Graduated Return to Work

A Graduated Return to Work (GRTW) is recommended for most people returning to work after a serious illness/injury. A GRTW involves developing a plan with your family doctor to gradually build up your work hours and job demands over several days or weeks.

A GRTW allows you to build your activity tolerance for work. This is more successful than trying to return to full hours and duties all at once.

Returning to work usually involves a significant increase in physical and mental activity.

You have likely learned that making gradual progress in other areas, such as exercise or social time, is more effective than a cycle of “overdoing it” and “crashing”.

Similarly, the goal of a GRTW is to start with an amount that will be manageable and take small, sustainable steps toward your regular work hours and job demands.

A GRTW plan typically includes your family doctor’s recommendations for temporary job accommodations (i.e. changes to your job hours or duties) that will make it easier for you to do your work given your current symptoms and abilities.

The GRTW plan should not contain any medical information aside from the recommended job accommodations; you are entitled to the privacy of your medical information.

We will go into detail about common job accommodations for concussion symptoms and the employer’s legal Duty to Accommodate their workers in another article.

A GRTW plan typically includes a schedule for how many hours you should work each day and how many days each week.

A GRTW often begins with two half-days in the first week (i.e. four hours Monday and four hours Wednesday) and builds gradually up to full-time hours at a pace recommended by your doctor. It may be helpful to have a day off in between the work shifts in the early stages. This can vary based on the workplace.

Feel free to take a look at this sample GRTW schedule [pdf].

Once you provide your employer with the GRTW plan, it is your employer’s responsibility to apply the recommended job accommodations. We will discuss this further in the article Employer’s Duty to Accommodate.

Once the necessary accommodations are prepared, you and your employer will agree on a start date to begin your gradual return!