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MODIFIED DUTY JOB OFFER INJURED WORKER S NAME: L&I CLAIM NUMBER: SUBMITTED
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How to fill out modified duty job offer

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How to fill out modified duty job offer:

01
Make sure to include the name and contact information of the employer at the top of the offer. This includes the company name, address, phone number, and email.
02
Provide the full name and contact information of the employee being offered the modified duty job. Include their job title, department, and any other relevant details.
03
Specify the effective date of the modified duty job offer. This is the date on which the employee should begin their new position.
04
Clearly state the reason for the modified duty job offer. This could be due to a workplace injury, illness, or other circumstances that prevent the employee from performing their regular job duties.
05
Outline the specific duties and responsibilities of the modified duty job. This should be tailored to accommodate the employee's restrictions or limitations, while still ensuring they can contribute to the organization.
06
Indicate the working hours and schedule for the modified duty job. This should align with any medical or physical restrictions the employee may have.
07
Mention the wage or salary for the modified duty job. This may be adjusted based on the changes in job duties or reduced working hours, so be clear about any differences in pay.
08
Include any additional benefits or accommodations that may be provided to the employee in their modified duty job position.
09
Specify any conditions or expectations that the employee must meet while in the modified duty job. This may include regularly providing medical updates, attending appointments, or adhering to workplace safety protocols.
10
Provide a deadline for the employee to accept or decline the modified duty job offer.

Who needs modified duty job offer:

01
Employees who have sustained a workplace injury or illness and are unable to perform their regular job duties due to medical restrictions.
02
Individuals with temporary disabilities or medical conditions that prevent them from carrying out their usual job responsibilities.
03
Employees who have undergone surgery or medical treatments that require a period of modified work duties during recovery.
04
Individuals who have been granted work accommodations under the Americans with Disabilities Act (ADA) or similar employment laws due to a disability.
05
Any employee who requires job modifications or alternative duties in order to safely and effectively perform their job while recovering from an injury or illness.
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Modified duty job offer is a job offer that includes modified duties to accommodate an employee's restrictions or limitations.
Employers are required to file modified duty job offers for employees who are unable to perform their regular job duties due to a work-related injury or illness.
To fill out a modified duty job offer, employers must include the employee's name, job title, modified duties, start date, and any other relevant information.
The purpose of a modified duty job offer is to provide injured or ill employees with the opportunity to return to work in a capacity that accommodates their restrictions or limitations.
Information that must be reported on a modified duty job offer includes the employee's name, job title, modified duties, start date, and any restrictions or limitations.
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