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GROUP BENEFITS CRITICAL ILLNESS PHYSICIAN STATEMENT OCCUPATIONAL HIV INFECTION MAILING ADDRESSINSTRUCTIONSMail:Cooperators Life Insurance Company Please print clearly and be sure all sections are
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Physicians statement - occupational is a form completed by a healthcare provider regarding an individual's health status as it relates to their ability to perform occupational tasks.
Employees who have a job that requires physical or mental fitness may be required to file a physicians statement - occupational.
To fill out a physicians statement - occupational, individuals must visit their healthcare provider who will assess their health and complete the form accordingly.
The purpose of physicians statement - occupational is to ensure that employees are physically and mentally fit to perform the tasks required by their job.
Information such as the individual's medical history, physical capabilities, and any restrictions or accommodations needed to perform job tasks must be reported on physicians statement - occupational.
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