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Return-to-Work Program

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​​Frequently Used Forms


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​ Lost Time Form
​​TMD Plan​
Report of Medical Status​​
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The mission of the Return-to-Work Program is to educate the employer on the importance and benefit of providing modified duty for an employee recuperating from a work-related injury.
This branch plays an integral role by providing agencies the resources and information needed to make the most informed decision regarding their ability to return injured employees to work.​


​Temporary Modified Duty (TMD)​

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If approved by the physician, agencies may be able to provide temporary modified duty to facilitate the transition back to work.
Temporary modified duty can:

          • - Assist the employee in remaining active and productive
          • - Ease employees' concerns about continued employment
          • - Allow skilled, experienced employees to remain on the job
          • - Increase communication with the employer
          • - Reduce or eliminate stress, boredom, or depression caused by an injury
          • - Decrease feelings of dependency or lack of control
          • - Assist employers in maintaining some control over the direction of the workers' compensation claim and costs​

Note: If you have an employee who has been injured on the job and that employee has either started losing time from work or started working modified duty, complete the Lost Time and Return-to-Work Form and submit with any supporting documentation.

If you have an employee who is beginning a modified duty program, you should first review the Report of Medical Status or agency specific Fitness for Duty Form provided by the employee's physician and alter the job tasks to fit the restrictions suggested.
Once specific, productive, and meaningful tasks are identified, a manager can complete the Temporary Modified Duty Plan if applicable. By using the Temporary Modified Duty​ Plan, both employer and employee are clear about what is expected during this time.

Temporary Modified Duty can be altered or canceled at the agency's discretion. However, please be mindful of other employment laws, such as the Family and Medical Leave Act (FMLA) and the Americans' with Disabilities Act (ADA) and all applicable state Statutes and Regulations.

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