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Click ‘Get Form’ to open the Light Duty Assignment Request Form in the editor.
Begin by entering your Name and Job Title in the designated fields. This information is essential for identifying your request.
Fill in the Date of Injury, which helps document the context of your light duty request.
Indicate whether you are currently on Worker’s Compensation by selecting 'Yes' or 'No'.
Choose whether a light duty assignment is available within your department by selecting the appropriate option.
Briefly describe the duties you will be performing during your light duty assignment in the provided space.
Specify the Start Date and Time for your light duty assignment, followed by the End Date and Time.
Sign and date the form at the Employee Signature section to confirm your request.
Ensure that your Supervisor signs and dates their approval, followed by Human Resources' approval if necessary.

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How long can an employee stay on light duty?

Under the ADA, or Americans with Disabilities Act, employees on light duty are entitled to work overtime if they are physically able to do so, the EEOC ruled.

Does light duty mean no overtime?

Light work generally means lifting 20 pounds maximum with frequent lifting and/or carrying of objects weighing up to 10 pounds. Light medium work means lifting 30 pounds maximum with frequent lifting and/or carrying of objects weighing up to 20 pounds.

What is the meaning of light duty?

Light Duty 5 Examples in Workers Compensation Cases Example of regular job dutyPossible corresponding light duty Stocking store shelves Taking inventory (no lifting) Valeting cars Manning the valet station (no walking) Working on a factory line Doing desk work (no standing)2 more rows Feb 7, 2025

What jobs are light duty?

There is no exact amount of time an employee is allowed to stay on light or modified duty. The length of modified duty will depend on your employers policy. Your employer is allowed to only temporarily provide modified duty if that is what your policy says.

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