Introduction - Return to duty guide for Canadian Armed Forces members
Overview of the CAF RTD Program
CAF RTD is a comprehensive recovery, rehabilitation and re-integration program for ill and injured Regular and Reserve Force members with the joint objective of returning the member fit for general and operational duties.
When a CAF member becomes ill or is injured, a Primary Health Care Provider (PHCP) may assign the member Medical Employment Limitations (MEL) and recommend a modified duty schedule. A CAF member is placed on RTD status when they have received an RTD recommendation from a PHCP that is being implemented in an RTD Plan approved by their commanding officer (CO).
Being placed on RTD status means that the ill or injured CAF member is still capable of performing work albeit at a reduced capacity and frequency. It also means that member’s recovery, rehabilitation, and reintegration are a part of their daily duties.
The ill or injured CAF member’s unit is responsible to develop an RTD plan that respects the member’s MELs and modified work week and promotes the member’s recovery, rehabilitation and reintegration.
The ill or injured CAF member is responsible to follow their RTD plan until such time as they are declared by a PHCP as fit for duty, or they are assigned MELs that will most likely lead to their release from the CAF for medical reasons.
Principles of CAF RTD
RTD is not a compromise between meeting the needs of the CAF member and the needs of the CAF as an organization. RTD is an organizational goal of the CAF and, as such, RTD plans should comply with the tactical, operational and strategic goals of the CAF. Successful RTD requires courage, compassion, commitment, communication and capacity. Courage for the ill or injured to overcome the uncertainty, anxiety, and fear that comes with an illness or injury. Compassion from the chain of command to overcome the stigma, judgement and prejudice towards the ill or injured. Commitment from the ill or injured to focus on their recovery, rehabilitation and reintegration and comply with their RTD plan. Communication must be open, frequent, and collaborative between all stakeholders. Capacity on the part of the organization to ensure that the resources are available within the unit and outside of the unit to promote RTD and support the ill and injured on RTD.
RTD is fundamentally a multidisciplinary approach that depends on the collaborative efforts of: the CAF member, the CAF member’s chain of command (COC); their HCP team; Personnel Support Programs (PSP) Specialists; and, the support and services provided by the local Transition Centre (TC). In order for RTD to be successful, the ill or injured member must be actively involved in the development of their RTD plan.
An RTD plan should satisfy the following principles:
- The RTD benefits the CAF member
- The RTD benefits the CAF as an organization
- The CAF member feels they continue to belong to the team and are contributing to the unit’s/organization’s mission
- The member is progressively challenged to take on more and more responsibility
- The RTD plan is a staged or phased approach to coincide with the goals established by the multidisciplinary team for recovery and rehabilitation
- The placement is deemed to be realistic by the member and the multidisciplinary team with full consideration of the member’s physical and mental capacities
- The placement is individually focused and driven by the member’s engagement
- The placement is respectful, dignified, safe and reflective of rank and experience
- The placement is flexible and creative and meaningful to the member
Leaders at all levels have a responsibility to ensure that their members understand that early RTD intervention is their best chance for recovery, rehabilitation and reintegration. Ill or injured members must have trust and confidence that their leadership will support them in all aspects of their RTD. This fosters loyalty and unit cohesion and maintains a shared identity for the ill or injured member within their team.
One of the most challenging barriers to successful RTD is stigma, both within the organization and within the individual ill or injured member. Stigma can deter the ill or injured member from seeking treatment. Members can be reluctant to come forward with an illness or injury for fear that it could lead to their release from the CAF. Leaders are further responsible to foster confidence, build trust and eliminate this stigma within the members under their command.
CAF RTD Stakeholders
RTD is not based solely on the recommendation of the member’s PHCP. There are numerous stakeholders to successful RTD planning, implementation and management. Each stakeholder has vested interests that complement the intended outcome of RTD. Each stakeholder has specific roles and responsibilities associated with successful RTD. The following list represents key stakeholders in the RTD Process:
- The CAF Member
- The Primary Health Care Provider
- The Parent Unit Chain of Command
- The TC RTD Coordinator
- The Unit RTD Representative
- The Employing Unit Supervisor/Chain of Command
- The Psychiatrist/Psychologist/Social Work Professional
- The Physiotherapy/Occupational Therapy Professional
- The PSP Regional Adapted Fitness (RAF) Specialist
- The PSP Physical Exercise (PE) Specialist
- The Nurse Case Manager
- The Member’s Spouse/Partner and Family
- The TC Services Manager
- The TC Platoon Commander (when the member is posted to JPSU)
- The Regional/Local Soldier On representative
Not all stakeholders need to be engaged in all aspects of RTD planning and implementation. However, effective and appropriate stakeholder engagement must be maintained throughout the RTD process.
More complex MELs may require specialist engagement (such as Occupational Therapists) to assist RTD planning that takes into consideration the CAF requirements, the member’s current and future capacity and the MELs.
Eligibility for CAF RTD
All serving members of the CAF who are ill or injured are eligible for the CAF RTD program. Although the program is aimed primarily at members who will be returning to duty in the Regular Force, ill or injured members of the Reserve Force are also eligible to receive support under the CAF RTD Program in accordance with their class of service.
Participation in the CAF RTD Program
CAF members who are expected to have a prolonged course of recovery and rehabilitation beyond 30 days coupled with a requirement for reintegration into their place of duty, should be placed on RTD. Members with an expected course of recovery less than 30 days should not normally be placed on RTD.
Depending on the nature of their illness or injury, a member may be assessed by a PHCP as having high, uncertain or no potential for success in their RTD. Members who are assessed with high potential for success (typically 30-90 days) will normally have their RTD plan coordinated at the unit level. These members should remain with their parent unit. Members who are assessed as having uncertain potential for success (120-180 days) should normally have their RTD plan coordinated at the TC level. They may or may not, depending on circumstances, remain with their unit or be placed outside of their unit. Those who are recommended for RTD that is expected to last beyond 6 months may be posted to the Joint Personnel Support Unit (JPSU). They may still be able to conduct RTD at their home unit. Those members who are assessed as having no potential for successful RTD should have a Release Transition Plan coordinated at the TC level. A detailed flow chart describing levels of RTD coordination based on potential for success is provided at Annex D to this Guide.
For members posted to the JPSU, the RTD process is facilitated by the TC RTD Coordinator. For those members who remain with their parent unit, the RTD process is facilitated by the Unit RTD Representative with the engaged support or guidance of the TC RTD Coordinator as required. In some instances, the member may benefit from joint facilitation between the Unit RTD Representative and the TC RTD Coordinator. The extent of this collaboration will depend on the duty placement needs of the member and the administrative capacities of the local TC and those of the Unit.
CAF members who are awaiting a decision regarding the assignment of permanent MELs that could be in high risk of breaching U of S are still to be employed within the limitations of their MELs. They should be considered participants in the CAF RTD program until their MELs are either removed or they are assigned permanent MELs that are in high risk of breaching U of S. Once these latter MELs are assigned or a decision is made to release, they will begin planning for transition. Furthermore, if a member’s illness or injury is of a nature that will most certainly lead to their release, they should not be participants in an RTD program, and should instead participate in a transition program.
A medical recommendation that supports a CAF member’s efforts to commence a program of vocational rehabilitation towards a civilian transition is, by its implied objective, not on a RTD program. While it promotes the recovery and rehabilitation of the CAF member, it excludes the interests of the CAF in promoting the member’s reintegration. The needs of the organization should be balanced with the needs of the member in this regard.
CAF RTD Program and CO’s Authority
All ill or injured members, whether posted to the CAF TG or remaining in the unit, continue to subject to the authority of their chain of command. As such, participation in the CAF RTD Program is subject to the approval of the member’s CO.
The CDS instructed in CANFORGEN - 128/03 ADMHRMIL 061 Oct 03, that MELs assigned by medical staff will be honoured by the chain of command without alteration. Commanding officers are reminded that they have no authority to overrule or disregard what the member’s PHCP recommends as medical care for members under their command.
Consequently, if the member’s CO does not support their participation in the CAF RTD Program, the CO is still obliged to respect the member’s MELs as recommended by the PHCP. In such cases, the immediate or short-term needs of the organization should be balanced with the immediate and long-term needs of the member and effort be made to collaboratively accommodate the member’s RTD placement requirements.
Participation in a CAF Release Transition Plan (RTP)
CAF members who have been assigned permanent MELs that are likely to lead to release, will be supported under a Release Transition Plan (RTP). Like RTD, they should be employed within the limitations of their MELs until such time as they are released. Support provided to members on RTP is the same to that provided to members on RTD. However, the goal and outcome of an RTP is different from RTD. Members on RTP are expected to establish, while still employed in the CAF, goals in their employment that support a transition to civilian life and work. The member’s chain of command is expected to support those goals through a gradual but timely shift away from a reintegration plan that focusses on unit operational needs towards a transition plan that focusses on the member’s future civilian employment needs.
CAF RTD Program Funding
The CAF RTD Program is not a funded program, and as such, the ill or injured member’s unit continues to be responsible for that member’s administrative or support costs associated with their placement on RTD. With respect to civilian RTD placements; associated administrative, training, and resource requirements should be covered by the civilian employer.
CAF RTD and CAF Regulations, Policies and Procedures
CAF ill and injured on RTD are subject to the same administrative and disciplinary regulations, policies and procedures as all members of the CAF. DAOD 5018-RTD establishes the policy related to CAF members on RTD with respect to the operating principles, conditions and administration of RTD.
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