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How do I fill this out?
Filling out the Return to Work Certification form is straightforward. First, gather all necessary medical documents and identification information. Ensure that all sections are completed accurately before submission.

How to fill out the Return to Work Certification Instructions?
1
Complete the associate information in Section A.
2
Obtain the necessary medical release from your healthcare provider.
3
Ensure any restrictions are noted in Section B.
4
Provide the form to your manager or HR on your return.
5
Submit your completed form to Sedgwick via email, fax, or upload.
Who needs the Return to Work Certification Instructions?
1
Employees returning from medical leave need the form for compliance.
2
HR personnel require it to track employee leave and accommodations.
3
Healthcare providers need the form to certify the associate's fitness for work.
4
Managers need it to plan for employee transitions back to work.
5
Workplace safety officers may need it to assess necessary accommodations or adjustments.
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1
Open the PDF in PrintFriendly's editor.
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Use the text fields to enter your information.
3
Make necessary adjustments to any sections as needed.
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5
Download the final version for submission.

What are the important dates for this form in 2024 and 2025?
Important dates related to the Return to Work Certification in 2024 and 2025 will depend on company-specific timelines for leave eligibility and medical certification. Keep track of these dates for timely filing of your certifications to avoid disruptions to your employment.

What is the purpose of this form?
The purpose of the Return to Work Certification form is to verify that an employee is fit to return to their role after a medical leave. This form ensures compliance with workplace policies and facilitates necessary accommodations based on health status. Proper completion of this form can help both employees and employers manage health-related workplace transitions effectively.

Tell me about this form and its components and fields line-by-line.

- 1. Associate Information: Personal details such as name, WIN, and contact information.
- 2. Leave Dates: The dates when leave began and when the return is expected.
- 3. Medical Release: Certification by the healthcare provider regarding fitness to work.
- 4. Restrictions: Any restrictions the associate may have when returning to work.
- 5. Manager Instructions: Guidance for managers on accommodating returning associates.
What happens if I fail to submit this form?
If the Return to Work Certification form is not submitted, the employee may face delays in their return to work. This could affect both the employee's health management and the employer's compliance with workplace regulations.
- Delayed Return: Failure to submit may lead to extended leave periods.
- Non-compliance Issues: Absence of documentation can lead to HR complications.
- Inadequate Accommodations: Without the form, necessary workplace adjustments may not be made.
How do I know when to use this form?

- 1. Post-Medical Leave: For employees timing their return after medical leave.
- 2. Employer Compliance: Used by employers to ensure all employees are fit to perform their tasks.
- 3. Requirement for Accommodations: Essential for notifying HR about any necessary work adjustments.
Frequently Asked Questions
What is the purpose of the Return to Work Certification?
This certification ensures that associates returning from medical leave are fit to resume their responsibilities.
How do I obtain this certification form?
The form is accessible through PrintFriendly, where you can fill it out online.
Who completes Section B of the form?
Section B is completed by the healthcare provider certifying the associate's ability to return to work.
How do I submit the form?
You can submit the completed form by uploading it, emailing, or faxing it to Sedgwick.
What should I do if I have restrictions?
Ensure that all restrictions are clearly noted in the medical release section for necessary accommodations.
Can I download the form for offline use?
Yes, after editing, you can download the form to your device.
Do I need to inform HR before submitting the form?
Yes, it's recommended to inform HR to facilitate a smooth transition back to work.
What happens if I forget to submit the form?
Failure to submit may delay your return to work; it's crucial to complete this step.
Is electronic signing acceptable?
Yes, electronic signatures are accepted on the PDF.
How can I ensure my information remains secure?
Use PrintFriendly’s secure editing tools to safeguard your information during the editing process.
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