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Return To Work Clearance Letter Template for Indonesia

A Return to Work Clearance Letter is a formal document used in Indonesia that confirms an employee's fitness to resume work duties following an absence due to illness, injury, or other medical conditions. This document, governed by Indonesian labor laws including Law No. 13 of 2003 on Manpower and related health and safety regulations, provides official medical clearance and specifies any necessary workplace accommodations or restrictions. It serves as a crucial documentation tool for employers, employees, and healthcare providers, ensuring compliance with occupational health and safety requirements while protecting both the employee's well-being and the employer's liability concerns.

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What is a Return To Work Clearance Letter?

The Return To Work Clearance Letter is a critical document in Indonesian employment practice, required when employees resume work after a significant absence due to health issues, injury, or medical conditions. This document is mandated under Indonesian labor laws, particularly Law No. 13 of 2003 on Manpower and various health and safety regulations. It serves multiple purposes: providing official medical clearance, documenting any necessary workplace accommodations, protecting employer liability, and ensuring employee well-being. The letter typically includes medical professional certification, specific return date, any work modifications required, and relevant health and safety protocols. It's particularly important in industries with strict safety requirements or where employees perform physical or high-risk tasks.

What sections should be included in a Return To Work Clearance Letter?

1. Letter Header: Company letterhead, date, reference number, and formal addressee details

2. Employee Information: Full name, employee ID, position/role, and department of the employee

3. Absence Information: Brief description of the reason for absence and duration of leave taken

4. Medical Clearance Statement: Clear statement confirming the employee is fit to return to work, referencing any medical assessment conducted

5. Return Date: Specific date when the employee is cleared to resume work

6. Authorization: Name, title, and signature of the authorized medical professional or company doctor providing clearance

What sections are optional to include in a Return To Work Clearance Letter?

1. Work Modifications: Details of any temporary or permanent workplace modifications, restrictions, or accommodations required - include when there are specific medical recommendations

2. Follow-up Requirements: Any required follow-up medical appointments or assessments - include when ongoing medical monitoring is needed

3. Gradual Return Plan: Schedule for phased return to work if applicable - include when employee requires gradual reintegration

4. Health and Safety Protocols: Specific health and safety measures to be followed - include during pandemic or specific health risk situations

What schedules should be included in a Return To Work Clearance Letter?

1. Medical Assessment Form: Detailed medical evaluation form completed by the healthcare provider

2. Work Modification Details: Detailed description of any required workplace adjustments or restrictions

3. Return to Work Schedule: Detailed timeline for gradual return to work if applicable

Authors

Alex Denne

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

Jurisdiction

Indonesia

Publisher

Genie AI

Document Type

Return to Work Form

Cost

Free to use

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