Comité SST

Progressive return to work: Elements to consider

Caroline had a work accident a few months ago. Her physician decided to put her off work so that she could receive the care and treatment required by her condition. Now recovered and without aftereffects, it is the opinion of her physician that she can go back to work, but ideally on a gradual basis. Hereafter are certain elements to consider in order that this step is a success for Caroline.

Returning gradually to work is called a “progressive return” for the worker whose injury is consolidated, that is, no improvement in her condition is foreseen. Naturally, it is up to the treating physician (the worker’s physician) to determine the right time for this return to work, because it is him who knows the medical situation of his patient. It should also be pointed out that there should not be any pressure put on this return, or rushed contrary to the physician’s opinion.

It is also up to the physician to evaluate if a progressive return is relevant or not. In order to make an informed decision, the healthcare professional can, before her doctor’s appointment, draw up a list of points that she would like to discuss with him. She must make sure to properly explain to him her understanding of the type of return that he is suggesting, and to ask him the necessary questions for specifying the parameters. Establishing a list of her questions first will enable her to address all of her concerns.

It must be understood that a progressive return is associated with a progression in time (and not with a progression in taking on tasks, because the worker has recovered and can return to her pre-injury job). Thus, the physician will give his opinion on the number of hours per day or on the number of days per week, and the number of weeks which will make up the worker’s reintegration to work, as the case may be. It is also possible that he will indicate if the days of work cannot be consecutive, or even the number of consecutive days allowed.

The purpose of a progressive return is to promote the best possible reintegration to work. If it is well planned, in certain cases it can reduce the risks of a relapse, recurrence or aggravation of the employment injury. Obviously, like for the other files of this nature, it is important that the worker inform her employer of any problem that she might encounter and which might compromise not only her reintegration, but especially her health and safety. It is also recommended to contact her local union team to obtain the necessary support.

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If, however, the worker remains with a permanent impairment and with functional limitations after her consolidation, her return to work will be more complicated and will require a more specific follow-up. Refer to your local union team to learn more, or consult the Your OHS file in 10 steps brochure.

It is important not to confuse “progressive return” and “temporary assignment”. The first applies to the worker whose employment injury is consolidated and who is able to return to work to the job she had before. The second applies to the worker who, because her injury is not consolidated, is not able to carry out her usual activities for a certain period of time. Her employer can then temporarily assign her work, while waiting for her to become able to return to her job, or even to perform suitable employment.

Unfortunately, the employer is not obliged to accept a request for a progressive return. The physician’s opinion is therefore used as a recommendation for the good of the worker and not an obligation.