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Workers' Compensation Light Duty Offer

Workers' Compensation Light Duty Offer

WORKERS' COMPENSATION LIGHT DUTY / MODIFIED DUTY OFFER

Date: [Offer Date]

To: [Employee Name]

[Employee Address]

From: [HR Contact Name]

[Employer Name]

[Employer Address]

Phone: [HR Contact Phone] | Email: [HR Contact Email]

Re: Light Duty / Modified Work Offer — Workers' Compensation Claim No. [Claim Number]

BACKGROUND

Dear [Employee Name],

This letter serves as [Employer Name]'s formal offer of light duty / modified work employment pursuant to the workers' compensation laws of the State of [Employer State]. You sustained a workplace injury on [Injury Date] while employed as [Original Job Title]. Your treating physician, [Treating Physician], has released you to modified duty work as of [Restrictions Date], subject to the following documented restrictions:

PHYSICIAN-DOCUMENTED RESTRICTIONS (as of [Restrictions Date]):

[Medical Restrictions]

These restrictions are in effect through [Restriction End Date], subject to update at your next scheduled medical appointment.

LIGHT DUTY POSITION OFFERED

[Employer Name] is pleased to offer you the following light duty / modified duty position:

Position Title: [Light Duty Title]

Department / Location: [Light Duty Department]

Work Schedule: [Light Duty Hours]

Wage Rate: [Light Duty Wage]

Report Date: [Report Date]

Direct Supervisor: [Supervisor Name]

JOB DUTIES

The following duties have been selected to comply with all restrictions documented by your treating physician. You will not be required to perform any task that exceeds your physician's restrictions:

[Light Duty Tasks]

WORKPLACE ACCOMMODATIONS

The following accommodations will be provided to support your restrictions during the light duty period:

[Accommodations]

TERMS OF THIS OFFER

1. This light duty offer is temporary in nature and is contingent upon the continued existence of work within your physician-documented restrictions. It does not constitute a permanent change in your employment terms.

2. If your physician updates your restrictions at any follow-up appointment, please provide the updated restriction documentation to [HR Contact Name] within 24 hours of that appointment. The duties assigned to you under this offer will be immediately reviewed for compliance with updated restrictions.

3. If at any time during the light duty period you are asked to perform a task you believe exceeds your restrictions, you must immediately notify [Supervisor Name] and contact [HR Contact Name] at [HR Contact Phone]. Do not perform any task that you believe will cause pain or re-injury.

4. Acceptance of this offer does not constitute a waiver of any workers' compensation benefits to which you are entitled under [Employer State] law.

5. If the wages paid for the light duty position are less than your pre-injury average weekly wage, you may be entitled to temporary partial disability (TPD) benefits for the wage difference. Please contact your workers' compensation insurer regarding your benefit entitlement.

6. This offer is valid through [Restriction End Date] and is contingent on continued physician approval for modified duty work.

IMPORTANT NOTICE REGARDING BENEFIT IMPLICATIONS

Under the workers' compensation laws of [Employer State], if you decline this offer of suitable modified duty work without good cause, your temporary total disability (TTD) benefits may be suspended or reduced. This offer has been structured to comply in full with the restrictions documented by [Treating Physician]. If you have questions about how acceptance or rejection of this offer will affect your workers' compensation benefits, you are encouraged to consult with your attorney before [Response Deadline].

Please indicate your acceptance or rejection of this offer by [Response Deadline] by signing and returning this letter to [HR Contact Name] at [HR Contact Email] or by mail to the address above.

EMPLOYER REPRESENTATIVE:

Name: [HR Contact Name]

Company: [Employer Name]

Date: [Offer Date]

EMPLOYEE RESPONSE:

[ ] I ACCEPT this light duty offer and will report to [Light Duty Department] on [Report Date].

[ ] I DECLINE this light duty offer. Reason (optional): _________________________________

Employee Name: [Employee Name]

Employee Signature: ___________________________ Date: _______________

Employer Representative

________________

Signature

Employee (Acceptance/Rejection)

________________

Signature

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What Is a Workers' Compensation Light Duty Offer?

A Workers' Compensation Light Duty Offer in the United States sets out the workers' compensation light duty offer and the obligations it places on the parties.

The offer serves three simultaneous functions. First, it demonstrates the employer's good faith effort to reintegrate the injured worker into the workplace, which is required or strongly encouraged under the return-to-work provisions of most state workers' compensation statutes. Second, it creates a documented record that a suitable position was available within the physician's restrictions — a record that becomes critical if the worker refuses the offer and the employer seeks to suspend temporary total disability (TTD) benefits. Third, it protects the worker by committing the employer in writing to specific task assignments and accommodations that comply with their restrictions.

The document must be specific and precise. A vague offer of 'light duty work in the office' will not satisfy most state workers' compensation requirements. The offer must identify the exact position title, the precise tasks the worker will perform, the daily and weekly schedule, the wage rate, the physical workplace location, the reporting date, and a complete list of accommodations provided. Every single task listed must fall within the physician's current documented restrictions — no exceptions.

The light duty offer letter is distinct from — but complementary to — a formal Return to Work Plan. The offer letter is the initial invitation; the RTW plan is the broader roadmap for the worker's progression back to full duty. Many employers issue both documents simultaneously once the physician releases the worker to any level of modified work.

When Do You Need a Workers' Compensation Light Duty Offer?

A light duty offer letter should be issued as soon as the employer becomes aware that the treating physician has released the injured worker to any level of modified or restricted duty work. This typically happens when the employer or insurer receives a return to work slip, a functional capacity evaluation, or an updated physician's report that documents specific work restrictions.

Employers in states with return-to-work incentive programs — including California, Colorado, Minnesota, New York, and Wisconsin — should issue the offer promptly after any modified duty release to qualify for available cost reimbursements, premium discounts, or experience modification rate credits. The qualifying criteria in these programs often require a written modified duty offer within a defined number of days after the physician's release.

The offer is particularly important when the injured worker is currently receiving temporary total disability benefits. A valid, properly written modified duty offer that the worker refuses without good cause triggers the employer's right to petition the state workers' compensation board for suspension or reduction of TTD benefits. Without a written offer on file, the employer has no basis for that petition regardless of whether suitable work was actually available.

Some employers issue a light duty offer letter even before the physician formally releases the worker, as a proactive measure to inform the worker that modified work will be available when their restrictions permit it. While this does not trigger the benefit implications of a formal offer, it demonstrates good faith and may encourage earlier cooperation in the return to work process.

For long-duration claims involving surgery or extended rehabilitation, new light duty offer letters should be issued each time the physician's restrictions are updated, as the type and scope of available modified work may change as the worker's functional capacity improves.

What to Include in Your Workers' Compensation Light Duty Offer

A valid, enforceable Workers' Compensation Light Duty Offer must contain specific elements to achieve its legal and operational purposes.

Physician restriction compliance is the absolute threshold requirement. The letter must accurately transcribe the treating physician's current restrictions and then demonstrate — task by task — that every duty in the offered position complies with those restrictions. If the physician says no lifting over 20 pounds, no task in the offer can require lifting over 20 pounds. If the restriction prohibits repetitive hand motion, no data entry quota can be imposed. Any disconnect between the physician's restrictions and the offered duties renders the offer legally vulnerable.

Position specificity is equally critical. The offer must name an actual, real position with real tasks — not a vague category of work. Listing specific duties ('review and verify outbound shipping documents,' 'enter shipment data into the warehouse management system') is far stronger than describing a general function ('perform clerical work'). Courts and workers' compensation boards scrutinize offer letters closely, and vague or conclusory descriptions are routinely found insufficient to suspend TTD benefits.

The wage disclosure section matters because of its benefit implications. If the light duty wage is less than the pre-injury average weekly wage, the injured worker may qualify for temporary partial disability (TPD) benefits to cover the difference — typically two-thirds of the wage gap up to the state maximum. The offer letter should acknowledge this entitlement rather than ignoring it, which demonstrates the employer's good faith and reduces the likelihood of a dispute.

The response deadline and benefit notice section is legally significant. Most state workers' comp statutes require the employer to provide the worker with a written offer and allow a reasonable time to respond — typically 5 to 10 days. The offer must include a clear statement that refusal of a suitable offer without good cause may result in suspension of TTD benefits. Without this notice, the employer may not be able to enforce the benefit suspension provision even if the refusal would otherwise qualify.

The employee response mechanism — an explicit accept or reject checkbox — creates an unambiguous record of the worker's decision. That record is essential if the employer later needs to petition the workers' compensation board for benefit modification.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Workers' Compensation Light Duty Offer (United States) [Legal document template]. Forms Legal. https://forms-legal.com/usa/employment/forms/workers-comp-light-duty-offer

MLA

"Workers' Compensation Light Duty Offer (United States)." Forms Legal, 2026, https://forms-legal.com/usa/employment/forms/workers-comp-light-duty-offer.

BibTeX
@misc{formslegal-workers-comp-light-duty-offer,
  author       = {{Forms Legal}},
  title        = {Workers' Compensation Light Duty Offer (United States)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/usa/employment/forms/workers-comp-light-duty-offer}},
  note         = {Free legal document template. Based on Fair Labor Standards Act (29 U.S.C. §201-219)}
}

Frequently Asked Questions

Based on Fair Labor Standards Act (29 U.S.C. §201-219) — Template last modified June 2026Verify the source →

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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