Return to Work Templates

This form is used for reporting a physician's evaluation and recommendation for an individual's return to work in California, along with any necessary voucher information.

This form is used for assessing an individual's functional abilities in order to plan for their early and safe return to work in Ontario, Canada.

This Form is used for employees in Maine to report their return to work after a work-related injury.

This document provides a toolkit for employers and employees in California regarding maternity and paternity leave and the return-to-work process. It aims to promote a healthy and supportive workplace environment for mothers and families.

This form is used for employees in Maine to report their return to work after an injury or illness. It helps employers and the Workers' Compensation Board track the progress of the employee's recovery.

This form is used for reporting the termination of temporary total disability (TTD) or temporary partial disability (TPD) in the state of Indiana.

This Form is used for conducting a Functional Capacity Evaluation (FCE) in the state of Minnesota. It helps assess an individual's physical ability to perform specific tasks and determine their level of functional capacity.

This Form is used for carriers in New York to report on rehabilitation efforts.

This document is used for creating a rehabilitation agreement in Ohio. It is a form that outlines the terms and conditions for the rehabilitation process.

This Form is used for medical certification required for employees returning to work after taking FMLA leave in the state of Oklahoma.

This form is used for employers in Texas to apply for reimbursement through the Return-To-Work program.

This document is used for notifying the Vermont Department of Labor about an employee returning to work.

This form is used to notify an employee in Oklahoma about their return to full-time work after a leave of absence or illness.

This form is used for returning to work after a medical leave. It is specific to the state of Maryland.

This form is used for reporting supplemental information about an employee's return to work in the state of Colorado. It provides details about the employee's job duties, work hours, and any restrictions or accommodations.

This is a notification completed by the employee and submitted to their employer after an FMLA leave - a leave requested and provided under the provisions of the Family and Medical Leave Act - is over.

This form is used for the medical certification required for an employee's return to work under the Family and Medical Leave Act (FMLA) in Oklahoma.

This form is used for applying to the Return-To-Work Supplement Program in California. This program provides financial assistance to eligible workers who have suffered a permanent disability due to a work-related injury.

This type of letter is used when an employee needs to take a leave of absence but would like to return to their job at some point with some restrictions on their return.

This Form is used for planning early and safe return to work in Ontario, Canada. It helps employers and employees assess functional abilities after an injury or illness, and develop a plan to reintegrate the employee back into the workplace.

This Form is used for making return to work recommendations under the Community Mental Health Program in Ontario, Canada. It is applicable for individuals who have been on leave due to mental health issues.

This Form is used for returning to work in Rhode Island.

This form is used for reporting rehabilitation actions taken for an injured employee. It helps track the progress of the employee's rehabilitation process.

This is a supplementary document attached to a job application by an individual who has not worked for a significant period of time being busy with managing a household yet wants to continue their professional career.

This document is used for requesting an early return to work on a temporary modified duty assignment in the state of Missouri.

This Form is used for employees in the State of Iowa to certify their readiness to return to work after a leave of absence.

This Form is used for certifying fitness for duty and granting a release to return to work in Wisconsin.

This form is used for physicians in Santa Cruz County, California to certify an employee's return from medical or disability leave.

This Form is used for claiming the Restaurant Return-To-Work Credit in New York. It provides instructions on how to complete the form and apply for the credit.

This Form is used for employers in Texas to apply for reimbursement under the Return-To-Work program.

This form is used for requesting preferred worker status in the state of Washington for individuals who speak Oromo.

This form is used for providing the necessary documentation from a doctor to confirm that an individual is medically fit to return to work after a period of absence.