Return-to-work kit for small employers
Three free templates for bringing an injured or ill employee back to work: a modified duties offer letter, a gradual return-to-work plan and a meeting checklist. Edit the parts in brackets.
1. Modified duties offer letter
[Date]
Dear [Employee name],
We want to support your return to work after your [injury / illness] on [date]. Based on the functional abilities information from [your health care provider / the Workers' Compensation Board] dated [date], we are offering you modified duties that fit within your current restrictions.
| Item | Details |
|---|---|
| Start date | [date] |
| Position and duties | [list the tasks, e.g. front counter, inventory counts, phone orders] |
| Tasks you will not do | [e.g. lifting over 10 kg, ladders, repetitive overhead reaching] |
| Hours | [e.g. 4 hours a day, Monday to Friday, 9 am to 1 pm] |
| Pay | [hourly rate or salary for these hours] |
| Supervisor and check-ins | [name]; we will meet every [week] to review how it is going |
| Review date | [date] |
These duties are temporary and will change as your abilities change. If any task causes pain or goes beyond your restrictions, stop and tell [supervisor] right away. Please let us know by [date] whether you accept this offer. If you have questions, or your health care provider has concerns, contact [name and phone].
Sincerely,
[Name, title]
I accept the modified duties described above. ____________________ Date: __________
2. Gradual return-to-work plan
| Employee | [name] | Plan start | [date] |
|---|---|---|---|
| Restrictions | [from the functional abilities form, e.g. no lifting over 10 kg; sit or stand as needed] | ||
| Goal | [e.g. back to regular duties and full hours by (date)] | ||
| Week | Hours a day | Days a week | Duties | Check-in notes |
|---|---|---|---|---|
| 1 | [4] | [3] | [modified duties] | |
| 2 | [4] | [5] | [modified duties] | |
| 3 | [6] | [5] | [modified, adding (task)] | |
| 4 | [8] | [5] | [regular duties if cleared] |
Signed by the employee, the supervisor and, where there is one, the union or WCB case worker. Update the plan whenever restrictions change.
3. Return-to-work meeting checklist
- Have the latest functional abilities or restrictions information. Ask about abilities and limits only, never the diagnosis.
- Agree on duties, hours and pay in writing (letter above).
- Name one contact person and set the check-in schedule.
- Agree what to do if a task hurts: stop, tell the supervisor, adjust the plan.
- Tell co-workers only what they need to know to work alongside the employee.
- Keep medical information separate from the regular personnel file.
- If you are registered with a workers' compensation board, keep the board updated on the offer, hours worked and any change.
- Write down every offer and every check-in, with the date.
Before you use it
- Base duties on the restrictions you have in writing, not on guesses about the condition.
- Employers have a duty to accommodate under human rights law, up to undue hardship. A return-to-work offer is one way to meet it, not the end of it.
- Some provinces add a legal duty to re-employ injured workers for certain employers. Check your workers' compensation board's rules.
Related
WCB claim cost calculator · WCB premium calculator · Accessible hiring pack · All templates
General information, not legal or medical advice. Checked November 11, 2026.
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