In brief
Law No. 6331 requires a return-to-work examination after repeated absences due to a work accident, occupational disease or health reasons if the employee requests it, and an examination on a change of job in every case. The workplace physician assesses the employee's fitness for their previous job; if there is an objection, the physician recommends a job suited to their state of health and submits it for the employer's approval. A phased return plan is the most practical way to prevent re-injury and long-term absence.
What is a return-to-work examination, and when is it carried out?
A forklift operator returning to the warehouse six weeks after herniated disc surgery, an accountant returning to the desk after a heart attack and an operator who caught a hand in a press and was treated for months all face the same question: can I go straight back to my old job? The return-to-work examination is the examination that seeks the answer to this question in light of the demands of the job.
The basis is Art. 15 of Law No. 6331 on Occupational Health and Safety. The Law requires the employer to have employees' medical examinations carried out in four situations; two of them are the subject of this article:
| Situation | Basis | Mandatory? |
|---|---|---|
| Return to work after repeated absences due to a work accident, occupational disease or health reasons | Law Art. 15/1-b-3 | Carried out if the employee requests it |
| Change of job | Law Art. 15/1-b-2 | Carried out in every case |
| Pre-employment | Law Art. 15/1-b-1 | In every case |
| Periodic | Law Art. 15/1-b-4 | At intervals determined by hazard class |
Art. 9 of the Regulation on the Duties, Authority, Responsibilities and Training of Workplace Physicians and Other Health Personnel also describes the physician's duty: to carry out a return-to-work examination after employees' repeated absences for health reasons, if they request it, and, for those whose work in their previous job is found objectionable, to recommend that they be given a job suited to their current state of health and submit this for the employer's approval.
The phrase "if requested" does not mean the examination should not be carried out. Reminding an employee returning after major surgery or a serious accident that an examination is available protects both the employee and the employer. Based on the risk assessment, the employer can make a return-to-work interview the workplace's standard procedure for certain situations.
The difference between a sick-leave report and a return-to-work assessment
The sick-leave report given by the treating physician shows how long the employee cannot work. The end of the report does not mean the employee is ready for any job. The treating physician usually does not know the employee's job, the loads they lift, their shift or the chemicals they are exposed to.
The workplace physician's assessment, by contrast, is job-specific. Of two people returning from the same back surgery, the office worker may be able to return to full hours on the first day, while the warehouse worker who moves heavy pallets may need to work with a lifting restriction for several weeks. This difference is the reason the return-to-work examination exists.
Returning to work after long illness or surgery: what does the physician look at?
In assessing return to work after a long illness or return to work after surgery, the physician compares the employee's state of health with the demands of the job. Typical headings:
- Physical capacity: Lifting, pushing and pulling, prolonged standing, work requiring stairs and height.
- Effects of medication: Medicines that cause drowsiness or reduce attention; particularly important for forklift, crane and machine operation.
- Wounds and healing: Whether the surgical wound is suitable for a dirty, hot or chemical environment; the risk of herniation or wound reopening with heavy work.
- Exposures: Dust or fumes after lung disease, chemical exposure after skin disease.
- Shift and night work: Medication times and sleep patterns in chronic illnesses.
- Psychological readiness: Returning to the same machine after a serious accident can cause anxiety.
A short preparatory interview with the employee before the examination makes the work easier. The employee is asked to bring the documents they have, such as a discharge summary, surgery notes or discharge certificate; and a short description of the job is obtained from the department manager: how many times a day and what weight of load is lifted, which machine is used, what is the shift pattern? When the physician puts these two pieces of information side by side, the assessment is based on the real demands of the job, not on guesswork.
With the employee's consent, the physician may request information from the treating physician. The assessment usually ends with one of three outcomes: fit, fit with restrictions (certain tasks are not done for a certain period) or temporarily unfit.
Phased return to work and job adjustment
Starting at full load on the first day after a long break is one of the most common causes of re-injury and further sick leave. A phased return plan prevents this. As an example, a plan prepared on the physician's recommendation for an employee returning to the warehouse after herniated disc surgery:
| Period | Tasks | Restriction | Check |
|---|---|---|---|
| Weeks 1–2 | Barcode scanning, stock counting, system entry | No manual lifting, alternating sitting and standing | Physician interview at the end of the week |
| Weeks 3–4 | Light carton picking | No lifting above the weight set by the physician, no lifting while bending | Monitoring of complaints |
| Weeks 5–6 | Normal tasks, mainly with a pallet truck | No manual straightening of heavy pallets | Physician check |
| After week 7 | Full duties | Restriction lifted or extended | Return to the periodic examination schedule |
The same adjustment is not possible in every workplace. To make the physician's recommendation workable, look at the following options together with the department manager:
- Splitting the task: The heavy part (e.g. straightening pallets) is given to a colleague and the light part to the returning employee.
- Equipment support: A pallet truck, vacuum lifter or height-adjustable table is used instead of lifting.
- Temporary change of duties: Work such as quality control, stock counting, training support or documentation.
- Shift pattern: A temporary day shift if medication times or sleep patterns require it.
- Break pattern: Short breaks that interrupt prolonged standing or staying in the same position.
A temporary change of duties is also a change of job; if the exposures of the new job are different, the physician assesses this too.
The plan should be in writing and known to three parties: the employee, the department manager and the physician. If the restriction is not applied on site, even the best plan becomes useless; the department manager should make sure the employee is not sent to restricted tasks. For lifting technique and ergonomic arrangements, see our article on manual handling and lifting technique. If a change in working hours is involved, this should also be assessed separately with HR from an employment law perspective.
Training obligations after a work accident and a long absence
Returning to work is not just a health matter. Art. 17 of the Law requires additional training in two situations:
- After a work accident or occupational disease: Before starting work, the employee is given additional training on the causes of the accident, ways of protection and safe working methods.
- After an absence of more than six months: An employee who has been away from work for more than six months for any reason is given refresher training before starting work.
We explained everything to do on return to work after an accident step by step in our article on what to do after a work accident. An accident is also one of the situations that require the risk assessment to be renewed regardless of its review period.
The change-of-job examination: a frequently skipped requirement
Unlike the return-to-work examination, the change-of-job examination does not depend on the employee's request. An employee moving from the warehouse to the paint line is now exposed to solvent vapour, and an operator moving from the press to the welding department to welding fumes and a different noise level. New exposure means a new examination and, if necessary, new tests.
In practice a change of job often happens by a shift supervisor's decision without the OHS team knowing. The way to prevent this is to add a line "workplace physician examination carried out" to the change-of-duties form. You can find which tests are required for which exposure in our article on periodic examinations and tests.
The return-to-work report: records and confidentiality
At the end of the examination, the physician issues a return-to-work report or assessment note. The part of this document that concerns the manager is not the diagnosis but the outcome and restrictions: which tasks the employee cannot do, for how long, and when the follow-up examination is.
The change of duties recommended by the physician is submitted for the employer's approval. If the employer cannot implement the recommendation, it should discuss this with the physician and look for an alternative arrangement; sending the employee to a job found objectionable creates serious liability in the event of an accident.
Linking return-to-work and change-of-job examinations to the health surveillance calendar is part of our health surveillance and workplace physician services; we plan tests with authorised laboratories and health institutions. You can use the OHS calendar to track follow-up examination dates.
Frequently Asked Questions
Is the return-to-work examination mandatory?
The Law provides for the examination on return to work after repeated absences due to a work accident, occupational disease or health reasons as an examination carried out if the employee requests it. On a change of job, however, the examination is mandatory in every case. Reminding the employee of this option after major surgery or a serious accident is good practice.
Can the employee return to their old job as soon as the sick-leave report ends?
The sick-leave report shows the period during which the employee cannot work; it does not assess job-specific fitness. For jobs involving heavy physical work, machine operation or special exposures, planning the return with the workplace physician's assessment is recommended.
What happens if the physician finds the employee unfit for their old job?
The physician recommends that the employee be given a job suited to their current state of health and submits this for the employer's approval. Restrictions are usually temporary and are reassessed at a follow-up examination.
Does the return-to-work report state the name of the illness?
The document shared with the manager contains not the name of the illness but the work-related restrictions and their duration. Health information is confidential by law, and detailed records are kept in the health file.
An exposure-based test plan, pre-employment and periodic examinations, confidential health files and an examination schedule tracked per person.
Bursa SİSTEMER OSGB Technical Team — written from the field experience of our OHS specialists and workplace physicians. Legal information is valid as of the publication/update date; contact us for an assessment specific to your business.