Return To Work Advisory Services

Frances
International SOS
PROCEDURES
MEDICAL SERVICES
Return to Work Advisory Services
Return to Work Advisory Services - A Topside

Support feature linked to WIICM ProcedureDesigned
for International Offshore operations only (excluding
North Sea)
Linked to Standards for Occupational Health
Version 1.01
Document Owner: Medical Services

Document Manager: Group Medical Director Occupational Health Services
Effective Date: 01 January 2016
© 2014 International SOS, all rights reserved. No text contained in these materials may be
reproduced, duplicated or copied by any means or in any form, in whole or in part, without
the prior written permission of International SOS.
The only controlled copy of this document is maintained electronically. If this document is
printed, the printed version is an uncontrolled copy.
PROCEDURES
© 2014 International SOS, all rights reserved. No text contained in these materials may be
reproduced, duplicated or copied by any means or in any form, in whole or in part, without
the prior written permission of International SOS.
The only controlled copy of this document is maintained electronically. If this document is
printed, the printed version is an uncontrolled copy.
Return to Work Advisory Services - A Topside Support feature linked to WIICM ProcedureDesigned for International Offshore operations only (excluding North Sea)
Version 1.01
01 January 2016
International SOS
Medical Services Return to Work Advisory Services - A Topside Support feature linked to WIICM Procedures & Processes
ProcedureDesigned for International Offshore operations only (excluding North Sea)
LINK TO STANDARD: Standards for Occupational Health DOCUMENT OWNER: Medical Services
EFFECTIVE DATE: 01 January 2016 DOCUMENT MANAGER: Group Medical Director Occupational Health Services
Revision History
Revision Rev. Date Description Prepared by Reviewed by Date Approved by Date
Dr. Beau Dees, Dr. Cesar

Vargas, Dr. Charl Van
Loggerenberg, Mr.
Charles Vijay, Dr. David
Teo, Mr. Christophe
Billan, Fanie Jute, Dr.
Fraser Lamond, Mrs.
Joanne Wong, Dr.
Mrs. Alessia Capula, Katherine Sinclaire, Mrs.
22nd
October Mrs. Lorraine Spence, Lorraine Lee, Dr. Mauro Dr. Neil Nerwich, 1st December
1.00 Original Document November
2014 Mr. Mathieu Rosey, Dr. Zambon, Dr. Mike Dr. Olivier LO 2014
2014
Olivier LO Causer, Dr. Nhlanhla
Mpofu , Dr. Olivier
Barles, Dr. Olivier LO Mr.
Dr. Rene De Jong, Mr.
Ricus Groenewald, Dr.
Ryan Copeland, Dr.
Stefanie Kruger,
Mrs.Theresa Burness,
Mr. Usman Qureshi
Change from “MD Guidelines”

January (ReedGroup) to “Official Disability Dr. Olivier LO 14th January 14th January
1.01 Frances Evans Dr. Olivier LO
2016 Guidelines (ODG)” for online return to Joey Botha 2016 2016
work guidelines
Click here to Click here to Click here to

enter a date. enter a date. enter a date.
International SOS Internal Use Only Page 3 of 45

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Responsibilities
It is the responsibility of all Regional & Country Medical Directors, Operations Managers to ensure the procedures in this document are adapted to each location where relevant
Abbreviations and Definitions

Refer to Sections 1.2 Acronyms
References and Attachments

Fitness for Work, The Medical Aspects, Fourth edition; Keith T. Palmer, Robin A.F.Cox, Ian Brown, Oxford University Press
Return to Work Programs by Leslie M. Batterson, CSP, CPEA, Bruce J. Fyfe, CSP, ARM, CPEA, & Deborah Weigand, RM/Insight www.asse.org
Bio-Psychosocial obstacles to return to work, Wadell G Br Med Bull 2006:77-78:55-69
Promoting healthy work for workers with chronic illness: A guide to good practice, European Network for Workplace Health Promotion (ENWHP).
© 2016 All copyright in these materials are reserved to AEA International Holdings Pte. Ltd. No text contained in these materials may be reproduced, duplicated or copied by
any means or in any form, in whole or in part, without the prior written permission of AEA International Holdings Pte. Ltd.

Return to Work Advisory Services - A Topside Support feature linked to WIICM ProcedureDesigned for International Offshore
operations only (excluding North Sea)
Version 1.01
01 January 2016
Return to Work Advisory Services - A Topside Support feature

linked to WIICM ProcedureDesigned for International Offshore
By providing my signature to this document, I commit that I have read, understood and will
comply with the instruction provided within this document
Staff Name Role/ Position Signature Date

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TABLE OF CONTENTS
TABLE OF CONTENTS ............................................................................................................................... 6
1 STRUCTURE OF THE DOCUMENT .............................................................................................................. 8

1.1 TOPICS THAT STRUCTURE THE DOCUMENT - OUTLINED BELOW: ..................................................... 8
1.2 OBJECTIVES ............................................................................................................................. 10
2 RETURN TO WORK URGENT ACTIVATION FROM WORKPLACE ............................................................... 13
2.1 FLOW CHART (SEE BELOW) ...................................................................................................... 13
...................................................................................................................................................................... 14
2.2 URGENT ACTIVATION FROM RESPONSE CENTRE’S PERSPECTIVE................................................ 15
2.2.1 Start of Return to Work process and on-shore referral ................................................................. 15
2.2.2 Use of the Return to Work form .................................................................................................... 16
2.2.3 Territorial Responsibility ............................................................................................................... 16
2.2.4 Briefing of Medical Provider (if within Response Centre Territory) ............................................... 17
2.2.5 Briefing of Assistance Centre (for cases which are not in the Response Centre's lead centre
territory) ………………………………………………………………………………………………………………………………………………..18
2.2.6 Return to Work status assessment ............................................................................................... 19
2.2.7 Return to Work final status ........................................................................................................... 20
2.3 URGENT ACTIVATION FROM ASSISTANCE CENTRE’S PERSPECTIVE.............................................. 21
2.3.1 Start of Return to Work process and on-shore referral ................................................................. 21
2.3.2 Schedule of appointment and reception of patient ...................................................................... 22
2.4 COMMUNICATION BETWEEN MEDICAL PROVIDER AND RESPONSE CENTRE VIA ASSISTANCE CENTRE
2.4.1 Communication with Medical Provider ......................................................................................... 23
2.4.2 Communication with Response Centre ......................................................................................... 23
2.5 URGENT ACTIVATION FROM PATIENT’S PERSPECTIVE ................................................................. 24
3 RETURN TO WORK NON-URGENT ACTIVATION FROM HOME OR FINAL CARE LOCATION ...................... 27
3.1 FLOW CHART – RETURN TO WORK ............................................................................................ 29
3.2 NON-URGENT ACTIVATION PROCESS FROM RESPONSE CENTRE’S PERSPECTIVE ........................ 31
3.2.1 Activation of the process............................................................................................................... 31
3.2.2 Collection of all necessary documentation ................................................................................... 32
3.2.3 Briefing Note to the Employee ...................................................................................................... 34
3.3 COORDINATION OF SPECIALIST (S) REFERRALS (IF NEEDED) ....................................................... 35
3.4 NON-URGENT ACTIVATION PROCESS FROM ASSISTANCE CENTRE’S PERSPECTIVE ...................... 38
3.4.1 Communication between Medical Provider and Response Centre via Assistance Centre............. 38
3.5 NON-URGENT ACTIVATION PROCESS FROM PATIENT’S PERSPECTIVE ......................................... 38
4 SCHEDULE OF FEES ................................................................................................................................. 40
4.1 RETURN TO WORK MEDICAL ADVISORY SERVICE (IF REQUESTED BY THE SUBSCRIBER)................. 40
5 ANNEXES ................................................................................................................................................ 41
5.1 RETURN TO WORK FORM – SECTION B ...................................................................................... 41
5.2 RETURN TO WORK FORM – SECTION C ...................................................................................... 42
5.3 RETURN TO WORK FORM – SECTION D ...................................................................................... 43
5.4 RETURN TO WORK REFERRAL LETTER ...................................................................................... 44

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6 ENFORCEMENT AND REPORTING BREACHES .......................................................................................... 45

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1 STRUCTURE OF THE DOCUMENT
1.1 Topics that structure the document - outlined below:
Practical Application
Objectives Appendices
Responsibilities, step-by-
The aim, scope and step instructions and Supporting materials, quick
learning objectives of the flowcharts supporting the reference guides and
procedure application of Intl. SOS FAQ’s
Return to Work Advisory
To improve readability, icons have been placed in the text:
Golden Rules Examples
In an Offshore context, the Return to Work service is arbitrarily separated into two distinct
processes
 Urgent Activation from Workplace (the offshore installation or asset)
 Non-Urgent Activation from Home or Final Care Location
The Urgent Activation from Workplace represents the first 72 hours (3 days) from the time an
employee is disembarked from an offshore installation to receive medical care on shore.
The 72 hours represent the average period during which an Offshore Installation Manager can
maintain its operation without the injured / ill employee on-board. He will require an employee to
be back to the installation within 72 hours (or consider calling back other replacement within his
organization as alternative) by then.
Intl. SOS is meant to complete the first Return to Work Advisory (Report) back to our client within
the first 72 hours.
The rule of 72 hours may vary from one company to another and is set as minimum standard in
this procedure.
It is the Offshore Installation Manager (or Rig Manager) who has the authority to request urgent
activation of the service (use of Work Order form as confirmation) through the Response Centre
upon disembarkation of the employee.
The Non-Urgent Activation from Home or Final Care Location concerns an injured / ill
employee already disembarked to shore beyond the 72 hours (3 days).
This situation corresponds to either

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 An injured / ill employee extending his care at the onshore vicinity beyond 72 hours following
a disembarkation, or
 An injured / ill employee has been sent back home / third location to a more definitive care
location by employer for further treatment or rest / rehabilitation (with or without Intl. SOS
Assistance involvement).
IT IS TYPICALLY THE CLIENT’S HUMAN RESOURCE (HR) MANAGER – COORDINATOR OR CLIENT’S MEDICAL
ADVISOR WHO HAVE THE AUTHORITY TO REQUEST ACTIVATION OF SUCH SERVICE TO THE INTL SOS
RESPONSE CENTRE.
This document outlines key elements explaining how the service is delivered through
 Flow charts (process flow)
 Return to work Forms (International excluding offshore North Sea in this version)
 Medical Referral Form (template)
 Work Order Form (customizable template)
It is essential to use both, flow chart(s) and the related forms together when delivering this
service.
“Short Term” or “Long Term” absence from work are terms defined by employer’s HR and are
unrelated to “Urgent Activation from Workplace ” / “Non-Urgent Activation from Home ” as defined
in this procedure. “Short Term” absence may vary from 1 day to 30 days while “Long Term”
absence may vary from 6 weeks to months and is used as triggers to manage absenteeism from
work. Do not use “Short Term”/”Long Term” absence wording when providing this service but
“Urgent Activation from Workplace”/ “Non-Urgent Activation from Home / Final Care Location”
instead (or an equivalent naming convention agreed with client if any).
The Return to Work Advisory Service (RTWA) – offshore - is a feature of enhanced Topside
where / when Intl. SOS installation medical personnel (IMP) are positioned on the client’s asset
offshore. This service does NOT apply to companies or geographical regions where Intl. SOS
does not provide medical personnel to the offshore site. In the latter case, do escalate
immediately to the Response Centre Manager for review.
Always check in the client’s operation procedure if any restriction of member’s eligibility to access
to the RTWA service applies. By default, the RTWA service concerns all crew members (intl.
assignees or nationals) directly employed by the Client. Any contractors on a specific offshore
asset may have access to this RTWA service under the direct (financial) responsibility of client
and on a case per case basis. In case of doubt, escalate to the Response Centre Manager for
review.
In a limited number of cases, employers may ask for Offshore Fitness Certificate as addition to the
Return to Work Form used in this procedure, before accepting an employee back to their offshore
asset. This requires Intl. SOS Response Centre to identify and select appropriate medical
provider(s) for issuance of an offshore certificate. Where possible, always attempt to select
approved medical providers that can complete both Offshore certificate and Return to Work Form
at the same time.
The specific situations are:

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 OGUK Fitness Certificate (Oil & Gas United Kingdom) = certificates delivered only by
accredited medical provider, mainly in United Kingdom but also internationally.
 Norwegian Offshore Directorate Certificate = certificates delivered by approved medical
providers typically in Norway.
 Companies having their own list of approved medical providers (i.e. Petronas Carigali
approved medical examiners in Malaysia for offshore certificate)…
 Others
 Do escalate to your Response Centre Operation Manager in such situations.
 Note that medical providers may be searched in SPIN – Service Provider Information
Network- under MedFit category if available in specific countries/locations.
Return to Work process others than offshore work places, especially related to in-country
national/domestic (onshore) fitness assignment is EXCLUDED from the scope of this service
and shall NOT be entertained. This procedure is designed for an international offshore
setting/assignment that may not be aligned with every applicable national / domestic legislation(s).
In such situation, do escalate immediately to the Response Centre Medical Director for review.
For Australasia: If client is requesting to use additionally Worker’s Comp forms, do escalate to
Australasia Occupational Health Medical Director or Group Medical Director – Occupational
Health Services for case direction.
1.2 Objectives
For employees:
The objective of the return to work process is to assist employees to return to productive employment
as quickly and safely as possible following an injury or illness at work.
For employers/clients:
The return to work process is designed to assist employers mitigate operational disruption when
employees are suddenly away from work during a short period of time. In a longer period of time,
such service focuses to assist bringing back employees to work. Statistically only 50% of employees
with disability for 6 months will return to work if left unattended. If employees are off longer than 12
months, only 5% approx. are likely to return to work.
The Return to Work Advisory service consists of coordinating care and medical information between
the following parties:
 Injured / ill employee - worker (with informed consent built into the Return to Work Form)
 Treating physician and/or health care provider (i.e. Family Practitioner or Specialist, others)
 Employer (offshore installation manager or rig manager or human resource HR-
manager/coordinator)
The Intl. SOS team involved in the Return to Work consists of
 The offshore installation medical personnel (IMP)
 The Response Centre (doctors and/or nurses) providing topside support - with support of
the MedFit / Occupational Health doctor team as per agreed procedure
 The Lead Assistance Centre (only as support to Response Centre where required)
Employees may face various “obstacles” preventing them to return to work.

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The related flow chart and forms included in this procedure focus on addressing the biological
dimension of possible disability preventing such return to work (see below).
Where psychological and / or social barriers are identified, issues need to be addressed between
employee and employer. Intl. SOS acts as a facilitator by highlighting the concerns to both parties
and/or may coordinate psychosocial referral and care upon request. Forms have been designed
accordingly.
Figure 1: Bio-psychosocial obstacles to (return to) work and corresponding interventions
AP Authorized Person
CMO Chief Medical Officer
CMT Construction Management Team
EPC Engineering, Procurement & Construction
FDA Food & Drug Administration
RC Response Centre
HCP Health Care Practitioner
HR Human Resource (department)
HSE Health, Safety & Environment
IADC International Association of Drilling Contractors
IIHL Incident, Injury, and Hazard Loss
JSHA Job Safety Hazard Analysis
MERP Medical Evacuation Response Plan
OCIMF Oil Companies International Marine Forum
OGP Oil & Gas Producers
OH Occupational Health
OH&S Occupational Health & Safety

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WII Occupational Injury & Illness

WIICM Occupational Injury & Illness Case Management
OSHA Occupational Safety & Health Administration
OTC Over The Counter
IMP Installation Medical Personnel
IP Injured/ Ill Patient
OIM Offshore Installation Manager
RTW/RTWA Return to Work/Return to Work (Medical) Advisory
MA Medical Advisor
W.O. Work Order

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2 RETURN TO WORK URGENT ACTIVATION FROM WORKPLACE
2.1 Flow Chart (See Below)

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Return to Work (RTW) Advisory

Response Centre 24/7 365 Assistance Centre 24/7 365
-Offshore-
URGENT ACTIVATION FROM WORKPLACE 1
Patient’s Journey
Injured or ill patient receiving care

on-site but needs to be reviewed
2.2.1 Optional
on-shore. RTW form must be 2.3.1
available on-site.
The Lead R.C. provides Topside support & endorses The A.C. ensures medical transfer coordination
the need for referral to on shore. (patient’s movement) with 3rd party medical provider.
A RTW process is identified and recommended. May include:
The Lead R.C. sends to the OIM the Work Order for - GOP-Guarantee Of Payment (upon request)
completion. - Medical Monitoring until discharge (upon request)
No Return to Work process.

The Lead R.C. verifies and ensure that the RTW form Case managed as standard referral
Does OIM or Rig Manager
is duly completed by the IMP on site and receive a Yes No
provide the Work Order ?
copy.
2.3.2 2.3.3 2.2.3.2
2.2.2 2.2.3.1 Yes
Following briefing and transfer of case from Lead R.C.:
1. The Lead R.C. directly brief /correspond with on 1. The A.C. arranges medical appointments and
shore medical provider (treating doctor). 2.2.3 reception of patient in treating medical facility.
2. The Lead R.C. arranges medical appointments and 2. The A.C. may organize a conf call briefing together
reception of patient in treating medical facility. Are the R.C and A.C. in with Medical Provider and R.C. to explain how to
Yes No
3. Completed RTW form is sent to the treating the same territory? complete RTW form.
doctor electronically as back up in case the original 3. RTW form is received and sent to the treating
has not been given to the patient by the IMP or not doctor electronically as back-up in case original has not
handed over to the doctor. been given to the patient by the IMP or not handed
over to the doctor.
Examining Doctor on shore:

1. Provides appropriate medical care to the patient.
2. Prior to patient’s discharge/release, describes patient’s ability /
limitation to perform his job using the provided RTW form.
If the lead A.C. and R.C. are not
2.2.4 in the same territory
2.3.4
The R.C. centralise all RTW information for the RC
Doctor, who will establish contact with patient/ The A.C. reviews and checks the RTW form from
employee (validation) and with the AP (Medical treating Doctor is fully completed and signed. If the
Advisor or OIM or Rig Manager, as per client’s RTW form is not fully completed, A.C. follows up with
procedures) to review the ability for patient to fulfill a call to the treating Doctor. RTW form is sent back to
his job and normal work duties on site (Any the R.C.
restriction ? Any accommodation of workplace?).
Patient / Employee on shore contacted by R.C.

1. Validate information reported by treating doctor
2. Provided with latest update on RTW status
Can the patient be

discharged/released
Yes within 72 hrs2 AND with
the full agreement of the
OIM/HR ?
See Non-Urgent RTW for future

request on the same patient No
2.2.5.2
(specific trigger / flow chart)
Does OIM/HR want to
R.C.Keeps A.P. updated and extend RTW
Yes pursue with this case as a
Urgent Activation case.
Non Urgent RTW case?
Note:
A.C. = Assistance Centre
A.P. = Authorized Person
2.2.5.1 No IMP = Installation Medical personnel
IP = Injured / Ill patient
R.C. keeps A.P. updated and inform IMP on medical OIM = Offshore Installation Manager
aspect/follow up of patient’s return to Site R.C. = Response Centre
RTW= Return to Work
1
This process flow does not apply for
worker’s compensation claims and
R.C. Close the Return to Work case And Patient / Employee updated management and case management (or its
conduct internal review and reporting. by R.C. on latest RTW status equivalent in a said country)
2
72h timeframe is for operational/safety
critical positions.

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2.2 Urgent Activation from Response Centre’s Perspective
The Installation Medical Personnel, prior to medical disembarkation of employee to shore due to an
injury / illness at work, escalates to the Lead Response Centre.
2.2.1 Start of Return to Work process and on-shore referral
The Lead R.C. provides Topside support & endorses the need for referral to on shore.
A RTW process is identified and recommended.
The Lead R.C. sends to the OIM/Rig Manager or Medical AP the Work Order for completion.
Actions for Response Centre Medical Team
1) Response Centre Doctor (RCD) confirms with IMP the need of the patient for a Return to
Work service and referral to shore.
2) Response Centre Doctor (RCD) ensures that the IMP has briefed the patient about the
process (see script on the Return to Work Form) and ensure that patient takes the form with
him/her to the medical provider onshore. Remind IMP to prompt patient to sign the consent
section to release information when in presence of the medical provider onshore.
Briefing note to the Employee:
You are about to start a Return To Work process designed to assist you to return to productive employment
as quickly and safely as possible following an injury or illness at work.
If you are currently “offshore”:

The Intl. SOS Medical Personnel on the offshore site has identified the need to refer you for further care or
evaluation to a physician/ health provider onshore after escalation/ discussion with his senior Intl. SOS
physician (Topside support).
Arrangements are being made for your safe disembarkation and to identify the appropriate receiving health
provider onshore for you, with the approval of the site manager.
If you are currently “onshore”:

You may have been disembarked onshore in the past and your employer has contacted Intl. SOS to assist
with your Return To Work medical evaluation. You will be / have been contacted by Intl. SOS and
arrangement is being made to refer you for further evaluation to a physician/ health provider for a Return to
Work recommendation.
In all cases, it is important that you bring this Return To Work Form along with you and hand it over duly
completed and signed (section B) to the receiving physician/ health provider you have been referred to. It is
critical that you are in the presence of the physician/ health provider when he/ she is completing this
evaluation form for a Return to Work evaluation.
If permitted by law, the physician/ health provider will forward his/ her recommendation to Intl. SOS directly. In
some countries, the physician/ health provider may be legally obligated to return this completed form only to
you. In this latter case, please email or fax this completed form to Intl. SOS as soon as possible (see contact
details at the bottom of the first page).
Figure 2: Return to Work Form – Section A
3) Response Centre Doctor (RCD) establishes initial contact with OIM/Rig Manager or Medical
AP to secure a verbal acknowledgement to proceed with RTWA. RCD initiates the process for
the CSE to secure a formal W.O. as soon as possible.

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Actions for Response Centre CSE
1) The IMP will have blank copies of the RTW form with them on site, once the RTW process
has been confirmed the RCD will ask the IMP to complete the RTW form.
2) Follow-up with the IMP until the completed RTW form is received, add to the patient’s existing
case and notify the medical team (verbally and via action) that the form has been received
3) A blank Work Order form must always be sent to the OIM to complete and return. This is the
instruction / authorisation for us to proceed with the RTW process. Follow-up with OIM until
received.
4) Once the completed Work Order form is received, add to the patient’s existing case and
check for completion. If not fully completed, return the Work Order form to the OIM and
request for the missing information to be completed. Continue to follow-up until the
completed Work Order form has been received.
2.2.2 Use of the Return to Work form
The Lead R.C. verifies and ensures that the RTW form is duly completed by the IMP on site and
receive a copy.
1) Response Centre Doctor (RCD) explains to IMP that patient needs to complete the consent
section of the form when face to face to the onshore doctor.
2) Response Centre Doctor (RCD) is responsible for determining the type and location of
medical referral on shore in the context of RTW if not already identified in client’s MERP. RCD
provides appropriate referral information to the facility (if in LC territory) or to the Assistance
Centre nearest to the offshore asset location. Actions for Response Centre CSE
3) Obtains the completed Return to Work form sent by the IMP
4) If the employee has not taken the Return to Work form with him/her, to forward a copy of the
form to the identified receiving provider onshore and escalate to the RCD.
2.2.3 Territorial Responsibility
Are the R.C and A.C. in the same territory?
The offshore asset is off the coast of Egypt. The Lead R.C. is Johannesburg. The R.C. finds issues to
identify and communicate with onshore medical provider in Egypt. Location is not under
Johannesburg A.C. Egypt can be serviced by Dubai A.C. The Lead R.C. Johannesburg will replicate
case with Dubai A.C.

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1) Confirm which AC is responsible for the country in which the arrangements will be made and
if the appointment will be in the territory of another AC, replicate the case to them to assist
with arrangements
2) If the appointment is required within on LC territory, continue to manage the case within the
Response Centre
2.2.4 Briefing of Medical Provider (if within Response Centre Territory)
1. The Lead R.C. directly brief /correspond with on shore medical provider (treating doctor).
2. The Lead R.C. arranges medical appointments and reception of patient in treating medical facility.
3. Completed RTW form is sent to the treating doctor electronically as backup in case the original
has not been given to the patient by the IMP or not handed over to the doctor.
1) Response Centre Doctor (RCD) introduces the Return to Work form to the receiving medical
provider for completion PRIOR to discharge of patient and within 72 hours from
consultation/admission. There are two types of Return to Work Forms. Use only one as
appropriate (see annex).
a. The International Form (outside of North Sea UK) is designed for specialist who are not
necessarily occupational health or with limited offshore knowledge.
b. If specified by client and / or MERP, an offshore / occupational health medical provider

may be used if already identified as first or secondary referral to complete the RWTA
Form. The RCD has authority to decide for each case.
2) Response Centre Doctor (RCD) to familiarize himself/herself with the Form prior to briefing
the medical provider. The Forms do not make reference to any diagnosis / disease but
instead focus on what a person “can do” from a functional stand point.
3) In case of “force majeure” where the medical provider is not able to send completed Return
to Work form (sections C and D – see annex) back to the Lead R.C., the Response Centre
Doctor (RCD) is authorized to self-complete the Return to Work form based on verbal
interview of the medical provider. Completion of the form (sections C and D – see annex) is
expected to take approx. 10 minutes maximum.
1) Once RCD has identified a suitable provider, contact the provider to make an appointment as
per the patient / client direction. If the local arrangement is made by client/port agent or any
other third party, ensure that details of the recommended/identified medical provider are
communicated to the relevant party on a timely basis.
2) Obtain an estimated cost for the appointment.
3) Contact the Client Authorising Person for approval of the costs for the appointment.
4) If authorised, place a guarantee of payment.
5) If Client has provided alternative payment instructions, these must be conveyed to the
provider ahead of the appointment i.e. patient must self-pay; private medical insurance etc.

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6) Update the IMP/OIM/Rig Manager or Medical AP with the appointment details and payment
arrangements.
7) Forward all relevant documentation (Completed RTW for / GOP) to the provider in advance of
the appointment.
8) Monitor appointment for attendance.
9) Follow-up and obtain results post appointment BEFORE the employee returns to offshore or
WITHIN the first 72 hours (whichever comes first).
10) Update RCD once results received.
2.2.5 Briefing of Assistance Centre (for cases which are not in the Response
Centre's lead centre territory)
Following briefing and transfer of case from Lead R.C.:
1) Response Centre Doctor (RCD) introduces the Return to Work form to the Assistance Centre
CD requesting the identified medical provider to complete the form PRIOR to discharge of
patient and/or within 72 hours from consultation/admission. There are two types of Return to
Work Forms. Use only one as appropriate (see annex).
a. The International Form (outside of North Sea UK) is designed for specialist who are
not occupational health expert or with limited offshore knowledge.
b. If specified by client and / or MERP, an offshore / occupational health medical

provider may be used if already identified as first or secondary referral to complete
the RWTA Form. The RCD has authority to decide for each case.
2) Response Centre Doctor (RCD) and Assistance Centre CD to familiarize himself/herself with
the form prior to briefing the respective parties. The Forms do not make reference to any
diagnosis / disease but instead focus on what a person “can do” from a functional stand point
to Work form (sections C and D – see annex) back to the Assistance Centre, the Assistance
Centre CD is authorized to self-complete the Return to Work form based on verbal interview
of the medical provider. Completion of the form (sections C and D – see annex) is expected to
take approx. 10 minutes maximum.
1) Initiate call with Assistance Centre and Medical team to activate and make arrangements for
medical referral.

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2) Lead RC to maintain communication with the Client keeping them updated with arrangements
3) Confirm with patient / IMP / Client suitable timeframe in which the appointment is to occur and
update the AC.
4) Confirm payment requirements with the Client i.e. authorisation to guarantee payment /
patient to self – pay etc. and update the AC.
5) Maintain communications with the IMP/OIM and keep them updated with the appointment
arrangements.
6) Monitor that the appointment has occurred and been attended updating the client of any
changes.
7) Chase the AC for the results post appointment.
8) Notify the RCD once the results have been received and added to the patient’s case
2.2.6 Return to Work status assessment
1) Response Centre Doctor to review the Return to Work form for completeness and for
understanding of recommendations. In case of “force majeure” where the medical provider is
not able to send completed Return to Work form (sections C and D – see annex) back, the
Response Centre Doctor is authorized to self-complete the form based on documented verbal
communication with the medical provider. Completion of the form (sections C and D – see
annex) is expected to take approx. 10 minutes maximum. If outside of the Response Centre
territory, the above function can be delegated to the Assistance Centre familiar with the
medical provider.
2) Response Centre Doctor (RCD) forwards the completed Return to Work form (with / without
an offshore medical certificate as per initial Work Order) to the Authorized Person (AP) as per
client’s procedure AND call the AP for conversation.
3) Response Centre Doctor (RCD) explains medically what the employee is able to do/not to do
and facilitate the discussion with client, who is the final decision maker if the employee is
authorized to return to work safely back to the offshore asset.
4) Response Centre Doctor (RCD) and AP determine at minimum during this contact
a. If the employee can return / cannot return back to work safely to the offshore asset
within 72 hours
b. If work modification is required/possible by the employer on the offshore asset, based

on the case (therefore accommodating patient’s condition and for how long)
c. If the employee should extend its medical care onshore beyond 72 hours instead

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d. Whether the Urgent Activation from Workplace Return to Work case can be closed or
extended into a Non-Urgent Activation from Home or Final Care Location Return to
Work.
5) Response Centre doctor makes contact with the patient to validate the information reported
by the treating doctor and to provide the patient with the latest update on RTW status.
2.2.7 Return to Work final status
Fit for Work
R.C. keeps A.P. updated and informs IMP on medical aspect/follow up of patient’s return to Site
1) Response Centre Doctor to confirm in writing the agreed action to the AP by email and/or fax
followed by a telephone conversation (i.e. Return to work closing case or further clarification
with treating doctor, or extension of the case with new evaluation in X period of time or
medical advice of work adjustment, or transfer of case to Assistance for further repatriation).
2) Always forward a copy of the completed RTW form to the IMP (subsequent follow up of the
patient on site by the IMP may be warranted).Courtesy call patient to keep him updated of the
process.
1) Ensure the case is completed before closure:
a. No outstanding billing issues
b. Script completed in full
c. Final update sent to client
d. No outstanding requests for assistance
2) Close file
Conclusive Assessment not possible at this stage
1) Response Centre Doctor to inform the AP accordingly. Request AP to give case direction
2) Extend the RTWA case (internally, transfer to RTWA Non-Urgent Activation from Home or
Final Care Location flow chart or
3) Close the case file
4) If further medical repatriation is required, transfer to Medical Assistance Case.

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1) Based on the outcome of the RCD conversation with the AP, the case may be continued or
closed
2) If the case is to be closed, ensure that:
a. No outstanding billing issues
b. Script completed in full
c. Final update sent to client
d. No outstanding requests for assistance
3) If the case is to be continued, then the case becomes a RTW Non-Urgent Activation
4) If the AP requests the patient be repatriated with our assistance, handover the case to the
Assistance Centre CSE and Medical Team
2.3 Urgent Activation from Assistance Centre’s perspective
After the RCD has confirmed that an Urgent Activation of RTWA from workplace – offshore- is
required, the IMP may escalate the case to the Assistance Centre (instead of Response Centre) to
coordinate the patient’s disembarkation (urgent medivac or not) with / without guarantee of payment
(GOP) and medical monitoring (or not) while onshore.
If client has subscribed to the Return to Work Advisory Services, such service should be activated via
the Response Centre.
The section below describes the sequence of events that should take place.
2.3.1 Start of Return to Work process and on-shore referral
Actions for Assistance Centre Medical Team
1) The Assistance CD carries on with his/her normal duties in relation to clinical supervision of
Intl. SOS installation personnel (IMP), patient’s movement (disembarkation, medical
evacuation) and receiving care facilities onshore.
2) Any Topside activities for subscribing clients (including the Return to Work Advisory Services)
should be referred to the Response Centre Doctor (RCD).
Actions for Assistance Centre CSE
1) Confirm replication of case and RFA
2) Escalate the new case to the medical team

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3) Allocate the case to the appropriate transmission
4) Any movement requirements are to be managed as per the MERP
N.B: If patient or OIM/Rig Manager refuses the Return to Work Advisory process, case is managed as
a standard referral case with no return to work forms or discussions.
2.3.2 Schedule of appointment and reception of patient
1) The Assistance Centre CD maintains its entire prerogative in coordinating patient’s care as
usual when it is part of patient’s movement (clinical supervision, disembarkation, medical
evacuation).
2) Upon request from the Response Centre (RCD), the Assistance CD will assist in identifying
appropriate receiving medical provider for the Return to Work case.
3) The Assistance Centre CD must familiarize himself/herself with the Return to Work form prior
to briefing the medical provider. The Form is in English only and does not make reference to
any diagnosis / disease but instead focus on what a person “can do” from a functional stand
point using simple tick list options.
4) The Assistance Centre CD may request a conference call with the Response Centre (RCD)
for a full debrief of the Return to Work form with a focus on sections C and D –see annex – to
be completed ultimately by the medical provider.
1) Once the Medical Team have identified a suitable provider, contact the provider to make an
appointment at as per the RC / patient / client direction. If the local arrangement is made by
client/port agent or any other third party, ensure that details of the recommended/identified
medical provider are communicated to the relevant party on a timely basis.
2) Obtain an estimated cost for the appointment
3) Update the RC for approval of the costs for the appointment
4) If authorised, place a guarantee of payment
5) If RC has provided alternative payment instructions, these must be conveyed to the provider
ahead of the appointment i.e. patient must self-pay; private medical insurance etc.
6) Forward all relevant documentation (including the return to work form received from the IMP)
to the provider in advance of the appointment

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2.4 Communication between Medical Provider and Response Centre via

Assistance Centre
2.4.1 Communication with Medical Provider
1) The Assistance Centre CD introduces the Return to Work form (on behalf of the Response
Centre (RCD) to the receiving medical provider for completion PRIOR to discharge of patient
and within 72 hours from consultation/admission. The language used in the Return to Work
Form is English. Explanation in a local language over the phone by the Assistance Centre CD
may be required.
2) The Assistance Centre CD to familiarize himself/herself with the form prior to briefing the
medical provider. The Form doesn’t make reference to any diagnosis / disease but instead
focus on what a person “can do” from a functional stand point.
to Work form (sections C and D – see annex) back to the Assistance Centre, the Assistance
Centre CD is authorized to self-complete the Return to Work form based on verbal interview
of the medical provider especially if due to language barrier. Completion of the form (sections
C and D– see annex) is expected to take approx. 10 minutes maximum.
1) The CD will call the provider prior to the appointment to brief the treating doctor
2) If requested, the RCD will assist to brief the provider of the required RTW process before the
patient attends the appointment. The Assistance CSE is to facilitate the call between the
RCD, CD and provider
3) On the day, monitor the appointment for attendance
4) Post appointment follow-up with the provider for the completed RTW form BEFORE the
employee returns to offshore or WITHIN the first 72 hours (whichever comes first).
5) Once received, add the RTW form to the patient’s file and check for completion and update
the CD and Lead RC. If the form is not completed go back to the provider and request the
missing information.
2.4.2 Communication with Response Centre
The Assistance Centre CD may request a conference call jointly with the Response Centre (RCD)
and the local medical provider in complex cases including but not limited to language or cultural

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issues. The objective is to facilitate a clear understanding of selected medical provider on how to
complete the Return to Work Form for their patient.
If requested, the RCD will assist to brief the provider of the required RTW process before the patient
attends the appointment. The Assistance CSE is to facilitate the call between the RCD, CD and
provider.
1) The Assistance Centre CD is accountable for the completeness and accuracy of the Return to
Work form completed and collected back from the selected medical provider.
2) The responsibility of the Assistance Centre CD for the return to work case ceases when the
fully completed Return to Work form has reached the Response Centre (RCD) and the
response centre has confirmed that no further assistance is required.
3) Depending on the case, a medical assistance case may need to continue for medical
monitoring purposes until repatriation can occur without any Return to Work further
consideration.
1) Action RC to inform them of the medical outcome, indicating which note the results are in.
2) Confirm no further assistance required and close the file.
3) Depending on the case, a medical assistance case may need to continue for medical
monitoring purposes until repatriation can occur without any Return to Work further
consideration.
2.5 Urgent Activation from Patient’s perspective
Actions from Installation Medical Personnel
1) The IMP is responsible to brief the injured / ill employee at work – on the offshore asset - prior
to any disembarkation on the following steps occurring:
a. There is a Return to Work process agreed with his employer for his medical condition
aiming to assist the employee to return to productive employment as quickly and
safely as possible following an injury or illness at work offshore. IMP to document in
provided form the contact number of patient while he/she will be onshore and provide
this to RC prior to patient leaving the asset offshore.

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b. The Intl. SOS medical team (Response Centre) will maintain contact with the
employee throughout the disembarkation and while on shore at the receiving medical
facility (courtesy call).
c. Intl. SOS medical team needs his verbal consent to initiate the Return to Work
process, liaise with the receiving onshore physician and consent in writing to disclose
limited functional information to his employer for a safe return to work later. The
Return to Work form must be completed and signed by the employee. Refusal of
consent by the injured/ill employee will stop the completion of the Return to Work
process.
d. The consent section of the RTWA Form (section B – see annex) is best signed in
presence of the physician / Health Provider the employee has been referred to,
onshore (European practices), but can also be completed in full prior to
disembarkation while offshore in presence of the IMP (Asian practices).
2) The IMP is responsible to ensure that the employee is carrying the RTW Form upon
disembarkation and hand it over completed and signed by the employee to the referred
physician/Health Providers on shore. A copy of the initial RWTA Form containing employee’s
demographic information is sent to the RC as soon as possible.
3) The IMP is responsible to alert the OIM when a need for a RTWA upon disembarkment is
identified with the help from Topside Support (RC). OIM may decide not to activate the Return
to Work Advisory service. IMP to inform the Response Centre accordingly.
Actions from Response Centre
1) The Response Centre is accountable for the IMP to brief the injured/ill employee on Return to
Work process, complete the Return to Work form appropriately.
2) The Response Centre is responsible to secure the RTWA Work Order from the OIM as soon
as possible to activate the RTWA service. An initial verbal authorization from the OIM may be
acceptable on a case per case basis upon approval from the RC operation manager.
Completion of the Work Order shall still take place in order to render the service. The IMP
may / may not assist with this administrative task, as his primary focus is patient care.
3) The Response Centre must maintain contact with the injured/ill employee at minimum at two
occasions (telephone conversation is the norm):
a. Upon receiving care onshore by the medical provider
b. Prior to discharge or before returning to the offshore asset (within 72 hours from
disembarkation).
4) The Response Centre is responsible to brief the injured/ill employee on the Return to Work
medical outcome & recommendation by the shore medical provider including outcome of the
discussion with his employer (OIM or Rig Manager and/or HR manager – coordinator as per
client’s procedure).
5) In case of no return of the employee to the offshore asset within an Urgent Activation from
Workplace, an explanatory conference call between his employer AP, employee, and
Response Centre (RCD) is proposed upon approval from the AP (conference call involving
treating doctor is optional, based on its availability).
Actions from Assistance Centre
There is no specific action toward the injured / ill employee or the client’s AP related to the Return to
Work process.

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Specific action may be requested on a case per case basis by the Response Centre.

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3 RETURN TO WORK NON-URGENT ACTIVATION FROM HOME

OR FINAL CARE LOCATION
The ”Non-Urgent Activation from Home or Final Care Location” return to work process (unlike the
“Urgent Activation from Workplace” return to work < 72 hours) has typically unique features
 Employees involved typically suffered more “serious injuries” at work and / or may have
“catastrophic / chronic ill health” that deteriorated while offshore
 Medical cases tend to be more complex and slow to resolve
 Coordination of care tends to take a longer time frame (i.e. weeks) involving multiple
medical care providers
This “Non-Urgent Activation from Home or Final Care Location” return to work is not a substitute /
full outsource to a return to work service for clients. It focuses on a specific “case review” (step 4 –
see below) only, that is medically driven.
In a global context, well organized employers follow (with some variation) a 6 steps approach of
their Return to Work methodology:
Step 1: HR department identify who needs to enter in a Return to Work process & when.
Step 2: HR department initiate contact with their “off work” employee.
Step 3: HR department set an initial meeting (face to face or by phone) with their employee
clarifying the objective of a return to work and attempt to identify the “obstacles” to return to work
(biological, psycho or social barriers).
Step 4: Case review. This is where the Intl. SOS Return to Work Advisory takes place
for/on-behalf of client.
Step 5: HR department / Supervisor develop a “get back to work “plan / program for the employee.
Step 6: HR department / Supervisor keep the plan under review.
Specific to “Non-Urgent Activation from Home or Final Care Location” Return to Work
 Medical confidentiality legislation / privacy laws in Europe (Germany, Belgium, France …)
are rapidly changing, preventing medical provider(s) to forward directly medical information
to third parties (i.e. Intl. SOS) even with patient’s consent. Medical provider(s) may only
accept providing written evaluation directly to their patient only.
 Always request Injured/ill employee to forward / collect medical information/reports to – from
his/her medical provider(s) (i.e. treating physician) as an option especially when handling a
RTWA from Europe or North America.
 In Europe or North America, accept (do not refuse) medical information sent directly by
medical provider(s) if they decide to do so (but do not actively chase a medical provider for
return to work report, follow up with the employee instead).
 Escalate to the R.C. Medical Director in unclear situation.
 In rare situation, selected physician/ Health Provider may elect not to share or restrict
disclosure of sensitive information to Intl. SOS or via the injured/ill employee for status seen
as “detrimental” to the wellbeing of individuals. Such cases concern poor prognosis cancer,

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some mental illness, HIV status etc... In such situation, escalate to the RC Medical Director
for case direction.
Specific to “Non-Urgent Activation from Home or Final Care Location” Return to Work:
 Intl. SOS is subscribing to the Official Disability Guidelines (ODG) offering internet online
support reference to the Response Centre (RCD). It contains a suite of tools with database
assisting physician(s) evaluating return to work durations (statistical benchmark &
physiological recovery) as well as rehabilitation information.
The website link www.medicaldurations.com or www.odg-twc.com
 Both websites give access to the same tools but with a different interface (look and feel) that
can be selected by users
 The current Response Centre / MedFit subscribers are:
Official Disability Guidelines (ODG) User Name List

Last Name User ID Pwd Position & Title
No. First Name
Yap internationalsos (lower case sensitive)

1 Annie 7378 RC Deputy MD - Sydney
Vargas internationalsos (lower case sensitive) 7378

2 Cesar RC Med. Director - Singapore / Kul
Christopher Bari internationalsos (lower case sensitive) 7378

3 MD, Occ. Health EEMEA
Golf Ren internationalsos (lower case sensitive) 7378

4 OH Med Advisor China
Johan Geyser internationalsos (lower case sensitive) 7378

5 MedFit OH physician JHB
Julian Eyears internationalsos (lower case sensitive) 7378

6 MD Occ.Health Europe
Katherine Sinclaire internationalsos (lower case sensitive) 7378

7 RC DMD- JHB
Katie Geary internationalsos (lower case sensitive) 7378

8 AC MD - London (RC Support)
Leonie Zhang internationalsos (lower case sensitive) 7378

9 OH Medical Officer- China
Louise Slaney internationalsos (lower case sensitive) 7378

10 MD Offshore UK (Intl.SOS Abermed)
Michael Stone internationalsos (lower case sensitive) 7378

11 RC CD - Sydney
Nhlanhla Mpofu internationalsos (lower case sensitive) 7378

12 MS & MedFit OH MD - Sydney (RC Support)
Olivier Lo internationalsos (lower case sensitive) 7378

13 Group MD - Occ.Health Services
Philip Nganwa internationalsos (lower case sensitive) 7378

14 Regional MD – JHB (RC Support)
Rene De Jongh internationalsos (lower case sensitive) 7378

15 Roving Regional Medical Director,
Assistance (RC Support)
Rocellawati Jamaluddin internationalsos (lower case sensitive) 7378

16 RC CD - Kul
Ryan Copeland internationalsos (lower case sensitive) 7378

17 Regional MD - London (RC Support)
Shirley Kong internationalsos (lower case sensitive) 7378

18 Senior MO – Intl.SOS Abermed
Stefanie Kruger internationalsos (lower case sensitive) 7378

19 MedFit - DMD - JHB (RC support)

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Vincent Yue internationalsos (lower case sensitive) 7378

20 Director – China Medical Services
 For requesting additional subscription, please escalate (e-mail) to the Response Centre
Medical Director, copy to the Group Medical Director – Occupational Health Services.
Existing email profile(s) and password may be “borrowed” within the Response Centre
temporarily amongst the members of the medical team until January 1st 2017.
 Do refer to the Tutorial (video) “ODG: Good to Go!” available from the main webpage
www.odg-twc.com prior to using the offered features. For a quick case management on
RTW medical duration, go directly to www.medicaldurations.com. Usage is intuitive and no
tutorial is provided from this site.
The “Non-Urgent Activation from Home or Final Care Location” Return to Work process does NOT
apply to any national / domestic process for worker’s compensation or insurance disability claim
management (or its equivalent in a said country).
 Do escalate to the Response Centre Medical Director in such situation.
 Australia: If a client is requesting the medical provider involved in the case assessment
to complete additionally a Worker’s Comp form (initial, follow up or final), do escalate to
the Australasia Occupational Health Medical Director or Group Medical Director –
Occupational Health Services for case direction.
3.1 Flow Chart – Return to Work

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Return to Work (RTW) Advisory

-Offshore-
Patient’s Journey
NON URGENT ACTIVATION FROM HOME OR FINAL CARE LOCATION 1
Follow-up requested from OIM/HR New request after patient has
after a RTW Urgent Activation case Patient requires further care onshore returned home or
(beyond 72 hours). 2 from Final Care Location
> 72 hrs OR patient is no longer close to shore and has
reached final location to receive definitive care /
rehabilitation. Patient remains off work.
3.2.1 3.2.1
• R.C. engages with HR or AP to get a Non Urgent
Is this a known patient
• R.C. engages with HR (or OIM) to get an authorisation of Activation RTW Work Order (WO).
Yes from a previous RTW No
Work Order extension via email or verbally. • RTW Form to be sent to HR and IP for consent to
Urgent Activation case ?
be signed
R.C. to check that all the following information is at hand from the Client’s HR Dept. (Ref. Work Order template) 3.2.2
- Patient’s demographic information as per the Work Order form
- Copy of Job Description / Normal duties
- Current geographical location contact details of the patient and confirmation that HR has informed patient of future contact from Intl.SOS
- Existing Medical Information/report (if available)
- Confirmation if a specific Offshore medical certificate (i.e. OGUK) is required for that case (optional)
- Confirmation if referral to additional specialist is pre-approved (Guarantee of Payment – optional)
R.C. coordinate with patient to send him RTW Form & referral letter. Patient is asked to liaise with his/her
treating doctor(s)/Health Provider(s) to obtain the RTW form completed / signed and send it back to R.C.
Case is reviewed by R.C.Doctor who collate key medical RTW information and identifies potential issues of RTW timeframe using the Online MD
guidelines (industry standard for RTW guideline).
R.C.Doctor call out for Occupational Health (OH) physician support if not present at the R.C. (i.e. MedFit) assigned to support the R.C.
No
Is pre- approved Is additional medical

financial authorization Yes referral to a specialist No
already granted by AP ? recommended ?
3.2.3 Yes
The R.C. (with the advisory support from OH physician assigned to the R.C.):
1. Is always the centre that request for specific medical information from specialist(s) as required (referral letter(s) drafted by OH physician)
2. May call treating /specialist physician to explain RTW objectives.
3. Provide the referral letter(s) to the treating / specialist physician(s).
4. Request medical report to be released via the patient who has the responsibility to send the report back to the R.C. if medical provider
refuses to send report back to R.C. directly. 3.3.1
1. The R.C. arranges medical appointment and
1. The A.C. arranges medical appointment and
reception of patient in treating medical facility
reception of patient in treating medical facility upon
(unless self arranged by patient)
Are the Lead R.C. and A.C. request
2. Guarantee of Payment (GOP) to the medical Yes No
in the same territory ? 2. Guarantee of Payment (GOP) to the medical
provider upon request
provider upon request
3. Update patient on current status of case & plan
3. Language assistance upon request
4. Language assistance upon request
The patient attends to the recommended medical provider(s):
1. Hand over a copy of the OH referral letter(s) / Request for specific medical
information and/or signed RTW form with consent
2. Collect in due time the written medical report and / or completed RTW form
back from the medical provider
3. Forward the medical report(s) / completed RTW form to the Lead R.C. ASAP
3.2.4
The Lead R.C. review the RTW status upon reception of all medical information from the patient (with
final review from OH physician assigned to support the R.C.) and update Client’s A.P.
- Using RTW Form completed by treating physician (as minimum)
- Providing additional medical recommendation as applicable on the RTW form
- Forwarding offshore medical certificate (from medical provider) if it was requested in the initial W.O.
The Lead R.C. Doctor courtesy call patient to update on medical RTW status & plan
Can the R.C. doctor / OH support

physician validate the offshore RTW
determination made by the treating
No doctor and/or specialist ? Is the time
frame for patient to RTW aligned Note:
with general industry standard (MD A.C. = Assistance Centre
Update client & patient on RTW guidelines) ? A.P. = Authorized Person
status and plan CD = Coordinating Doctor
Yes JD = Job Description
&
Close RTW patient’s Case MA = Medical Advisor
OIM = Offshore Installation Manager
1
This process flow does not apply for worker’s compensation or insurance disability claim’s Management R.C. = Response Centre
(or its equivalent in a said country). R.C.D.= Response Centre Doctor
2
72h timeframe is for operational/safety critical positions. OIM may decide on a different timeframe for Return to Work. RTW= Return to Work

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3.2 Non-Urgent Activation Process from Response Centre’s perspective
3.2.1 Activation of the process
Follow-up requested from OIM/Rig Manager / Medical AP or HR after a RTW Urgent

Activation case (beyond 72 hours):
New request after patient has returned home or from Final Care Location:
1) Intl. SOS MedFit physician / Occupational Health (OH) physician(s) provide support to the
R.C. (RCD) for “Non-Urgent Activation from Home or Final Care Location“ Return to Work
service by:
a. Reviewing the initial Return to Work case & upon request
b. Drafting OH referral letter(s) / Request specific medical information that matters for a
return to work plan for patient’s treating specialist(s)
c. Reviewing the final Return to Work recommendation by the referred physician/Health

Provider and RCD advice prior to release to client’s AP.
2) The R.C. (RCD) still “owns” the Return to Work case and does not transfer the case to an Intl.
SOS MedFit department.
The support allocation is as follow:
i. Johannesburg Response Centre  Johannesburg MedFit physician(s)
ii. London Response Centre  Abermed clinic OH physicians (Aberdeen) are excluded
from this procedure version 1
iii. Kuala Lumpur Response Centre  Kuala Lumpur Response Centre OH physician(s).
Back up Johannesburg MedFit physician(s)
iv. Sydney Response Centre  Sydney/Auckland MedFit physician(s)
v. Phoenix (USA) and Rio de Janeiro (Brazil) are excluded from the program until
further notice.
vi. Norwegian OH clinics, North Sea Norwegian continental shelf are excluded from the
program until further notice.
1) If the request is related to a previous Urgent Activation from Workplace RTWA, contact the
OIM/Rig Manager/Medical AP and request approval for an “extension” of the service beyond

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72 hours and obtain a completed Work Order (or email confirmation). Continue to use the
existing case. If the OIM refers the authorization of the on-going RTWA case to his HR
department, collect relevant contact details and update the existing Work Order after
establishing contact with HR.
2) If the request is not related to an existing open Urgent Activation from Workplace RTW then
written authorization must be obtained from HR using the Work Order Form. Non-Urgent
Activation from Home / Final Care Location is typically managed by client’s HR who is
initiating the request for service. In situation where this is not the case, secure a Work Order
from the requestor after confirming that he/she is a client’s AP as per client’s procedure.
3) A new case is required to be opened.
3.2.2 Collection of all necessary documentation
1) The Response Centre (RCD) validates the WO and has the responsibility to escalate for
support if information provided seems incomplete. He / she remains accountable for “driving”
case progress and clarify request & medical issue(s) with client’s AP.
2) The R.C. must use the existing Return to Work Form for the “Non-Urgent Activation from
Home or Final Care Location”.
3) Specific Return to Work Form provided by clients (if provided) may also be used instead. RC
to confirm with MedFit if client has a MedFit or MedTrack program already in place with a
specific RTW form to use. Escalate to the Response Centre Medical Director in this situation
for validation and update.
4) Use the Online MD Guidelines (Medical Disability Advisor tool) to:
a. Assist with asking appropriate medical information from treating physician(s) from a Return
to Work stand point based on medical condition(s) of patient

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b. Assist with providing medical advice to client’s AP on possible work accommodation, time
line.
5) The Response Centre (RCD) is responsible to establish the initial contact with the ill/injured
employee and brief the employee using the below script (outlined in the RTWA Form). Any
additional information (i.e. Medical report not held by the employer) /request to /from the
employee reviewing the objectives of the RTW service is set during this critical call with the
employee:

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3.2.3 Briefing Note to the Employee
You are about to start a Return To Work process designed to assist you to return to productive employment as quickly and safely as possible following an injury or illness at
work.
If you are currently “offshore”:

The Intl. SOS Medical Personnel on the offshore site has identified the need to refer you for further care or evaluation to a physician/ health provider onshore after escalation/
discussion with his senior Intl. SOS physician (Topside support).
Arrangements are being made for your safe disembarkation and to identify the appropriate receiving health provider onshore for you, with the approval of the site manager.
If you are currently “onshore”:

You may have been disembarked onshore in the past and your employer has contacted Intl. SOS to assist with your Return to Work medical evaluation. You will be / have
been contacted by Intl. SOS and arrangement is being made to refer you for further evaluation to a physician/ health provider for a Return to Work recommendation.
In all cases, it is important that you bring this Return To Work Form along with you and hand it over duly completed and signed (section B) to the receiving physician/ health
provider you have been referred to. It is critical that you are in the presence of the physician/ health provider when he / she is completing this evaluation form for a
Return to Work evaluation.
If permitted by law, the physician/ health provider will forward his/ her recommendation to Intl. SOS directly. In some countries, the physician/ health provider may be legally
obligated to return this completed form only to you. In this latter case, please email or fax this completed form to Intl. SOS as soon as possible (see contact details at the
bottom of the first page).
Return to work Form – Section A

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1) Ensure that all of the following information has been received from the employee’s HR:
a. RTW form signed by the patient confirming authorisation and informed consent
b. Job description / normal duties
c. Complete administrative / geographical details (i.e. the information required to open a

case: current location, full name, DOB etc., contact details)
d. Medical information related to the request
e. Offshore medical certificate
2) Once all information received and added to the patient’s case, notify the RCD verbally for
them to review and also set an action.
3.3 Coordination of Specialist (s) referrals (if needed)
1) The Response Centre (RCD) drives the case forward and decides.
2) The MedFit / OH physician(s) review and advice.
3) Disagreement between the two parties is escalated to the Response Centre Medical Director
for resolution. Final escalation involves Group Medical Director – Occupational Health
Services & Group Medical Director Assistance.
4) OH Medical Referral letter(s) / Request for specific medical information are templates with
some degree of flexibility relevant to the case (see annex)
5) Coordination of appointment must be accompanied with a referral letter to the medical

provider(s) with clear questions to be answered for all cases.
6) Additional information that may be relevant to collect for RTWA – based on each specific
case- may be

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i. Past Work History
ii. Length of employment
iii. Absenteeism
iv. Performance review records
v. Any history of substance misuse
vi. Social history, support system, family history (if relevant to the case)
If an appointment is required:
1) Confirm with RCD which provider is to be used. The medical provider can be found in SPIN
under MedFit provider in a said area or known by the nearest A.C. or requested by client
2) Contact the provider to arrange an appointment
3) Send through the referral letter and any requests for specific medical information to the
provider and confirm receipt
4) Confirm if a GOP is required and send to the provider if authorised by the Client
5) Update the patient and HR with the appointment details
6) Following the appointment, the patient must obtain the medical report / completed form and
provide to the RC
7) Once received, add to the patient’s file and notify the RCD to review
NB: If location where patient is to have the appointment is not within the RC territory, then activate the
relevant AC and brief them verbally of the new request.
1) The Return to Work Form and related report must all be reviewed & validated by the MedFit /
OH physician assigned to the R.C. as quality control prior to release to client.
2) Medical confidentiality must be maintained at all times and confidential medical report(s) from
medical provider(s) shall not be shared with non-medical client’s AP (it is the prerogative of

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the injured/ill employee himself/herself to share confidential medical report(s) with his / her
employer).
3) Deliverables of “Non-Urgent Activation from Home or Final Care Location” Return to Work to
client’s AP are restricted to:
a. Use of mutually agreed Return to Work Forms duly completed
b. Medical recommendation from RCD – MedFit/OH physician(s) as applicable
c. Offshore certificate (optional, upon initial request only)
4) Any other deliverables must be escalated to the Response Centre Medical Director for review
prior to release to third parties.
5) For clarity, the RTWA Form designed in this program CAN be released to the AP /employer
as long as it has been duly completed and signed by the ill/injured employee (consent).
6) The Response Centre (RCD) with the assigned OH physician support (i.e. MedFit) is
expected to provide an advice to client at the end of the RTWA form (ONLY FOR
INTERNATIONAL, excluding North Sea).
7) The 4 options (as outlined below) is a quality review of the RTWA in an International setting
where an OH medical examiner or treating specialist may not be familiar with the Offshore
environment.
8) This qualitative “advisory” is NOT a fitness determination that is the responsibility of the
selected referred physician/Health provider.
This section to be completed by Intl.SOS Response Centre Occupational Health Physician

Based on confidential medical report(s) & the above medical evaluation, Intl.SOS confirms the following:
Fully concur with the above Return To Work determination made by the treating physician/ health provider. The case may
proceed according to the recommendation.
Incomplete medical or work-related information have been identified. More information is required on what the employee’s job
entails. Further evaluation is recommended after discussion with employer, employee and physician / health provider to facilitate a
future Return To Work or potential for work accommodation. Additional recommendation will follow.
Significant discrepancy has been identified between current medical condition and intended duration period to be “off work”
prior to a Return to Work. Further discussion is required with physician/ health provider and employee/employer. Additional
recommendation will follow.
Others:
This is an Intl.SOS electronic document for and on behalf of Intl.SOS – no signature required -
Return to Work Form - Section C
Once the RCD has reviewed and concluded the medical information, send the updates required to the
Client AP and also HR.

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3.4 Non-Urgent Activation Process from Assistance Centre’s perspective
3.4.1 Communication between Medical Provider and Response Centre via

Assistance Centre
Similar engagement of a local Assistance Centre as described in the “Urgent Activation from
Workplace” Return to Work.
Specific difference for the “Non-Urgent Activation from Home or Final Care Location” Return to Work:
NOTE: The A.C. CD is not required to obtain any medical report from the selected medical
provider(s).
1) The CD will call the provider prior to the appointment to brief the treating doctor.
2) If requested, the RCD will assist to brief the provider of the required RTW process before the
patient attends the appointment. The Assistance CSE is to facilitate the call between the
RCD, CD and provider
3) On the day, monitor the appointment for attendance.
4) Post appointment follow-up with the provider for the completed RTW form BEFORE the
employee returns to offshore or WITHIN the first 72 hours (whichever comes first).
5) Once received, add the RTW form to the patient’s file and check for completion and update
the CD and Lead RC. If the form is not completed go back to the provider and request the
missing information.
NB: RC will maintain communication with the patient.
3.5 Non-Urgent Activation Process from Patient’s perspective

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Actions from Response Centre
1) The patient is contacted by the Response Centre (RCD) who is responsible to brief the
injured / ill employee once Work Order is confirmed with the client’s AP on the following
2) There is a Return to Work process agreed with his employer for his medical condition aiming
to assist him to return to productive employment as quickly and safely as possible following
an injury or illness at work.
3) The Intl. SOS medical team (Response Centre) will maintain contact with the employee
throughout the process at an agreed frequency (courtesy call).
4) Intl. SOS medical team needs his consent (if not already secured via client’s HR using our
Return to Work Form) to initiate the Return to Work process, liaise with the receiving medical
specialist(s) and disclose limited functional information to his employer for a safe return to
work later. The Return to Work form must be completed and signed (consent) by the
employee. Refusal of consent by the injured/ill employee will stop the Return to Work
process.
5) Always request Injured/ill employee to forward / collect medical information/reports to – from

his/her medical provider(s) (i.e. treating physician) as an option especially when handling a
RTWA from Europe or North America.
6) In Europe or North America, accept (do not refuse) medical information sent directly by
medical provider(s) if they decide to do so (but do not actively chase a medical provider for
return to work report, follow up with the employee instead).
7) Escalade to the R.C. Medical Director in unclear situation.
8) In rare situation, selected physician/ Health Provider may elect not to share or restrict
disclosure of sensitive information to Intl. SOS or via the injured/ill employee for status seen
as “detrimental” to the wellbeing of individuals. Such cases concern poor prognosis cancer,
some mental illness, HIV status etc... In such situation, escalate to the RC Medical Director
for case direction.
Actions from Assistance Centre
No specific action from the Assistance Centre related to the patient; Activation upon request from the
Response Centre

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4 SCHEDULE OF FEES
4.1 Return to work medical advisory service (if requested by the Subscriber)
When the Subscriber requests “Return to Work Medical Advisory Service”, a Return to Work Medical Advisory
Service Fee will be charged as follows:
Urgent Activation from Workplace (up to 72 hours)
Treatment Type Return to Work Medical Advisory Service

Fee
Return to Work Medical Advisory Service Fee (Outpatient) USD 340 / EUR 265/ CNY 2,365 per case
Return to Work Medical Advisory Service Fee (Inpatient) USD 565 / EUR 450/ CNY 3,905 per case
This Return to Work Medical Advisory Service Fee ceases the earliest of either (a) when the Member returns to
work; (b) when the Member returns to home, (c) when the Subscriber requests that the advisory services ceases,
or (d) 72 hours have passed since the opening of the case.
If the Subscriber requests Return to Work Medical Advisory Service to continue past these dates, an additional
Return to Work Medical Advisory Service Fee of USD 255/ EUR 205/ CNY 1,760 per day will be charged to the
Subscriber.
Non-Urgent Activation from Home or Final Care Location:
Treatment Type Return to Work Medical Advisory Service

Fee
Return to Work Medical Advisory Service Fee (per report) USD 340 / EUR 265/ CNY 2,365 per case
This Return to Work Medical Advisory Service Fee ceases the earliest of either (a) when the Member returns to
work; (b) when the Subscriber requests that the advisory services ceases, or (c) 6 weeks have passed since the
opening of the case.
If the Subscriber requests additional reports within the 6 weeks’ timeframe, an additional Return to Work Medical
Advisory Service Fee of USD 340/ EUR 265/ CNY 2,365 per additional report will be charged to the Subscriber.
If the Subscriber requests Return to Work Medical Advisory Service to continue past these dates, an additional
Return to Work Medical Advisory Service Fee of USD 255/ EUR 205/ CNY 1,760 per day will be charged to the
Subscriber.

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5 ANNEXES
5.1 Return to Work Form – Section B
Section B – Consent Form – to be completed by the Employee

Please hand this form to the physician / health provider on arrival for consultation. This form requests your consent on the
following:
Section B – Declaration YES NO
I agree to undergo any physical examination or test, which may be deemed appropriate by the
physician / health provider. The nature and purpose of these will be explained to me.
I hereby authorise Intl.SOS to collect, use, store, process, disclose and release my medical
information from this medical evaluation ONLY as follows:
(a) Sections A – D to Intl.SOS medical professionals AND my employer’s line manager for the
sole purpose of Return to Work review and potential work adjustment; and
(b) (Where my employer is a contractor/ subcontractor) Sections A – C to my employer’s
contracting company or operator of the site.
I understand that the purpose of this medical evaluation is to provide my employer with information
regarding my fitness for work and I will be given a copy. Any advice given will be expressed in terms
of my fitness for employment and/or fitness to carry out my duties now and in the future. (*Note to
employee: you will be asked to confirm consent for this at the end of the consultation.)
I agree to Intl.SOS holding and processing data in accordance with the applicable local law, and the
data will be kept no longer than is desirable for the purposes for which they were collected.
Data Protection
Information about your health, medical history and any treatment you have received is known as personal sensitive data. We require your
written informed consent to obtain and process any health related data about you. Intl.SOS will store data in a secure environment and it will
only be accessed and processed by personnel who have explicit and reasonable need to do so. Anonymised data may be used by Intl.SOS
for research or statistical purposes. No individual will be identified in this anonymised research. On occasion, named data may be required to
be disclosed to regulatory bodies such as the HSE, MCA or local equivalent body.
Employee Name: Date:
Employee Signature:

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5.2 Return to Work Form – Section C

SECTION C - Return To Work Fitness Status - to be completed by physicians/ health providers familiar with offshore
industry
Recommendation following Medical Evaluation Tick as appropriate
1. Is the injury/illness thought to be work-related? Yes No
2. Fit to return to full duties offshore
3. Fit to return to restricted work offshore

(please complete Section D)
4. Unfit for any work at the time of examination
This employee has been assessed as unfit to return to offshore work because of the following reason(s):
Medical condition currently incompatible with work offshore due to safety concerns
Medical condition incompatible with helicopter transfer
Medical condition which requires further investigation prior to returning to offshore work
Dental condition which requires further treatment/time to settle
Medical condition which under assessing physician/ health provider’s opinion requires specialist assessment to
assist with additional risk evaluation
Medical condition which would currently significantly impact on the individual’s ability to perform his/ her normal
role
Other (please specify)
Further fit to return consultation (by the same physician/ health provider)
Full Occupational Health consultation

Review suggested
GP (General Practice) report required (i.e. from personal treating doctor)
Specialist assessment required
Suggested timing of review

(to be initiated by Employer –
Month/Year)
Physician/ Health Provider Name and Address / Tel and Email Date & Signature
This section to be completed by Intl.SOS Response Centre Occupational Health Physician

Based on confidential medical report(s) & the above medical evaluation, Intl.SOS confirms the following:
Fully concur with the above Return To Work determination made by the treating physician/ health provider. The case may
proceed according to the recommendation.
Incomplete medical or work-related information have been identified. More information is required on what the employee’s job
entails. Further evaluation is recommended after discussion with employer, employee and physician / health provider to facilitate a
future Return To Work or potential for work accommodation. Additional recommendation will follow.
Significant discrepancy has been identified between current medical condition and intended duration period to be “off work”
prior to a Return to Work. Further discussion is required with physician/ health provider and employee/employer. Additional
recommendation will follow.
Others:
This is an Intl.SOS electronic document for and on behalf of Intl.SOS – no signature required -

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5.3
Page 1Return
of 1 to Work Form – Section D
SECTION D - Fitness Restriction details - Physician/ health provider to complete this section if there is restriction to
working Offshore-
The content of this section will assist with the medical evaluation and potential accommodation of a Return to Work.
(This Section D will take approximately 5-10 minutes to complete.)
Please describe in detail what the employee CAN do:

Not
Applicable/
Yes No Not part of
normal
duties
Able to stand/ walk/ bend
Able to squat/ kneel/ crawl
Climb stairs
Climb ladders
Sedentary (occasionally lifts < 5kg)

Lifting (1) ability
Light (occasionally lifts up to 9kg, frequently lifts up to 5 kg)
Medium (occasionally lifts up to 22kg, frequently lifts 5-11kg, constantly lifts 5kg)
Heavy (occasionally lifts up to 45kg, frequently lifts 11-22kg, constantly lifts 4.5-9kg)
(1) includes pushing, pulling, carrying activities.
Repetitive arm use above shoulder height

PHYSICAL ACTIVITIES
Repetitive arm use waist to chest height

Reaching / Stretching
Work with vibrating tools
Work in noisy environment
Work in dusty environment
Work in /hot environment
Work in cold environment
Able to use a computer
Work in confined space

Carry out actions likely to be required in the event of a helicopter ditching at sea (i.e. able to fasten seatbelt & hold
brace position, good hearing & visual acuity, exit through emergency access from underwater, swim to surface).
Carry out actions likely to be required in the event of a platform evacuation (i.e. full physical ambulatory ability, move
through emergency hatches).
Participate in ERT (Emergency Response Team) activities including fire fighting and wearing SCBA (Self Contained
Breathing Apparatus)
Work Alone
Shift Work
Visual function adequate for time- keeping
Overtime
Maintain concentration
COGNITIVE
ACTIVITIES
Work in stressful environments

Work in safety critical role
Able to use standard computer
Classroom / e-learning
Additional Comments to Employer Line Manager:

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5.4 Return to Work Referral Letter

(Note: To use such referral letter template in association with Return to Work Form that includes
consent from patient. This referral letter is designed for completion by the Intl.SOS OH physician supporting the
Response Centre as part of a “Non Urgent Activation fromHome / Final Care Location” Return to Work process.Please
delete this note before sending final referral letter).
<Date>
Dear Doctor
I would be very grateful for your report following an assessment of this offshore <job title > who works for <Company
name> (the employer) to whom we provide occupational health advice. Please direct your report to us via this patient
and do not communicate directly with the employer.
Upon receipt of your report we will advise the employer on fitness to return to work offshore based on your findings
and taking into consideration, the employer’s operating environment and organisational risk appetite.
Mr X presented with < > symptoms offshore and here is a summary timeline of the main events:
(The Intl.SOS OH physician is to summarize the issue with relevant details. See below a typical example. Please
adjust the narrative according to each specific case.)
1. 13 May 2014 – Onboard a vessel, offshore Angola, Mr X advised a colleague that he could not continue his
duties as < >, the colleague contacted < > management and arrangements were initiated to bring him back to shore.
< > was assessed by < > as fit to travel to shore by routine helicopter transport. < > was met off the helicopter by< >
representative and accompanied to an Intl.SOS arranged clinic.
2. 14 May 2014 – Dr Rory McKeown of Intl.SOS advised that Mr X is diagnosed as having “anxiety with a
depressive component”, “He was commenced on Mexozalam 1 tablet three times per day and Zoloft, one tablet at
night” and “He is currently fit to fly”. Mr X was released from the clinic and spent the night in the < >x staff house, with
other < > staff, whilst arrangements were confirmed to fly him back to South Africa.
3. 15 May 2014 – Mr X was accompanied to the airport and flew to Johanesburg South Africa, < > checked that
Mr X had arrived safely home and maintained regular ad-hoc contact thereafter.
4. 28 May 2014 – Mr X confirms that he has recovered & wishes to return in the role of < > at the next rotation
[due to start 27 July] and will attend his Doctors to get confirmation of his fitness to return to work.
5. 07 June 2014 – Mr X supplies fit for work letter from a doctor which indicates he is fit to return to work.
Understandably the employer is keen to ensure that Mr X is returning to work at an appropriate time, taking into
account the precipitating factors which may have lead to this episode, and any underlying < > factors. As such we
have advised the employer that Mr X be assessed by an experienced occupational physician or specialist with
knowledge of the working environment offshore.
As you are well aware, the offshore environment, given the isolation from normal society and treatment options, and
enforced social interaction in close quarters, is not an appropriate workplace for an individual with < > symptoms,
nor does it particularly support recovery. There are also safety considerations given Mr X’s role, as with any offshore
role.
We would appreciate a full report indicating:

(Note: To use such referral letter template in association with Return to Work Form that includes
consent from patient. This referral letter is designed for completion by the Intl.SOS OH physician supporting the
- any past < > condition, how it presented, management, precipitating factors, resolution timescale
Response Centre as part of a “Non Urgent Activation fromHome / Final Care Location” Return to W ork process.Please
delete this note before sending final referral letter).
- symptoms associated with this episode, any known precipitators, treatment to date, ongoing management
plan, current symptoms
- medication use and whether this is likely to affect him in a safety critical role
- any co-morbid factors eg. alcohol or drug use
- whether Mr X perceives that his work has contributed to his recent < > ill-health? If so in which way?
- prognosis and recommended management plan to reduce risk of recurrence
Please specify
 Is the employee fit for work?
 When will the employee become fit for work?
 Are any job restrictions or adjustments required?
 If so, are the restrictions temporary or permanent?
 Are there any work factors which need to be addressed?
 What can the company/employer do to assist?
Thank you in anticipation of your soonest response.
Best regards
< Medical Team Name >
Response Centre address details
Tel: +
E-mail
Web: www.internationalsos.com
Worldwide reach Human touch

International SOS is the world’s leading international healthcare, medical assistance, and security services company.

Version 1.01
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6 ENFORCEMENT AND REPORTING BREACHES
Breaches of this Procedure will have serious legal and reputation repercussions and could cause
material damage to International SOS. Consequently, breaches will lead to disciplinary action that
could include summary dismissal and to legal sanctions, including criminal penalties.
All employees are expected to promptly and fully report any breaches of the Procedures. A report
may be made to the employees’ supervisor or the Group General Counsel. Reports made in good
faith by someone who has not breached this Procedure will not reflect badly on that person or their
career at Intl. SOS. Reports may be made using the following e-mail address:
Compliance@internationalsos.com.
© 2016 All copyright in these materials is reserved to AEA International Holdings Pte. Ltd. No text
contained in these materials may be reproduced, duplicated or copied by any means or in any form, in
whole or in part, without the prior written permission of AEA International Holdings Pte. Ltd.

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Return to Work Advisory Services

Return to Work Advisory Services - A Topside

Linked to Standards for Occupational Health

Document Owner: Medical Services

Dr. Beau Dees, Dr. Cesar

Change from “MD Guidelines”

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Abbreviations and Definitions

References and Attachments

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Return to Work Advisory Services - A Topside Support feature

Staff Name Role/ Position Signature Date

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1 STRUCTURE OF THE DOCUMENT .............................................................................................................. 8

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6 ENFORCEMENT AND REPORTING BREACHES .......................................................................................... 45

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1 STRUCTURE OF THE DOCUMENT

1.1 Topics that structure the document - outlined below:

To improve readability, icons have been placed in the text:

Golden Rules Examples

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Figure 1: Bio-psychosocial obstacles to (return to) work and corresponding interventions

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WII Occupational Injury & Illness

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2 RETURN TO WORK URGENT ACTIVATION FROM WORKPLACE

2.1 Flow Chart (See Below)

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Return to Work (RTW) Advisory

Injured or ill patient receiving care

No Return to Work process.

Examining Doctor on shore:

Patient / Employee on shore contacted by R.C.

Can the patient be

See Non-Urgent RTW for future

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2.2 Urgent Activation from Response Centre’s Perspective

2.2.1 Start of Return to Work process and on-shore referral

Actions for Response Centre Medical Team

If you are currently “offshore”:

If you are currently “onshore”:

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Actions for Response Centre CSE

2.2.2 Use of the Return to Work form

Actions for Response Centre Medical Team

3) Obtains the completed Return to Work form sent by the IMP

2.2.3 Territorial Responsibility

Are the R.C and A.C. in the same territory?

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Actions for Response Centre CSE

2.2.4 Briefing of Medical Provider (if within Response Centre Territory)

Actions for Response Centre Medical Team

b. If specified by client and / or MERP, an offshore / occupational health medical provider

Actions for Response Centre CSE

2) Obtain an estimated cost for the appointment.

4) If authorised, place a guarantee of payment.