Fit for duty form 2025

See details

4 out of 5

30 votes

The document is a Fitness for Duty Report intended for completion by an attending physician to assess an employee's ability to return to work. It outlines the process for determining whether the employee can return to their regular job, limited-duty, or cannot return at all. The report includes sections for evaluating physical capabilities, lifting capacities, and any necessary accommodations while ensuring compliance with the Genetic Information Nondiscrimination Act (GINA) by prohibiting the inclusion of genetic information.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out fit for duty form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the fit for duty form in the editor.
Begin by entering the employee’s full name in the designated field. This ensures that the report is accurately attributed.
Select the appropriate status by checking one of the options: 'May return to regular job', 'May return to limited-duty', or 'May not return to work at this time'. Complete relevant items based on your selection.
In the activity section, circle the duration of each activity (Sit, Stand, Walk) that applies to the employee's capabilities.
Check off the capacity for each physical activity listed (Bend, Climb, Crawl, etc.) according to what applies.
Indicate lifting capabilities by checking the appropriate weight ranges and restrictions.
Provide physician comments or suggestions in the designated area and list any side effects from medications that may affect work performance.
Finally, ensure that both the treating physician's name and signature are included along with the date before submitting.

Start using our platform today for free to streamline your document editing and completion process!

See more fit for duty form versions

We've got more versions of the fit for duty form form. Select the right fit for duty form version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2012	4 Satisfied (30 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the OSHA fit for duty policy?

Fitness for Duty. Medical evaluations under this Program are required in order for the Agency to determine if covered employees are physically and medically capable of performing the essential duties of the position efficiently and without posing a hazard to themselves or others.

What is a fit for duty letter?

Fitness for Duty (FFD), also known as Fitness for Duty Evaluations (FFDE) are medical examinations conducted by a physician to determine whether an employee is fit (physically, mentally, or emotionally) to perform essential job functions.

What is the fit for duty procedure?

A fit-for-duty exam determines if the employee is physically and/or psychologically able to safely perform their current role. These specialized exams are typically reserved for more labor-intensive roles, and the exams are unique to each employer and their positions.

What is the OSHA standard duty clause?

Zweber stated, Section 5(a)(1) of the Occupational Safety and Health Act (the General Duty Clause) requires an employer to furnish to its employees: employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees

How do you determine fit for duty?

A fit for duty evaluation should be performed by an outside medical professional in order to guarantee an objective, non-biased evaluation and final report. The evaluation analyzes the employees job requirements, assesses the employees physical capabilities, and assesses the employees psychological state.

Who fills out the fitness for duty form?

The employee is required to provide a complete and sufficient Fitness for Duty Certification, completed by his or her health care provider, prior to returning to work from FMLA leave. This certification is being sought only with regard to the particular health condition that caused the employees need for FMLA leave.

What are the rules for fit for duty?

An employee is fit for duty when they are able to perform their essential job functions, with or without a reasonable accommodation, in a manner that does not pose a direct threat. An employees essential job functions are the fundamental duties of the position or the primary reasons the position exists.

Fit for duty form 2025

Here's how it works