Return to work - California Department of Industrial Relations - State - dir ca 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name and claim number. This ensures that your form is correctly associated with your case.
3. In the section labeled 'Employer or Claims Administrator', input the name of the claims administrator and their contact details. This is crucial for communication regarding your job offer.
4. Fill out the job title and starting date for the position being offered. Make sure to indicate whether this position is at the same location and shift as your pre-injury role.
5. Review the compensation details carefully. Ensure that the wages offered are at least equivalent to 85% of what you were earning at the time of injury.
6. Finally, sign and date the form in the employee section, indicating whether you accept or reject the offer. If rejecting, provide a reason if applicable.

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