical practitioner's assessment of the worker's current capacity to work, including any restrictions or limitations

4. Work Restrictions and Accommodations: Specific details about physical/mental restrictions and recommended workplace modifications

5. Duration and Review: Expected duration of restrictions, proposed review date, and anticipated progression

6. Medical Practitioner Declaration: Treating medical practitioner's details, qualifications, and certification of assessment

7. Employee Declaration: Worker's acknowledgment and agreement to the assessed conditions and restrictions

Optional Sections

1. Treatment Plan Summary: Overview of current treatment plan and recommendations - include when ongoing treatment is required

2. Medication Impact Statement: Details of medications that may affect work performance - include when prescribed medications could impact safety or performance

3. Alternative Duties Assessment: Detailed assessment of suitable alternative duties - include when standard role cannot be performed

4. Psychological Capacity Assessment: Specific assessment of psychological/mental health capacity - include when mental health is a factor

5. Pre-existing Condition Statement: Declaration of any relevant pre-existing conditions - include when condition may be affected by pre-existing issues

Suggested Schedules

1. Physical Capacity Assessment Chart: Detailed chart showing specific physical capabilities and limitations

2. Workplace Modification Checklist: Checklist of required workplace modifications or equipment

3. Follow-up Appointment Schedule: Schedule of planned review appointments and assessments

4. Return to Work Plan Template: Template for developing a graduated return to work program based on medical assessment

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓƵ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions
























Clauses



















Relevant Industries

Healthcare

Construction

Manufacturing

Mining

Retail

Hospitality

Transportation

Agriculture

Education

Professional Services

Public Sector

Warehousing and Logistics

Technology

Financial Services

Relevant Teams

Human Resources

Workplace Health and Safety

Risk Management

Operations

Employee Relations

Occupational Health

Workers Compensation

People and Culture

Legal

Compliance

Relevant Roles

Human Resources Manager

Health and Safety Officer

Return to Work Coordinator

Occupational Health Nurse

Risk Management Officer

Workers Compensation Coordinator

HR Business Partner

Operations Manager

Line Manager

Department Supervisor

Workplace Health and Safety Manager

Employee Relations Manager

Rehabilitation Coordinator

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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