Return to Work Plan Builder
Build a return-to-work plan after a workplace injury — current capacity, restrictions, suitable duties, a graduated hours schedule and review dates for you and your employer.
Last verified: 20 June 2026Assemble a structured return-to-work plan: current capacity, treating-practitioner restrictions, suitable duties, a graduated hours schedule, review milestones and sign-off — then print it or save it as a PDF. Obligations and timeframes vary by state.
Worker and injury details
Current capacity
Enter the capacity certified on the worker's certificate of capacity. This sizes the graduated return schedule below.
Restrictions and suitable duties
Review and responsibility
Opens your browser's print dialog. Choose "Save as PDF" to keep a copy or share it with the worker, treating practitioner or insurer.
Obligations and timeframes vary by state
Return-to-work obligations, suitable-employment periods and review timeframes are set by each state and territory workers' compensation scheme and are NOT uniform across Australia. There is no single national timeframe. This plan is a starting template only — confirm the exact duties, periods and forms that apply to you with your scheme regulator or insurer.
Return to Work Plan
Draft template prepared with FairWorkMate.com.au — not legal advice.
Worker and injury details
- Worker
- To be completed
- Role / position
- To be completed
- Employer
- To be completed
- Date of injury
- To be completed
- Scheme / jurisdiction
- To be confirmed
Current work capacity
- Current certified capacity
- 4 hours per day, 5 days per week
- Pre-injury ordinary hours
- 8 hours per day
Treating-practitioner restrictions
- To be completed from the worker's certificate of capacity.
Proposed suitable duties
- To be agreed between the worker, employer and treating practitioner.
Graduated return-to-work schedule
Review milestones
- Next review date: To be completed.
- Review the plan with the worker and treating practitioner at each milestone, and whenever capacity, duties or restrictions change.
- Update the certified capacity and schedule after each new certificate of capacity.
Who is responsible
- Return-to-work coordinator / supervisor
- To be completed
- Worker
- Attend agreed duties within certified capacity and the agreed hours, and report any difficulty.
- Treating practitioner
- Certify capacity and review restrictions at each milestone.
Sign-off
- Worker signature / date
- ________________________
- Employer signature / date
- ________________________
- Treating practitioner (where required)
- ________________________
Notes
- Three core employer obligations apply across the schemes: provide suitable or pre-injury duties so far as reasonably practicable once the worker has capacity; participate in an injury-management / return-to-work plan developed with the worker and treating practitioner; and act within the scheme's timeframes. (Source: Safe Work Australia, Comparison of Workers' Compensation Arrangements, Ch 6.)
- Suitable duties are meaningful, productive duties matched to the worker's certified capacity and restrictions — not make-work. They may be modified hours, modified tasks, a different role, or a different location.
- This plan is a template to support a conversation between the worker, employer, treating practitioner and insurer. It is general information, not legal advice, and does not replace your scheme's official forms.
State-variation disclaimer
Return-to-work obligations, suitable-employment periods and review timeframes are set by each state and territory workers' compensation scheme and are NOT uniform across Australia. There is no single national timeframe. This plan is a starting template only — confirm the exact duties, periods and forms that apply to you with your scheme regulator or insurer.
Structure verified as at 2026-06-20. Sources: Safe Work Australia, Comparison of Workers' Compensation Arrangements (Ch 6); SIRA NSW and WorkSafe Victoria for the general obligations.
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General information and estimates only — not legal, financial or tax advice. Always check your specific award, agreement or contract, or a qualified professional, before you rely on the result.