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1. Document Control: Version number, date, and review information
2. Employee Information: Details of the returning employee, including their role, department, and relevant medical conditions or restrictions
3. Assessment Details: Date of assessment, assessor details, and other participants in the assessment process
4. Current Work Capacity: Summary of medical clearance, work restrictions, and current capabilities as certified by healthcare providers
5. Job Role Analysis: Breakdown of regular duties, physical demands, and environmental factors of the role
6. Risk Identification: Specific identification of potential hazards and risks related to the return to work
7. Risk Assessment Matrix: Evaluation of identified risks using likelihood and consequence ratings
8. Control Measures: Detailed description of required modifications, adjustments, and control measures to manage identified risks
9. Implementation Plan: Timeline and responsibilities for implementing control measures
10. Monitoring and Review: Schedule and process for reviewing the effectiveness of control measures and adjusting as needed
11. Sign-off: Approval section for all relevant parties including employee, supervisor, and return to work coordinator
1. Psychological Risk Assessment: Additional section for assessing mental health and psychosocial risks, used when psychological factors are relevant to the return to work
2. Remote Work Considerations: Section addressing specific risks and controls for employees returning to work in remote or hybrid arrangements
3. Equipment Requirements: Detailed section on specific equipment or modifications needed, used when significant physical adjustments are required
4. Team Impact Assessment: Analysis of how return to work arrangements affect team operations, used in collaborative or interdependent roles
5. Training Requirements: Section outlining any additional training needed before or during return to work, used when skill gaps or new processes are identified
1. Risk Assessment Matrix Template: Standard template for evaluating likelihood and consequence of identified risks
2. Physical Demands Analysis Checklist: Detailed checklist for assessing physical requirements of the role
3. Workplace Modification Checklist: List of potential workplace modifications and ergonomic adjustments
4. Review Schedule Template: Template for scheduling and documenting regular reviews of the return to work arrangement
5. Medical Restrictions Summary: Template for summarizing medical provider recommendations and restrictions
6. Control Measures Register: Detailed register for tracking implementation and effectiveness of control measures
Control Measures
Duties
Hazard
Health and Safety Representative (HSR)
Hierarchy of Controls
Incident
Injury Management
Likelihood
Medical Certificate
Modified Duties
Monitoring
PCBU (Person Conducting a Business
Reasonably Practicable
Recovery at Work
Residual Risk
Return to Work Coordinator
Return to Work Plan
Risk
Risk Assessment
Risk Control
Risk Matrix
Safe Work Method Statement
Safety Management System
Suitable Duties
Supervisor
Treating Health Practitioner
Work Capacity
Work Capacity Certificate
Work Related Injury
Workplace Rehabilitation
Workplace Rehabilitation Provider
Identification
Health and Safety
Risk Assessment
Workplace Modifications
Medical Requirements
Monitoring and Review
Compliance
Consultation
Implementation
Confidentiality
Reporting
Training
Emergency Procedures
Record Keeping
Review and Evaluation
Authority and Responsibilities
Communication Protocol
Support Measures
Dispute Resolution
Manufacturing
Construction
Healthcare
Education
Retail
Mining
Transportation
Professional Services
Public Sector
Hospitality
Information Technology
Agriculture
Logistics
Financial Services
Telecommunications
Human Resources
Workplace Health and Safety
Risk Management
Operations
People and Culture
Occupational Health
Legal
Workers Compensation
Industrial Relations
Human Resources Manager
Work Health and Safety Manager
Return to Work Coordinator
Occupational Health and Safety Officer
Risk Management Officer
HR Business Partner
Operations Manager
Line Manager
Department Supervisor
Workplace Health and Safety Advisor
Injury Management Coordinator
People and Culture Manager
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