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This document serves as a notice from the employer offering modified or alternative work to an employee who has sustained an injury, detailing the terms, conditions, and employee's options regarding
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How to fill out dwc-ad 1013353 notice of
How to fill out DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK
01
Obtain a copy of the DWC-AD 10133.53 form from the appropriate workers' compensation board website or office.
02
Fill in the employer's name and contact information in the designated section on the form.
03
Provide the employee's name and claim number to associate the offer with the correct worker's compensation case.
04
Clearly describe the modified or alternative work being offered, including job duties, schedule, and location.
05
Indicate the starting date for the modified or alternative work.
06
Include any accommodations or modifications made to support the employee's ability to perform the work.
07
Ensure to sign and date the form at the bottom to verify the offer.
08
Submit the completed DWC-AD 10133.53 form to the employee and retain a copy for your records.
Who needs DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?
01
Employers who have injured workers returning to work may need to provide this notice to offer modified or alternative work options.
02
Employees who are currently receiving workers' compensation benefits and have been injured may need this notice to consider their return to work options.
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Workers' Compensation Claim Form (DWC-7) Form DWC-7 is a notice to provide injured workers with rights, benefits and contact information.
What does DWC mean in work?
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What is an offer of modified or alternative work?
Modified or alternative work options are available for employees who cannot perform their regular job duties due to a workplace injury or illness. These modified or alternative work options may include reducing hours, changing job duties, or providing additional assistance.
What does DWC stand for in medical billing?
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What is DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?
DWC-AD 10133.53 is a form used in California's workers' compensation system that notifies employees of an employer's offer of modified or alternative work that accommodates their medical restrictions.
Who is required to file DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?
Employers who have an injured employee that is capable of returning to work in a modified or alternative position must file the DWC-AD 10133.53 form.
How to fill out DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?
To fill out the form, employers must provide specific details about the job offer, including the job duties, hours, wage, and any requirements associated with the modified or alternative work position.
What is the purpose of DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?
The purpose of this notice is to inform the employee of the availability of modified or alternative work and to ensure compliance with California workers' compensation laws to facilitate the employee's return to work.
What information must be reported on DWC-AD 10133.53 NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?
The form must report the nature of the modified or alternative work, specific tasks to be performed, job location, anticipated hours, wage details, and a statement confirming that the work is within the employee's medical restrictions.
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