How to Support Employees With a Return-to-Work Agreement After Rehab

How to support employees returning to work after rehab

The prevalence of substance use disorders in the workplace is significant and requires an informed employer response. According to the CDC, “70 percent (about 13.6 million workers) of all adults with an alcohol or illicit drug use disorder are employed, making the workplace an important setting to address [substance use disorders].” 

Returning to work can be an important milestone for post-rehab employees, but several measures should be taken to help ensure a successful transition. We recommend the following best practices for supporting employees in their return to work.

1. Establish a return-to-work agreement.

A return-to-work agreement (RTWA) is a written document outlining an employer’s expectations for a returning employee. The U.S. Department of Labor recommends that an RTWA be in place before a staff member returns to the workplace. This agreement outlines expectations — including complying with a drug-free workplace — and acknowledges that failure to meet these standards may be grounds for termination. This agreement is an important accountability tool.

In your RTWA, include both performance expectations and treatment continuation requirements.

Performance expectations

• Clear job responsibilities and performance standards
• Attendance and punctuality requirements
• Compliance with the company’s drug-free workplace policy
• Participation in required monitoring or support programs
• Communication protocols with supervisors
• Consequences for policy violations

Treatment continuation requirements

• Proof of ongoing treatment participation (if applicable)
• Authorization for employer contact with treatment providers
• Schedule accommodations for treatment appointments
• Random drug testing consent and procedures

2. Create a comprehensive return-to-work plan.

If you want to set your returning team member up for success, have a return-to-work plan in place. This differs from the return-to-work agreement in that the RTWA is about guidelines and requirements, while the return-to-work plan details specific initiatives that will be implemented. 

For example, it can be helpful to outline flextime, allowing the employee to choose a work schedule that works best for both your company and the worker. This often includes working four 10-hour days or allowing some days to work remotely, giving them a better opportunity to attend support groups and required meetings. Another part of your return-to-work plan might include frequently checking in with the employee to assess their success or administering random drug tests to ensure they are drug-free.

Here are some actions you may want to take when executing the return-to-work plan:

Week 1-2: Initial reintegration

• Conduct welcome-back meeting with employee and immediate supervisor.
• Review return-to-work agreement and expectations.
• Provide updated company policies and procedures.
• Establish regular check-in schedule (daily initially, then weekly).
• Assign workplace mentor or support person.

Month 1: Adjustment period

• Monitor workload and stress levels.
• Assess need for schedule accommodations.
• Evaluate effectiveness of support systems.
• Address any workplace challenges or concerns.
• Document progress and areas for improvement.

Months 2-6: Ongoing support

• Conduct monthly performance reviews.
• Adjust accommodations as needed.
• Maintain open communication channels.
• Monitor for signs of stress or relapse risk.
• Celebrate milestones and achievements.

Long-term: Sustained recovery support

• Transition to standard performance review cycle.
• Continue available accommodations as needed.
• Maintain access to employee assistance programs.
• Provide ongoing professional development opportunities.

3. Support your employee with a workplace mentor.

Keep in mind that it’s often with mixed emotions that a recovering addict returns to the workplace following rehab. Returning to this environment can be challenging, especially for a team member who fears dealing with overly curious or critical co-workers. While not every colleague may be trying to dig up dirt for the company office mill, even those who are trying to be supportive may inadvertently ask inappropriate questions.

It can be helpful to have one or two leaders who know what the recovering employee has been through and can help integrate them back into the office scene. These colleagues can be a positive addition to the worker’s recovery system. 

These mentors should:

• Be willing to participate voluntarily and have a genuine interest in helping.
• Have excellent communication and interpersonal skills.
• Be able to maintain confidentiality.
• Have a strong understanding of addiction and recovery.
• Have previous experience with recovery (personally or professionally).

• Understand addiction as a medical condition.
• Be able to recognize signs of stress or potential relapse.
• Know appropriate versus inappropriate questions and conversations.
• Know company policies regarding substance abuse and recovery.
• Know the available resources and referral procedures.

4. Provide comprehensive mental health benefits.

Mental health benefits can be a great way to support employees returning to work after rehab. You can provide mental health resources such as counseling, therapy and employee assistance programs (EAPs). Host regular check-in meetings with the staff member to ensure they are doing OK and encourage them to take mental health days when needed. Explaining these benefits clearly is essential so they know what options are readily available.

According to the CDC’s workplace supported recovery guidelines, employers should “offer health and well-being programs that promote work-life fit and teach functional coping skills.” These can include:

• Stress management workshops
• Mindfulness and meditation programs
• Physical fitness programs
• Nutrition education and support
• Sleep hygiene education
• Crisis intervention support
• Financial and legal consultation services

5. Prevent workaholism as a substitute addiction.

Some individuals in recovery end up substituting one addiction for another. Alcoholism or drug abuse can morph into workaholism. Your worker may use job demands as an excuse to escape other challenging emotional situations or avoid dealing with painful feelings and broken relationships post-rehab. Yes, as an employer, you may love your employee’s newfound work ethic, but it’s just as important that they make time to reconnect with friends and family, attend meetings and enjoy sober-related activities. 

>> Read related article: Ways to Prevent Employee Burnout

Signs of workaholism to monitor include:

• Consistently working excessive hours beyond job requirements.
• Difficulty taking breaks or vacation time.
• Anxiety when away from work.
• Isolation from colleagues and family.
• Neglecting self-care and recovery activities.

You can help prevent workaholism by:

• Setting clear boundaries on work hours and availability.
• Encouraging and monitoring use of vacation time.
• Promoting work-life balance through company culture.
• Hosting regular check-ins about workload and stress levels.
• Referring the team member to EAP services if concerning patterns emerge.

6. Respect privacy and maintain confidentiality.

Above all else, remember that neither you nor your returning team member owes anyone else an explanation for the employee’s absence or past behaviors. Your company may have specific policies in place for dealing with this challenging situation, but no matter what, your returning staff member deserves to be treated with respect. While some recovering addicts may wish to be open about their journey to connect with or inspire others, not everyone is ready for this step. If they’re not ready to talk about their recovery, respect this desire for privacy.

Under the Family and Medical Leave Act (FMLA), employers are required to keep medical records confidential and maintain them in separate files from more routine personnel files. Employers must also maintain records with confidentiality as required under other laws, such as the Americans with Disabilities Act (ADA). Learn more about this below.

Legal protections and compliance requirements for employees returning from rehab

If you’re in the position of welcoming an employee back into the workplace after rehab, there are several important legal frameworks you should understand to ensure compliance with anti-discrimination employment laws.

Americans with Disabilities Act (ADA) protections

The Americans with Disabilities Act (ADA) “prohibits discrimination against people in recovery from opioid use disorder (OUD) who are not engaging in illegal drug use, including those who are taking legally prescribed medication to treat their OUD.” 

According to SHRM, “An alcoholic is generally a person with a disability under the ADA, whereas someone who is addicted to drugs is protected under the ADA only if [they] are not currently using illegal drugs.”

To comply with the ADA, employers:

• Cannot discriminate against employees in recovery from substance use disorders.
• Must provide reasonable accommodations for employees with disabilities.
• Cannot ask disability-related questions during pre-employment.
• Must maintain confidentiality of medical information.
• Cannot retaliate against employees for requesting accommodations.

Reasonable accommodations can include:

• Modified work schedules for treatment appointments.
• Flexible break times for medication or support group attendance.
• Leave of absence for intensive treatment programs.
• Temporary reduction in job responsibilities during early recovery.
• Transfer to a less stressful position if available.

Family and Medical Leave Act (FMLA) considerations

The FMLA states that “substance abuse may be a serious health condition if certain conditions are met. However, FMLA leave may only be taken for treatment for substance abuse by a health care provider or by a provider of health care services on referral by a health care provider.” Importantly, “absence because of the employee’s use of the substance, rather than for treatment, does not qualify for FMLA leave.”

To comply with the FMLA, keep in mind that:

• Eligible employees may use FMLA leave for substance abuse treatment.
• Treatment must be provided by or referred by a healthcare provider.
• Employers must maintain job protection during approved leave.
• Medical certification may be required.
• Confidentiality requirements apply to all medical information.

How to overcome common return-to-work challenges

Developing and maintaining an effective return-to-work program for employees in recovery requires addressing several common obstacles that organizations face.

Challenge 1: Stigma and workplace culture

Problem: Employees may believe substance use disorder is a moral failing and recovery isn’t possible.

Solutions:

• Implement company-wide education programs about addiction as a medical condition.
• Train supervisors and managers on appropriate language and behavior.
• Develop clear anti-discrimination and anti-harassment policies.
• Promote recovery success stories (with employee consent).
• Create alcohol-free and health-focused work social events.

Challenge 2: Balancing safety and support

Problem: It can be difficult to ensure workplace safety while supporting employees in recovery, particularly in safety-sensitive positions.

Solutions:

• Develop clear fitness-for-duty protocols.
• Implement appropriate drug testing programs.
• Create alternative assignments for safety-sensitive roles during early recovery.
• Establish clear return-to-safety-sensitive-duties criteria.
• Provide additional safety training and monitoring as needed.

Challenge 3: Resource allocation and cost management

Problem: Providing adequate support while managing program costs and resource allocation can weigh on the company.

Solutions:

• Partner with existing EAP providers to expand services.
• Leverage community resources and support groups.
• Implement peer support programs using existing employees.
• Utilize technology solutions for remote support and monitoring.
• Measure return on investment through reduced turnover and improved productivity.

Challenge 4: Legal compliance complexity

Problem: Navigating multiple, sometimes overlapping legal requirements (ADA, FMLA, state laws) is overwhelming and confusing.

Solutions:

• Consult with employment law attorneys to develop compliant policies.
• Train HR staff on relevant legal requirements.
• Develop standardized procedures for handling accommodation requests.
• Maintain detailed documentation of all interactions and decisions.
• Regularly review and update policies based on legal developments.

Challenge 5: Supervisor and manager preparedness

Problem: Front-line managers lack the knowledge and skills to effectively support employees in recovery.

Solutions:

• Provide comprehensive supervisor training on addiction and recovery.
• Develop clear escalation procedures for challenging situations.
• Create decision-making tools and resources for managers.
• Establish regular consultation with HR and EAP professionals.
• Implement ongoing education and refresher training programs.

Building a recovery-supportive workplace

Returning to work after rehab is a critical part of recovery for many former addicts. Work provides a structured routine, stimulates the mind, and offers opportunities for socialization and positive interactions in a safe and controlled environment. But in addition to being beneficial for the returning employee, welcoming a staffer back after rehab can also benefit your business. For example, if the worker was a high performer before the substance abuse began, there is a good chance they will become a high performer once again. 

By implementing comprehensive policies, providing appropriate training, ensuring legal compliance and addressing common challenges proactively, employers can create workplaces that not only support employees returning from rehab but also contribute to long-term business success. The investment in supporting staffers through recovery demonstrates corporate responsibility while building a more resilient and productive workforce.