Injured Worker Checklist


I. Injured Worker After Injury

Worker received first aid or medical treatment

Notified worker's family or next of kin

Obtained written authority from the worker for release of information

Discussed RTW with the worker, doctor and/or insurer

Discussed preventive measures with the worker to avoid recurrence

II. Injured Worker During Recovery

Maintained regular contact with worker

Briefed worker on RTW process and the role of stakeholders

Assessed RTW barriers and developed strategies

Contacted insurer about RTW

III. Return to Work Planning/Suitable Duties Program

Identified RTW needs

Host employee discussed with insurer if no suitable duties are available at usual workplace

RTW time/date confirmed with injured worker, supervisor and others

Completed consultations and case conferences with stakeholders

Briefed co-worker about SDP and worker duties

Completed SDP requirements

Shows goals, objectives, timeframes, review date

Consistent with medical certificate/report, worker's injury, experience, education and age

Duties are meaningful and have regard to the objective of the worker's rehabilitation

Copy provided to worker and supervisor

Copy sent to the insurer

Copy kept on worker's file

Completed required worker interactions

Support needs identified

Met at start of first day to explain RTW process

Monitored for pain/distress on first day

Asked for feedback after first day of RTW

IV. Improvement Planning
Obtained feedback from the following

Worker still employed 12 months later?

Completed by: