Fillable physical demands analysis worksheet form

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PRINT PHYSICAL DEMANDS ANALYSIS WORKSHEET CLAIMANT NAME POLICY NUMBER CERTIFICATE NUMBER JOB TITLE JOB LOCATION INDICATE NUMBER OF TIMES PER DAY THE LISTED ACTIVITY IS PERFORMED: LIFTING (Includes pushing and pulling effort while stationary) 1 but less than 5 lbs. (0.5 but less than 2.3 kgs.) 5 but less than 10 lbs. (2.3 but less than 4.5 kgs.) 10 but less than 25 lbs. (4.5 but less than 11.3 kgs.) 25 but less...
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physical demands analysis worksheet
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