If an employee is absent from work due to a work or personal injury for more than three days, they must provide a Return to Work Release Form or notice before reporting to their shift. Certain conditions may apply depending on the circumstances and what is included in the Form or notice.
Work Related Injury
Once a Work Status Report has been processed, it must also be determined if the employee is to return to work (regular duty or modified program). If the employee is authorized to return to work by the Training Manager or Senior Leadership Team WITH RESTRICTIONS they must sign a Bona Fide Offer.
The Work Status Report and the Bona Fide Offer are both sent via email to the appropriate contacts (see Work Status Report).
An email with the temporary work assignment must be sent to the employee's BSS (Building Services Supervisor). The BSS must have the temporary work assignment communicated verbally (either by phone or in person).
Work Related RTW Checklist:
- Send email to Contacts with attached scans of WSR and BFO
- Communicate temporary work assignment to BSS verbally
- Send email to BSS with temporary work details (see Email Template)
Non Work Related Injury
Return To Work Release Form
A Return To Work Release Form will most likely need to be completed before reporting to their shift if they need to be released to return to work.
(Image links to Return to Work Release Form document)
Doctor Note
If a Doctor Note is submitted and has work restrictions, work limitations, or other activity restrictions, you may need to draft a Non WCI BFO Letter with a modified program. Send Return to Work emails to HR and the BSS (as you would with a WCI), but keep in mind that the work restrictions are not tied to any claims or insurance adjusters. Custodial Services is charged with following doctor restrictions to prevent further injury to the employee.
Non Work Related Injury Checklist:
- Provide the Return to Work Release Form to the employee (if applicable)
- Determine if the Return to Work Release Form is complete and includes restrictions and a specified end date to work restrictions, or conclude if the work restrictions on Doctor Note warrant a BFO (see Training Manager for specific instructions)
- Scan the Form or Doctor Note (with restrictions) and save to Common and SharePoint (See Filing Medical Records)
- Confer with Training Manager or Senior Leadership Team Member to determine if employee is eligible for a Modified Program - a Bona Fide Offer must be drafted and signed (see Modifed Program)
- Send email to Contacts with attached scans of WSR and BFO
- Communicate temporary work assignment to BSS verbally
- Send email to BSS with temporary work details (see Email Template)
Email Templates
- Return to Work Communication sample to BSS
- Return Communication sample to HR for non-work related injury with BFO attached
Contacts
Two Emails must be sent. One to BSS to give notification of any changes to assignment:
Subject: Return to Work for (Employee First, Last Name) - Date of Return 0/0/00
TO:
Craft Supervisor (Varies)
CC:
Training Manager or Senior Leadership Team Member (Currently: Elizabeth Saavedra)
Night or Day Shift Manager (Night: Andy Yanez, Day: Seyfi Yazicioglu)
The other email must go to HRSS, which will include a scan of the signed BFO and Return to Work Release Form or WSR. Physical copies must be submitted.
Related articles
Tip
Night Shift BSS are available between 5-5:30 PM as they are required to attend a BSS meeting at the Admin Office.
Tip
Do not include RTW Release Form in email. Be sure to provide temporary work assignment in communication.
