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