Medical Certificate For Return To Work Template for Indonesia

The Medical Certificate For Return To Work is a crucial document required under Indonesian employment and healthcare legislation when employees resume work following medical leave or illness. It ensures compliance with Labor Law No. 13 of 2003 and related regulations while protecting both employer and employee interests. The certificate must be issued by a qualified medical practitioner and includes essential information such as the employee's health status, fitness for work assessment, any required workplace modifications, and specific restrictions if applicable. This document is particularly important in Indonesia's workplace health and safety framework, as it helps organizations maintain proper documentation for compliance purposes while ensuring appropriate support for returning employees. It also serves as a risk management tool by clearly documenting medical clearance and any necessary accommodations.

1. Healthcare Provider Information: Details of the medical practitioner and healthcare facility issuing the certificate, including registration numbers and contact information

2. Employee Information: Full name, date of birth, employee ID, and position/role of the employee

3. Medical Leave Details: Period of medical leave taken and the general nature of the medical condition (respecting privacy requirements)

4. Fitness Assessment: Clear statement of the employee's fitness to return to work, including date of assessment

5. Return to Work Date: Specific date when the employee is cleared to resume work duties

6. Work Capacity Statement: Assessment of the employee's capacity to perform their regular duties

7. Authentication: Medical practitioner's signature, date, and official stamp