ORS FORM PPD-4PF 1 August 2023

U.S. Department of Labor

Bureau of Labor Statistics 

Occupational Requirements Survey

Private Industry

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O.M.B. #1220-0189

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ESTABLISHMENT INFORMATION

Establishment Name

Schedule Number Quote Number

JOB INFORMATION Job Description: ☐ Yes ☐ No Job Observation: ☐ Yes ☐ No

Job Title Full-time ☐ Part-time ☐

# Full-time Employees________# Part-time Employees____________

Job Work Schedule ________hrs/day __________hrs/wk ________wks/yr.

 Work Schedule Varies? ☐ Yes ☐ No

Critical Job Function

Critical Tasks

10% Tasks

SUPERVISORY INFORMATION

Supervisory Duties: ☐ None ☐ Lead Worker ☐ Supervisor ☐ Manager

Frequency of Work Being Checked:

☐ Every few minutes ☐ At least once per hour ☐ At least once per day ☐ At least once per week

☐ Less than once per week, including never

Supervisor Present: ☐ Yes ☐ No
2 August 2023

SPECIFIC VOCATIONAL PREPARATION (SVP)

Minimum Education

(If no minimum, must workers 

be able to read and write?)

Experience

Credentials

On-the-Job-Training

WORK PACE

Control of Workload:

☐ Machinery, equipment, or software ☐ Numerical performance targets (company determined)

☐ People (such as customers, supervisor, etc.) ☐ Self-paced by worker ☐ Other (specify) _________

Work Pace: ☐ Consistent – Fast ☐ Consistent – Slow ☐ Varies

Pause Control (ability to step away): ☐ Yes ☐ No

COMMUNICATION & HEARING

Work Related Communication

Speaking: (Duration – % of time)

☐ Up to 2% ☐2% up to 1/3 ☐ 1/3 up to 2/3 ☐ 2/3 or more ☐ Not Present ☐ Present, Duration Unknown

Internal Verbal Interactions:

☐ Every few minutes ☐ At least once per hour ☐ At least once per day ☐ At least once per week

☐ Less than once per week, including never

External Verbal Interactions:

☐ Every few minutes ☐ At least once per hour ☐ At least once per day ☐ At least once per week

☐ Less than once per week, including never

People Skills: ☐ Basic ☐ More than Basic

Hearing

In-person Speech: ☐ Yes ☐ No Telephone: ☐ Yes ☐ No

Other Remote Speech (such as walkie-talkies, intercoms, public address systems, etc.): ☐ Yes ☐ No

Far Visual Acuity: ☐ Yes ☐ No

Vision 

Near Visual Acuity: ☐ Yes ☐ No

Peripheral Vision: ☐ Yes ☐ No 

ORS FORM PPD-4PF

Driving: ☐ Yes ☐ No Vehicle: _________________
ORS FORM PPD-4PF 3 August 2023

PHYSICAL DEMANDS

Sitting vs. Standing/Walking

Sitting (hours or percent) Standing/Walking (hours or percent)

Sit/Stand at Will: ☐ Yes ☐ No

Lifting/Carrying

Most Weight Ever Lifted lbs.

Items lifted/carried

Seldom

(Up to 2% of the time)

Occasional

(2% up to 1/3 of the time)

Frequent

(1/3 up to 2/3 of the time)

Constant

(2/3 or more or the time)

☐ None ☐ None ☐ None ☐ None

☐ Negligible ☐ Negligible ☐ Negligible ☐ Negligible

☐ 1 to 10 lbs. ☐ 1 to 10 lbs. ☐ 1 to 10 lbs. ☐ 1 to 10 lbs.

☐ 11 to 25 lbs. ☐ 11 to 25 lbs. ☐ 11 to 25 lbs. ☐ 11 to 25 lbs.

☐ 26 to 50 lbs. ☐ 26 to 50 lbs. ☐ 26 to 50 lbs. ☐ >25 lbs.

☐ 51 to 75 lbs. ☐ 51 to 75 lbs. ☐ >50 lbs. ☐ Unknown

☐ 76 to 100 lbs. ☐ 76 to 100 lbs. ☐ Unknown

☐ >100 lbs. ☐ >100 lbs.

☐ Unknown ☐ Unknown

Pushing/Pulling

Up to 2%

2% up to 

1/3

1/3 up to

2/3

2/3 or 

More

Not Present

Present, 

Duration 

Unknown

One / Both

Hands/Arms: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Feet/Legs: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Reaching/Manipulation

Up to 

2%

2% up to 

1/3

1/3 up to

2/3

2/3 or 

More

Not Present

Present, 

Duration 

Unknown

One / 

Both

Overhead Reaching: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

At/Below Shoulder 

Reaching: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Gross Manipulation: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Fine Manipulation

(include time spent 

keyboarding)

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Foot/Leg Controls: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Keyboarding: ☐ Yes ☐ No ☐ Unknown

Note: Duration % = percentage of the worker’s time

 None = Lift/Carry not present for duration 
4 August 2023

Low Postures

Up to 2%

2% up 

to 1/3

1/3 up to

2/3

2/3 or 

More

Not 

Present

Present, 

Duration 

Unknown

Work At/Below Knee Level: ☐ ☐ ☐ ☐ ☐ ☐

Stooping: ☐ Yes-Required ☐ Yes-Worker's Choice ☐ No ☐ Unknown

Kneeling: ☐ Yes-Required ☐ Yes-Worker's Choice ☐ No ☐ Unknown

Crouching: ☐ Yes-Required ☐ Yes-Worker’s Choice ☐ No ☐ Unknown

Crawling: ☐ Yes-Required ☐ Yes-Worker’s Choice ☐ No ☐ Unknown

Climbing

Ramps or Stairs, Structural: ☐ Yes ☐ No

Up to 2%

2% up to 

1/3

1/3 up to

2/3

2/3 or 

More

Not Present

Present, 

Duration 

Unknown

Personal 

Protective 

Equipment 

Ramps/Stairs, 

WorkRelated:

☐ ☐ ☐ ☐ ☐ ☐

Ladders/ 

Ropes, or 

Scaffolds:

☐ ☐ ☐ ☐ ☐ ☐

High, Exposed 

Places: ☐ ☐ ☐ ☐ ☐ ☐ ☐

ENVIRONMENTAL CONDITIONS AND WORK SETTING

Up to 2%

2% up to 

1/3

1/3 up to

2/3

2/3 or 

More

Not Present

Present, 

Duration 

Unknown

Personal 

Protective 

Equipment 

Outdoors: ☐ ☐ ☐ ☐ ☐ ☐

Extreme Heat ☐ ☐ ☐ ☐ ☐ ☐

Extreme Cold: ☐ ☐ ☐ ☐ ☐ ☐

Wetness: ☐ ☐ ☐ ☐ ☐ ☐

Humidity: ☐ ☐ ☐ ☐ ☐ ☐

Heavy 

Vibration: ☐ ☐ ☐ ☐ ☐ ☐

Hazardous 

Contaminants: ☐ ☐ ☐ ☐ ☐ ☐ ☐

Proximity to 

Moving 

Mechanical 

Parts:

☐ ☐ ☐ ☐ ☐ ☐ ☐

Public Work Area: ☐ Yes ☐ No Working Around Crowds: ☐ Yes ☐ No Telework: ☐ Yes ☐ No

Noise Intensity Level: ☐ Quiet ☐ Moderate ☐ Loud ☐ Very Loud

Personal Protective Equipment: ☐ Yes ☐ No 

ORS FORM PPD-4PF