Return To Work Certification Form Template for England and Wales

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Key Requirements PROMPT example:

Return To Work Certification Form

"I need a Return To Work Certification Form for an employee returning from a 3-month stress-related absence in March 2025, including provisions for a phased return and reduced working hours for the first month."

Document background
The Return To Work Certification Form is a crucial document in English and Welsh employment practice, designed to manage the process of employees returning to work after periods of absence, whether due to illness, injury, or other circumstances. This document serves multiple purposes: it provides legal protection for both employer and employee, ensures compliance with health and safety regulations, documents any required workplace adjustments, and maintains proper records for HR purposes. The form is particularly important in contexts where there may be ongoing health considerations or where adjustments to working conditions may be necessary. It helps organizations fulfill their duty of care obligations while protecting employee rights under relevant employment legislation.
Suggested Sections

1. Employee Information: Basic details including name, employee ID, department, contact information

2. Absence Details: Information about the period of absence including start date, end date, and reason for absence

3. Return Date Declaration: Formal declaration of the intended return to work date

4. Fitness Declaration: Employee's formal declaration that they are fit to return to their duties

5. Manager Authorization: Section for line manager's review and approval of the return to work

Optional Sections

1. Medical Certification: Section for medical clearance details, required when returning from long-term illness or medical procedure

2. Workplace Adjustments: Details of any required modifications to workplace or duties, used when medical conditions necessitate changes

3. Phased Return Schedule: Detailed plan for graduated return to work, used for employees returning from long-term absence

4. Health and Safety Assessment: Workplace safety evaluation section, required for injury-related returns or when specific risks need assessment

Suggested Schedules

1. Schedule A - Medical Evidence: Attachments of relevant fit notes, medical certificates or doctor's clearance

2. Schedule B - Risk Assessment Documentation: Completed workplace risk assessment forms and related documentation

3. Schedule C - Adjustment Plan: Detailed documentation of agreed workplace modifications and implementation timeline

4. Schedule D - Occupational Health Report: Any relevant occupational health assessments and recommendations

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant Industries
Relevant Teams
Relevant Roles
Industries

Health and Safety at Work Act 1974: Primary legislation governing workplace health and safety in the UK, setting out employers' responsibilities to ensure the health, safety and welfare of their employees returning to work

Management of Health and Safety at Work Regulations 1999: Requires employers to assess and manage risks to their employees' health and safety, including when returning to work after absence

Employment Rights Act 1996: Outlines basic employment rights including provisions related to sick leave, return to work procedures, and protection against unfair treatment

Equality Act 2010: Protects against discrimination and requires employers to make reasonable adjustments for employees with disabilities or health conditions returning to work

UK General Data Protection Regulation (UK GDPR): Governs the processing of personal data, including health information collected during the return to work process

Data Protection Act 2018: UK's implementation of data protection requirements, specifically regarding the handling and protection of sensitive health information

Social Security (Medical Evidence) Regulations 1976: Specifies requirements for medical evidence and certification in relation to work absence and return

Fit Note Guidance: Official guidance on Statements of Fitness for Work, which doctors issue to certify fitness to return to work

Health Protection (Coronavirus) Regulations: Specific regulations related to COVID-19 workplace safety measures and return to work protocols during the pandemic

Industry-Specific Regulations: Sector-specific health and safety requirements that may affect return to work procedures in particular industries

Professional Body Requirements: Standards and guidelines set by professional organizations that may govern return to work procedures for specific professions

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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