A return-to-work assessment is a review, after sickness absence or injury, of whether a worker can come back to work and on what terms: which duties, which hours and which workplace adjustments. It brings together medical advice, such as a fit note or an occupational health opinion, and the employer’s risk assessment, and should lead to a return-to-work plan agreed with the worker. For the job-specific health judgment behind it, see fitness-to-work.
What HSE expects in Great Britain
HSE’s guidance on managing sick leave and return to work names the Equality Act, the Employment Rights Act and the Health and Safety at Work etc Act among the relevant laws. It says employers should:
- keep in contact with workers who are off sick, focused on their health, safety, well-being and return to work;
- consider workplace adjustments, such as shorter hours, flexible or part-time working, or adapted work equipment;
- review the risk assessment where a worker’s health condition makes them or others more vulnerable, or where adjustments could affect others;
- get professional advice on fitness-to-work or adjustments, for example from occupational health providers, nurses, occupational therapists, pharmacists, physiotherapists or doctors.
HSE’s best-practice principles, which describe good practice rather than the law, add that contact should happen in the first four weeks of absence, that the return-to-work plan should be prepared before the worker comes back with their input and agreement, and that phased returns can help a gradual, supported return. Risk assessments should be reviewed if the absence was caused by work-related injury or ill health.
How the fit note feeds in
The UK Department for Work and Pensions fit note guidance for employers explains the Statement of Fitness for Work:
- Doctors, nurses, occupational therapists, pharmacists and physiotherapists can issue it.
- The professional records either “not fit for work” or “may be fit for work”, with options for a phased return, altered hours, amended duties or workplace adaptations.
- The advice is about general fitness for work, not just the worker’s current role, and the employer is not obligated to agree.
- Workers do not need a fit note to come back: “People do not need to be signed back to work.”
- The employer must keep the worker’s medical details confidential, available only to those who genuinely need them, such as HR (see employee health records vs personnel files).
United States
EEOC guidance under the Americans with Disabilities Act allows disability-related inquiries or a medical exam when a worker returns from medical leave if the employer has a reasonable belief that a medical condition will impair essential job functions or that the worker will pose a direct threat. Any exam must be limited to what is needed to assess the ability to work, usually the condition behind the leave.
MyC helps teams coordinate absence, workplace adjustments and return to work on one occupational health platform.
Related terms
- Fitness-to-work: Fitness-to-work is an assessment of whether a worker's health lets them do a specific job safely, without danger to their own health or that of others.
- Health surveillance: Health surveillance is a program of repeated health assessments for workers still exposed to a hazard after controls, to identify ill health caused by work.
- Employee medical record: Employee medical record, under OSHA 29 CFR 1910.1020, means a record of an employee's health status made or kept by a physician, nurse or health care staff.