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Medical Leave Return To Work Form

Medical Leave Return To Work Form Template for Germany

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Key Requirements PROMPT example:

Medical Leave Return To Work Form

"I need a Medical Leave Return To Work Form for our Berlin-based tech company that complies with German law, includes standard medical clearance requirements, and has sections for both the company doctor and direct supervisor to sign off on the employee's return."

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Document background
The Medical Leave Return To Work Form is a crucial document used in German workplaces to manage and document an employee's return to work following a period of medical leave. It is required under various German labor laws, including the Entgeltfortzahlungsgesetz (EFZG) and Sozialgesetzbuch IX (SGB IX), particularly when an employee has been absent for more than six weeks. The form serves multiple purposes: it confirms medical clearance for return to work, documents any necessary workplace accommodations or restrictions, outlines the return schedule (including any graduated return plan), and ensures proper communication between all relevant parties. This document is essential for legal compliance, risk management, and ensuring a safe and appropriate return to work process while protecting both employer and employee interests.
Suggested Sections

1. Employee Information: Basic details including name, employee ID, department, and regular position

2. Leave Information: Details of the medical leave period, including start and end dates

3. Medical Clearance: Confirmation from healthcare provider about fitness to return to work, with any applicable restrictions or modifications

4. Work Capacity Declaration: Statement of current work capacity (full or partial) and any limitations

5. Required Workplace Accommodations: Specific modifications or adjustments needed for the return to work

6. Return Schedule: Planned date of return and schedule details, including any graduated return plan

7. Signatures and Approvals: Space for employee, supervisor, HR representative, and medical professional signatures

Optional Sections

1. Follow-up Medical Appointments: Schedule of upcoming medical appointments if ongoing treatment is required

2. Risk Assessment: Evaluation of workplace risks relative to the employee's condition, used when returning from serious illness or injury

3. Emergency Response Plan: Special procedures in case of medical emergencies, required for certain medical conditions

4. Performance Limitations: Detailed description of any temporary performance limitations, used for complex medical situations

5. BEM Protocol Reference: Reference to Betriebliches Eingliederungsmanagement (BEM) protocol, required for absences longer than 6 weeks

Suggested Schedules

1. Medical Provider Statement: Detailed medical clearance form completed by healthcare provider

2. Graduated Return Schedule: Detailed weekly schedule for stepped return to work, if applicable

3. Workplace Modification Checklist: List of required workplace adjustments and their implementation status

4. Employee Rights Information: Summary of employee rights and responsibilities during return to work process

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions

























Clauses
















Relevant Industries

Healthcare

Manufacturing

Information Technology

Financial Services

Retail

Education

Public Sector

Construction

Transportation

Hospitality

Professional Services

Energy

Telecommunications

Pharmaceutical

Automotive

Relevant Teams

Human Resources

Occupational Health and Safety

Legal

Compliance

Operations

Employee Relations

Risk Management

Medical Services

Personnel Administration

Benefits Administration

Relevant Roles

Human Resources Manager

HR Business Partner

Occupational Health and Safety Manager

Company Doctor

Personnel Administrator

Benefits Coordinator

Employee Relations Manager

Risk Management Officer

Workplace Safety Coordinator

Compliance Officer

Department Manager

Line Supervisor

HR Director

Operations Manager

Disability Management Specialist

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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