WebPrior to any medical evaluation declaring the employee permanent and stationary, the physician may be sent Form [DWC- AD 10133.33, "Description of Employee's Job … WebForm [DWC-AD 10133.35 “Notice of Offer of Work for Injuries Occurring On or After 1/1/13.”] §10133.36. Form [DWC-AD 10133.36 “Physician’s Return-to-Work & Voucher Report.”] § 10133.51. Notice of Potential Right to Supplemental Job Displacement Benefit. § 10133.52. Form [DWC-AD "Notice of Potential Right to Supplemental Job Displacement

DESCRIPTION OF EMPLOYEE

WebDec 16, 2024 · Section 10133.33 - Form [DWC-AD 10133.33 "Description of Employee's Job Duties Form."] Prior to any medical evaluation declaring the employee permanent … WebDWC Form PR-4 (Rev. 10/2015) Date of Injury Last Date Worked Date of Last Exam Date of Current Exam Permanent & Stationary Date Date of Birth. DWC Form PR-4 (Rev. 10/2015) Sheet 2 of 6 ... For injuries occurring on or after 1/1/13 also complete DWC-AD Form 10133.36 Limited, but retains MAXIMUM capacities to LIFT (including upward … how many carbs in a large bagel

Message - California Code of Regulations - Westlaw

WebDWC AD 10133.36 Freeman Rehabilitation Services Debbie Freeman P.O. Box 370, San Carlos CA 94070 Phone: 650-595-4447 ~ Fax: 866-804-0574 [email protected] Physician’s Return-to-Work & Voucher report For dates of injuries post 1/1/13 physicians are required to complete a Physician’s … WebForm [DWC-AD 10133.35 “Notice of Offer of Work for Injuries Occurring On or After 1/1/13.”] §10133.36. Form [DWC-AD 10133.36 “Physician’s Return-to-Work & Voucher Report.”] § 10133.51. Notice of Potential Right to Supplemental Job Displacement Benefit. § 10133.52. Form [DWC-AD "Notice of Potential Right to Supplemental Job Displacement high roofing design