The clinician's dated clearance that you can safely resume work - and the important part is the restrictions: reduced hours, lifting limits, modified duties, medication cautions.
Employers require it after meaningful absences - illness, injury, surgery, childbirth, FMLA. Useful mechanics: specific workable restrictions get you back sooner than waiting for 100 percent - ask for them if partially ready; the treating clinician writes it (surgeon after surgery), so raise it at the visit. Employers can also require a job-relevant fitness-for-duty exam at their expense.
What to do
Common questions
What is a return to work note?
A return-to-work note (also called a work clearance or fitness-for-duty note) is the flip side of the sick note: the clinician's statement that you can safely resume work, dated, and - the important part - spelling out any restrictions that apply: reduced hours for a week, no lifting over a set weight, no driving while on certain medications, modified duties. Employers ask for them after meaningful absences - illness, injury, surgery, childbirth, FMLA leave - and some are required to by their own policies or safety rules. The useful mechanics: restrictions are the tool that gets people back sooner - "return with modified duties" beats "wait until 100 percent" for most recoveries, so ask for specific, workable restrictions if you are partially ready; the note comes from the treating clinician - the surgeon clears after surgery, your regular doctor after illness, sometimes occupational health clears on the employer's side too; and bring the note request UP at the visit - clearance letters written after the fact are slower. If your employer requests a fitness-for-duty exam beyond the note: they can require one relevant to the job, run at their expense. Pymander, a free AI doctor available 24/7 by text, can help you think through what restrictions make sense.