RETURN TO WORK PLAN

Worker Details Name: John Smith Job Title: Qualified Carpenter Date of Injury: 15 March 2024 Date of Return to Work: 1 April 2024 Claim Number: WC-8839201

Plan Details Plan Review Date: 15 April 2024 Supervisor: Mike Jones (Site Manager) Medical Practitioner: Dr. Sarah Lee (Sydney Medical Centre)

Medical Capacity This plan is based on the medical advice provided by Dr. Sarah Lee on 28 March 2024. The current medical capacity indicates the worker can perform light sedentary duties only. No lifting over 5 kilograms. No prolonged standing or sitting. No overhead work. No working at heights.

Proposed Duties The following duties are proposed for the worker during this recovery period:

1. General tidying of the site shed and workshop area.
2. Ordering and checking off materials deliveries.
3. Answering phone calls and updating the daily site diary.
4. Assisting with basic tool inventory checks.

Hours of Work Start Time: 7:00 AM Finish Time: 11:00 AM Days: Monday, Wednesday, Friday Total Hours Per Week: 12

Workplace Modifications List any changes made to the workplace or equipment to assist the worker:

1. A chair with lumbar support has been provided for the shed office.
2. Materials are delivered to the ground floor to avoid using stairs.

Risks and Controls List specific risks related to the injury and how they are controlled:

• Risk: Aggravation of back injury by lifting heavy tools. Control: John is not permitted to lift toolboxes. He must ask apprentices to move heavy items.
• Risk: Slips or trips while walking on uneven ground. Control: John is to remain in the concrete slab area of the site or inside the shed.

Signatures By signing below, we agree to the details of this Return to Work Plan.

Worker Signature: J. Smith Date: 1/04/2024

Employer/Supervisor Signature: M. Jones Date: 1/04/2024