Medical Certificate For Return To Work Template for Canada

1. Workplace Restrictions: Specific limitations or restrictions on duties, to be included when the employee requires modified work arrangements

2. Accommodation Requirements: Detailed description of workplace accommodations needed, used when specific modifications to work environment or duties are necessary

3. Gradual Return Plan: Schedule for phased return to full duties, included when employee needs graduated return to work

4. Follow-up Requirements: Schedule of follow-up appointments or assessments, included when ongoing medical monitoring is needed

5. Workplace Exposure Limitations: Specific environmental or exposure restrictions, used for employees with sensitivity or exposure-related conditions

6. Duration of Restrictions: Timeframe for how long modifications should remain in place, included when restrictions are temporary

1. Schedule A - Detailed Accommodation Plan: Comprehensive outline of required workplace accommodations including specific equipment, environmental modifications, or schedule adjustments

2. Schedule B - Gradual Return Schedule: Detailed timeline and progression of work hours or duties for graduated return to work

3. Schedule C - Physical Demands Analysis: Breakdown of physical requirements of the job and employee's current capabilities

4. Appendix 1 - Medical Monitoring Plan: Schedule of required follow-up assessments and monitoring requirements

5. Appendix 2 - Emergency Response Plan: Specific procedures to follow in case of medical emergency related to the employee's condition