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RETURN TO WORK SUPPLEMENT PROGRAM WRITTEN COMMENTS ON THE PROPOSED REGULATIONS Speaker Entity Issues Raised Method Hazel Ortega Counseling Center 1) Will the applicant attorney receive fee for RT

How to fill out return to work supplement

How to fill out return to work supplement:

1. Obtain a copy of the return to work supplement form. This form is typically provided by your employer or workers' compensation insurance company.
2. Fill in your personal information at the top of the form, including your name, address, and contact information.
3. Specify the date of your injury or illness that caused you to be away from work.
4. Describe the nature of your injury or illness and provide any necessary details or medical documentation.
5. Indicate the date you are planning to return to work or have already returned.
6. State any accommodations or restrictions needed for your return to work, such as modified hours or duties.
7. Sign and date the form to certify that the information provided is accurate and complete.
8. Make a copy of the completed form for your records before submitting it to your employer or insurance company.

Who needs return to work supplement:

1. Employees who have been on leave due to a work-related injury or illness may need to fill out a return to work supplement.
2. Workers' compensation recipients who are getting medical treatment and rehabilitation services may also be required to complete this form.
3. Employers and insurance companies use the return to work supplement to evaluate an employee's readiness to return to work and to ensure appropriate accommodations are made if needed.

For pdfFiller’s FAQs

What is return to work supplement?

Return to work supplement is a financial incentive provided to encourage individuals receiving unemployment benefits to return to work.

Who is required to file return to work supplement?

Individuals who are receiving unemployment benefits and have returned to work are required to file return to work supplement.

How to fill out return to work supplement?

To fill out return to work supplement, individuals must provide information on their new employment status and wages.

What is the purpose of return to work supplement?

The purpose of return to work supplement is to support individuals in transitioning from unemployment to work and improve workforce participation.

What information must be reported on return to work supplement?

Information such as new employment details, wages, and employer information must be reported on return to work supplement.

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