Get Return To Work Agreement

Completing the Return To Work Agreement is an essential step in facilitating a successful return to work program for employees recovering from illness or injury. This guide will provide you with clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the Return To Work Agreement online.

1. Use the ‘Get Form’ button to access the Return To Work Agreement. This will allow you to open the form in your preferred online editor.
2. Fill in Part A, which includes employee details. Enter the employee's title, surname, and given names. Include their date of birth, payroll number, QSuper claim number, standard hours per fortnight, superannuable salary, substantive position, fax number, and email address.
3. Proceed to Part B for employer details. Fill in the department name, the rehabilitation and return to work coordinator's name and phone number, along with the supervisor's name and phone number.
4. In Part C, provide program details. State the program goal, return to work position, and location. Include the medical condition as stated by the treating medical practitioner, the program length, start date, and end date.
5. Complete the weekly breakdown in Part C, detailing the substantive hours and program hours for each day of the week. Indicate duties to be performed along with any restrictions or supports required for the employee.
6. In Part D, have the employee declare their understanding of the agreement by entering their surname, given names, work phone number, work email address, and signature. Ensure the date of signing is included.
7. If applicable, have the supervisor complete Part E by providing their signature and date to confirm the plan will be implemented.
8. In Part F, the rehabilitation and return to work coordinator should check the appropriate boxes regarding the discussion and supporting medical evidence. They must also sign and date the section.
9. Part G requires details about the treating medical practitioner, including their surname, given names, postal address, specialty, and phone number, alongside a signature acknowledging their support for the agreement.
10. Once all sections of the agreement are completed, ensure that it is sent to QSuper Insurance Management via email, fax, or post as directed.

Start filling out the Return To Work Agreement online to ensure a smooth transition back to work.