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Medical Ability to Work

The Sample Medical Ability to Work Form provides more comprehensive information on limitations or restrictions that the employee has upon returning to work. The Sample Medical Ability to Work Form is developed by the Commission to assist employers and employees with common medical information issues that arise in the workplace. It is intended to ensure that the employer, not the doctor, decides which modified duties are available. And the doctor's information reflects a functional analysis of the employee's abilities rather than advice about which jobs the employee can do.


Applications of Medical Ability to Work Form:

* Employers may provide the forms to employees and ask that their doctors complete them. * Employees may use the forms to get information from their doctors for their employers or benefit carriers. * Doctors may adapt the forms for use in their practices.The Points Worthy of Notice about Sample Medical Ability to Work Form:* It is not intended to replace any medical forms that are required by WCB or a third-party insurer, or employer-prescribed forms for an employer-funded benefit plan. * It is intended to help small to medium-sized employers who do not have a disability management position to assist managers and employees with such matters. * It takes into consideration the employee's right to privacy as well as the employer's right to all of the information that is reasonably necessary for a proper inquiry into accommodation. * It will remove the barriers that are created in workplaces by poor medical information, and thereby keep employees on the job. * It is not required by law in any situation.

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