Does the employer have to accept the plan?

Not every element, but they cannot ignore it. The Disability Discrimination Act requires an employer to make reasonable adjustments unless doing so would cause unjustifiable hardship, and the Fair Work Act's general protections prohibit adverse action because of illness or disability. In practice the letter is a proposal the manager and the employee work from; where an element cannot be accommodated, the employer should say why and propose an alternative, and you can adjust the medical parameters if the alternative is clinically acceptable.

Should the letter name the condition?

No, unless the patient decides it should. A manager needs to know what the person can do, in what conditions, for how long, and when it will be reviewed. None of that requires a diagnosis. Where the patient wants adjustments that only make sense with some explanation, they choose what to disclose, with the knowledge of who will read it.

What about pay during reduced hours?

Not the letter's business, and it should be silent on it. Whether reduced hours are paid pro rata, topped up with leave, or otherwise arranged is between the employee and the employer under their award, agreement or contract. A letter that wanders into pay loses its standing as a medical document.

How long should a graduated return take?

There is no fixed rule. Weeks to a few months is typical, and the plan should be driven by review rather than by a calendar fixed at the start. What matters is that each phase has a date, each review has a date, and the plan says what happens if a review finds the person is not ready for the next step.

What if the return stalls or the person deteriorates?

The plan should say in advance: step back to the previous phase, hold there, and review at a stated interval, with the medical certificate re-issued to match. A setback that the plan anticipated is a pause; one it did not is a crisis for the manager and a failure for the plan.

Is this the same as a WorkCover return-to-work plan?

No. Where a workers' compensation claim exists, the scheme's return-to-work process applies, with a return-to-work coordinator, scheme forms and obligations on the employer that the scheme enforces; the WorkCover guide and presets in this library cover that. This letter is for a return after a mental health absence outside a claim, where the employer's obligations come from the Fair Work Act, the Disability Discrimination Act and work health and safety law.

The graduated return-to-work letter: a plan a manager can roster, without the diagnosis

What this letter is for

The patient has been off work with a mental health condition and is ready to go back, gradually. Two people at the employer need something from you: the manager or return-to-work coordinator who has to roster the person's hours and duties week by week, and HR, who needs a document on file that supports the arrangement. Neither is a clinician. Both need the medical parameters of the return in terms they can act on, and neither needs the diagnosis.

The letter is delivered with the patient's consent, and usually by the patient. It sits alongside the medical certificate (which certifies capacity) and any accommodation letter (which requests adjustments), and it is distinct from a workers' compensation return-to-work plan, which runs under a scheme with its own coordinator and forms.

The frame the employer works in

The employer's obligations come from three places, and knowing them makes the letter easier to write. The Fair Work Act protects the employee from adverse action because of illness or disability. The Disability Discrimination Act requires reasonable adjustments unless they would cause unjustifiable hardship. Work health and safety law requires the employer to look after the returning worker and everyone around them, which is why a manager will want restrictions they can actually implement. And privacy law means the employer is entitled to information about capacity relevant to the role, not to the diagnosis.

The letter therefore speaks in capacity and conditions. It proposes; it does not direct. And it leaves the operational plan, who covers what, how the roster changes, to the people who own the roster.

What it must contain

The patient's name and the date of your assessment, and that the letter is provided at the patient's request.
The start date, and confirmation that the person is fit to begin a graduated return from it.
The phases. For each: dates, hours per day and days per week, the duties to be resumed, and the duties to be held back. Three to five phases is usual. A manager should be able to roster from this section alone.
The conditions. Environmental and organisational restrictions in functional terms: no night shifts, no lone working, no client-facing work, no on-call, a predictable start time. Each one something a roster can carry.
Supports. A named workplace contact, scheduled check-ins, a quiet workspace, flexibility around appointments. Requests, not requirements, unless they are adjustments the person needs.
Review points. Dates, who reviews (you, at each phase boundary), and that progression to the next phase depends on the review.
Setbacks. What happens if a review finds the person not ready: hold the phase or step back one, review again at a stated interval, certificate re-issued to match.
The end point. The phase at which full duties resume, and what would confirm it.
What the letter does not cover. Pay, leave arrangements and the operational roster, which are for the employee and employer.
Your identification and signature, on letterhead.

Building the phases

Start lower than the person expects, step up on review rather than on a fixed calendar, and change one thing at a time where possible: hours before duties, or duties before hours, but not both in the same step. Hold back the duties that carry the most load early, named functionally (high-conflict interactions, deadline-critical work, supervision of others), and bring them back in a stated later phase. Put the first review within the first fortnight. A plan that runs eight weeks with no review point is a guess with dates on it.

Where plans fall short

Hours are stated without duties, so the manager fills the hours with whatever needs doing, which is usually the hardest work.
Restrictions are clinical rather than functional, and the roster cannot carry them.
The plan is a fixed calendar with no review points and no owner of the review.
Setbacks are not anticipated, so the first bad week ends the plan.
The diagnosis appears, when the patient did not choose to disclose it.
The letter drafts the operational roster, or pay, and loses standing as a medical document.
There is no named contact and no check-in, so problems surface only when they are serious.
The plan and the medical certificate disagree on hours or dates.

A skeleton that works

To [Manager / HR contact], [Employer]

Re: [Name]. Graduated return to work.

I assessed [Name] on [date]. This letter is provided at [his / her / their] request to support a graduated return to work. [Name] is fit to begin a graduated return from [date] on the following basis.

Phase 1, [dates]. [x] hours per day, [y] days per week. Duties: [list]. Held back: [list].

Phase 2, [dates]. [...]

Phase 3, [dates]. [...]

Phase 4, [dates]. Full hours and duties, subject to review.

Conditions during the return. [No night shifts / no lone working / no on-call / predictable start time / other, in functional terms.]

Supports requested. [A named contact; a brief scheduled check-in each week; flexibility for appointments; other.]

Review. I will review [Name] at the end of each phase, on or about [dates]. Progression to the next phase depends on that review, and I will confirm each step in writing.

If a review finds [Name] is not ready to progress, the current phase will be held or the previous phase resumed, with review after [interval], and the medical certificate re-issued accordingly.

This letter addresses medical capacity and conditions only. Pay, leave and rostering arrangements are matters for [Name] and [Employer].

[Name, qualifications, AHPRA registration number, provider number, practice, contact, signature, date]

How PsychDispatch drafts this

The Employer - Graduated Return to Work preset drafts the letter in the structure above, from the consultation in which the return was planned, with the phases, conditions and review dates in rosterable terms and the diagnosis left out. Patient Intelligence supplies the functional trajectory across recent consultations and, at each review, what the previous phase set out, so the next letter steps forward from the last rather than restating it. Dates and hours are verified against the source before you sign, the letter is rendered onto your letterhead, and it goes to the employer, with the patient's agreement, by secure link.