Page 187 - Personnel Policy and Procedures Manual
P. 187
K. Physical Capacity Evaluation Form - notification from the authorized treating physician which
outlines the medical limitations of the injured employee.
Section 1000.613 Workers Comp Temporary Duty Forms
A. Request for Temporary Duty Assistance Form
B. Temporary Duty Employee Performance Evaluation Form
All Rights Reserved – As approved by the Commission on 05-07-2019 187 | P a g e