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Employee must report to Custodial Services when treating physician gives work restrictions via DWC Form-073. (shown below) 

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Step-by-step guide

 

Concentra (a medical provider) typically sends a different Work Status Report format, but the restrictions should be clearly specified with an end date.

Work Status Report Checklist:

  •  Ensure that the employee's social security number is blacked or whited out
  •  Ensure that the report has a specific end date (if there are restrictions listed)
  •  Ensure that the medical provider has signed and provided a follow up date (if needed)

 Contacts

 

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Related issues 
Info

If the report is missing or incorrectly filled out, seek assistance from the Training Manager or a senior leadership team member to clarify what options you have to remedy the issue.

Typically, a phone call to the provider will clarify any ambiguous work restrictions.