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[DOC File]LIGHT DUTY WORK AGREEMENT - Service Lloyds
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Duty Limitations * _____ Employee Responsibilities *Report to work at assigned time. *Report to supervisor the date and time of all doctor and therapy appointments. *Notify supervisor as soon as possible in situations involving absence from work and tardiness.
light duty forms template

[DOCX File]SAMPLE MODIFIED DUTY/RETURN TO WORK PROGRAM
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If the work restrictions require modified/light duty work, then such assignment will be evaluated and made available in the work unit if possible. b.If any question should arise concerning the injured employee's ability to perform a specific modified/light duty assignment, the doctor who authorized the modified/light duty work must be contacted ...
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[DOC File]WORKERS' COMPENSATION: MODIFIED-LIGHT DUTY …
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These work duties are offered to you as of_____and will be re-evaluated on _____if you have not been released to full duty. We are offering you this position to accommodate the medical restrictions identified by your physician. You must follow your abilities and restrictions as prescribed by your physician.
light duty work restrictions form

[DOCX File]NOTICE TO RETURN TO MODIFIED DUTIES
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Notice -Return to Work. This letter is sent to employees to notify them that they have been released to return to work. The letter includes all information necessary to defend a termination petition should the employee not return to work as ordered by this letter. If the employee voluntarily returns to work, this letter is not required.
light duty job description templates

OP 52.57 Early Return-to-Work, Alternate, and Light Duty ...
a. Granting alternate/light duty is optional, and the offer of alternate/light duty may be terminated at any time in accordance with the operational needs of the university. The offer or termination of alternate/light duty must be communicated to the employee in writing using the Return to Work (Alternate/Light …
light duty work form

[DOCX File]Employers Job Description (F252-040-000)
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Worker Name: Claim Number: Job Title: F252-040-000 Employer’s Job Description Form 05-2020. F252-040-000 Employer’s Job Description 05-2020
light duty restrictions letter

Template for light duty work