Return To Work Arrangements
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3RETURN TO WORK ARRANGEMENTS
(INCLUDES PROPOSED SUITABLE OR PRE-INJURY EMPLOYMENT)
Note: These return to work arrangements are not a new employment contract.
These arrangements will be reviewed over time to ensure that the duties and hours are consistent with your capacity for work and are helping to progress your
return to work.
For information about developing return to work arrangements see page 3.
DETAILS
These return to work arrangements are for
Name of worker
WorkSafe claim number
Pre-injury work
Job title
Days/hours of work
Location
Name of employer
RETURN TO WORK ARRANGEMENTS
Duties or tasks to be undertaken
Describe the specific duties and tasks required. Include any physical and other requirements, e.g. lifting, sitting, rotation of tasks, etc.
Workplace supports, aids or modifications to be provided
Describe workplace supports, aids or modifications, e.g. rest breaks, buddy system, special tools, equipment, training, etc.
Specific duties or tasks to be avoided
Describe the specific duties and tasks that are to be avoided or restricted, e.g. no loading pallets, tasks that are only to be undertaken with the
assistance of another worker.
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Parent category: Business