What to Do When the Doctor Won’t Release the Injured Worker to Return

A common (and frustrating) obstacle in workers’ compensation management is this scenario:

An employee is injured. The employer has a transitional duty program ready. But the treating physician says, “No work until further notice.” End of story—at least, that’s how it feels.

Unfortunately, many employers accept this without question, assuming they have no choice but to wait. Meanwhile, the costs pile up: lost wages, replacement labor, lost productivity, higher claims reserves, and a stalled recovery.

But here’s the truth: You don’t have to sit on the sidelines. You have tools—and rights—that allow you to challenge an unnecessary “no work” designation and get your injured employee back to safe, productive duty faster.

Why This Happens

There are several reasons doctors may delay releasing a patient to work:

• Lack of information about the employee’s job or your transitional duty program

• Overly cautious attitude or fear of liability

• Time constraints during the visit

• Assumption that “no work” is best for recovery

• Pressure from the employee or misunderstandings about the injury

Often, it’s not about the injury—it’s about communication gaps. And those can be fixed.

Step 1: Make Sure the Doctor Knows You Offer Transitional Duty

One of the biggest mistakes employers make is failing to communicate clearly that they can accommodate any temporary restrictions. If a doctor believes your company expects full-duty work or has no light-duty options, they’re more likely to write a blanket “no work” order.

Action:

• Create a simple flyer or letter that explains your transitional duty program.

• Send it with the injured employee to every medical appointment.

• Include sample light-duty tasks and a contact name for questions.

Make it known: Your company can and will provide safe, modified work.

Step 2: Provide a Job Description or Job Video

Doctors can’t determine whether an injured employee can return to work if they don’t understand what the job requires. And sadly, many employers don’t have detailed, ADA-compliant job descriptions ready.

Action:

• Provide a physical demands analysis or a detailed job profile.

• Even better: send a video of the job being performed.

• Offer information on alternate duties if the regular job is too demanding.

When the provider can see what’s involved, they’re more likely to release the employee to partial work.

Step 3: Engage in Physician-to-Physician Communication

Sometimes, a peer needs to challenge a peer. If the treating doctor is overly cautious or vague, a call from your company’s medical advisor—or a physician working with your third-party administrator (TPA)—can make all the difference.

Action:

• Request a physician peer review.

• Ask your TPA to have their doctor call the treating physician directly.

• Clarify that the employer is offering modified work within restrictions.

This isn’t about undermining the treating doctor—it’s about making sure the decision is fully informed and medically justified.

Step 4: Use Evidence-Based Medicine to Set Expectations

Every injury has a range of expected recovery times. Tools like MDGuidelines and ODG by MCG provide benchmarks for how long a typical worker should be off the job. If the duration your employee is out significantly exceeds those guidelines, you have reason to question it.

Action:

• Compare the projected recovery time to injury duration guidelines.

• If there’s a major discrepancy, ask for documentation explaining why.

• Highlight that your company is ready to accommodate restrictions within that recovery window.

Having clinical data on your side gives you credibility when pushing for a faster return.

Step 5: Challenge Unreasonable Restrictions—Respectfully

Doctors aren’t perfect, and they’re not always up to date on the nuances of workers’ compensation. If you’ve offered modified duty, provided job info, and still get “no work,” it’s appropriate to challenge the decision—respectfully.

Action:

• Ask for clarification in writing.

• Use peer review and job documentation to support your case.

• Remind the provider of the negative health effects of prolonged inactivity—physical deconditioning, psychological disengagement, depression, etc.

Always keep the focus on what’s best for the employee’s recovery, not just cost.

Bonus Tip: Don’t Let “No Work” Stop the Process

Even if the doctor initially says “no work,” that doesn’t mean it’s permanent. Re-evaluate weekly. Continue to send updated job options, and keep communication open. Injured employees often want to return but don’t feel empowered to speak up. Show them you’re invested in their recovery.

Bottom Line

When a doctor won’t release an employee to work, it can feel like your hands are tied—but they’re not. With proactive communication, physician collaboration, and evidence-based guidelines, you can turn “no work” into “modified work.”

The key is to stop being passive in the process. Advocate for your employee’s recovery. Advocate for your company’s financial health. And never accept “no” as the final answer until every option has been explored.

Michael Stack, CEO of Amaxx LLC, is an expert in workers’ compensation cost containment systems and provides education, training, and consulting to help employers reduce their workers’ compensation costs by 20% to 50%. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.” Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center. WC Mastery Training teaching injury management best practices such as return to work, communication, claims best practices, medical management, and working with vendors. IMR software simplifies the implementation of these best practices for employers and ties results to a Critical Metrics Dashboard.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

Injury Management Results (IMR) Software: https://imrsoftware.com/

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.