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To document an offer of modified or alternative work by the employer at the time of injury, as well as the acceptance or rejection by the injured employee. Applicable for injuries occurring on or
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How to fill out NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK

01
Obtain the NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK form from the appropriate source.
02
Fill out the employee's name and contact information at the top of the form.
03
Include the date of the offer.
04
Describe the modified or alternative work being offered, including job duties and location.
05
Specify the start date and expected duration of the modified or alternative work.
06
Outline any changes to compensation or benefits related to the new work arrangement.
07
Provide an explanation of how the modified or alternative work accommodates the employee's medical condition or restrictions.
08
Include a section for the employee's signature to indicate their acceptance or rejection of the offer.
09
Review the completed form for accuracy.
10
Submit the form to the relevant parties as required by your organization's policies.

Who needs NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK?

01
Employees who are unable to perform their usual work duties due to medical reasons or workplace injuries.
02
Employers looking to provide modified or alternative work options to accommodate employees' needs.
03
HR professionals responsible for managing employee benefits, accommodations, or workplace injuries.
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The NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK is a formal notification provided by an employer to inform an injured worker about the availability of modified or alternative work options that accommodate their injury and allow them to return to work.
Employers who wish to offer modified or alternative work to an injured employee must file the NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK.
To fill out the NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK, employers must provide details such as the job description, nature of the modified work, location, wages, and any necessary accommodations to ensure the work is safe for the employee's condition.
The purpose of the NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK is to facilitate the return of injured workers to the workforce by offering suitable job options that accommodate their restrictions, thereby promoting recovery and reducing workers' compensation costs.
The NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK must report information including the employee's name, the nature of their injury, the details of the modified or alternative position offered, the wages for the position, and any specific accommodations that are being made.
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