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Click ‘Get Form’ to open the return to work doctors note in the editor.
Begin by filling out the worker information section. Enter the worker's title, last name, first name, middle initial, and preferred first name. Ensure you include their WorkSafeBC claim number and personal health number.
Next, provide the employer information. Fill in the employer's name as registered with WorkSafeBC, along with their contact details and address.
In the details of injury section, specify the worker’s occupation, dates of injury and layoff, and whether they have returned to work. Answer questions regarding their ability to earn as much as before the injury.
Complete any additional information required about payments made during disability and peculiar circumstances related to the case.
Finally, ensure that an authorized person signs and dates the form before submission.
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May 9, 2016 The request may be made by the employee, or it may be made in a doctors note releasing the employee to return to work with certain restrictionsRead more
Medical Leave-Return to Work Form. NOTE: A portion of this form must be completed by a Health Care Provider. A copy of this Medical. Certification form mustRead more
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