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Return To Work Medical Certificate

Return To Work Medical Certificate Template for New Zealand

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Key Requirements PROMPT example:

Return To Work Medical Certificate

"I need a Return To Work Medical Certificate for a manufacturing employee returning from a back injury, with provisions for modified duties and a graduated return schedule starting March 2025, including specific lifting restrictions and requirements for ergonomic equipment."

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Document background
The Return To Work Medical Certificate is a vital document in New Zealand's workplace health and safety framework, designed to facilitate the safe and effective return of employees to work following medical absence. This document is required when an employee needs to resume work after a significant illness, injury, or medical condition, whether work-related or not. It must comply with various New Zealand legislation, including the Health and Safety at Work Act 2015, Privacy Act 2020, and ACC requirements. The certificate provides crucial information about an employee's work capacity, any required workplace modifications, and specific medical recommendations, while maintaining appropriate medical privacy. It serves as a key tool for risk management and ensuring duty of care obligations are met by both medical practitioners and employers.
Suggested Sections

1. Medical Practitioner Details: Full name, registration number, practice details and contact information of the certifying medical practitioner

2. Patient Information: Employee's full name, date of birth, and relevant identification details

3. Consultation Details: Date of examination and whether it's an initial or follow-up assessment

4. Diagnosis/Condition: Brief description of the medical condition or injury affecting work capacity (with patient consent)

5. Work Capacity Assessment: Clear statement of whether the employee is fit for normal duties, modified duties, or unfit for work

6. Duration: Specific period for which the certificate applies, including start and end dates

7. Work Modifications: Specific workplace restrictions or modifications required (if applicable)

8. Next Review: Date of next medical review if required

9. Declaration: Medical practitioner's declaration and signature confirming the assessment

Optional Sections

1. Treatment Plan: Overview of ongoing treatment requirements - include when there's an active treatment plan that may affect work arrangements

2. Workplace Hazards: Specific workplace hazards that need to be avoided - include when there are specific environmental or task-related risks

3. Hours Restriction: Detailed breakdown of recommended working hours - include when graduated return to work is recommended

4. ACC Information: ACC claim number and details - include when the return to work is related to an ACC claim

5. Specialist Referral: Details of any specialist referrals - include when ongoing specialist care is required

Suggested Schedules

1. Physical Capacity Evaluation: Detailed assessment of physical capabilities and limitations

2. Graduated Return to Work Plan: Week-by-week breakdown of increased work hours or duties

3. Required Workplace Modifications: Detailed list of specific workplace modifications or equipment needed

4. Follow-up Appointment Schedule: Timeline of planned follow-up medical assessments

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

Manufacturing

Construction

Professional Services

Retail

Education

Mining

Agriculture

Transportation

Hospitality

Public Sector

Information Technology

Financial Services

Telecommunications

Relevant Teams

Human Resources

Health and Safety

Occupational Health

Risk Management

Employee Relations

Operations

People and Culture

Workplace Relations

Medical Services

Compliance

Relevant Roles

Human Resources Manager

Health and Safety Coordinator

Occupational Health Nurse

Return to Work Coordinator

HR Business Partner

Operations Manager

Line Manager

Workplace Health and Safety Officer

Risk Management Officer

Employee Relations Manager

Rehabilitation Coordinator

HR Administrator

General Practitioner

Occupational Health Physician

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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