Physician return to work template

    • [DOCX File]WORKPLACE CAPABILITIES FORM

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      Early and Safe Return to Work. Revision Date: 08-Jun-15. Page 1 of 1. M:\Committees and Groups\Standing Committees\OHS\Forms\WCB Forms\Medical Restrictions Form.docx. Revision Date: 27-Jan-15. Page 2 of 1. The purpose of this form is to; p. rovide. restrictions to the . employer to. enable the worker to return to alternate or mod . ified work as soon as . possible, to . i. dentify suitable ...

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    • [DOC File]Sample Template for RTW Policy and Procedures

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      Title: Return to Work (RTW) Date of Issue: Approved by: Review/Revise Date: POLICY STATEMENT A brief statement confirming the company’s commitment to the program and explaining the company’s return to work (RTW) philosophy. Example [Company name] is committed to providing a healthy and safe workplace for our workers. Preventing work- related injuries and illnesses is our primary goal. Our ...

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    • [DOC File]PHYSICIAN RETURN TO WORK LETTER

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      PHYSICIAN RETURN TO WORK LETTER. Re: (Employee’s Name) Date: Dear Dr: (Company name) Return to Work Program provides assistance to our injured employees in accomplishing as expeditious and productive a return to work as possible. Everyone benefits when an injured employee returns to work. The employee’s self esteem, earning potential and co-worker relationships are maintained, and we ...

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    • [DOCX File]Health and Safety Policy Statement

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      Stay at Work and Return to Work programs for employees with work-related injuries enable companies to reduce the cost of injury and illness. The employee suffers no loss in remuneration and is assigned productive work, which takes into consideration any physical restrictions, identified by you, the medical practitioner. The modified work may consist of modifying the employee’s existing job ...

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    • [DOC File]Attending Physician’s Statement - Trent University

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      Employee fit for return to work: ( Modified hours /duties in compliance with the functional limitations listed in. Section D (see back of page): How long? _____ Reassessment date _____ Complete recovery expected: ( Yes or ( No If no please explain: _____ SECTION C: (to be completed by a licensed medical practitioner) Is the employee under your active care? ( Yes or ( No If no please indicate ...

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    • [DOC File]Injury Management Return to Work - BC Forest Safe

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      To the Attending Physician, Modified work programs assist in the rehabilitation, Stay at Work or an earlier Return to Work of employees with work related injuries while enabling companies to reduce the cost of injury and illness. The employee suffers no loss in remuneration and is assigned productive work, which take into consideration any physical restrictions, identified by you the medical ...

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