It must be received by Worker's Compensation coordinator for your campus within 3 work days. Instruct employee to return the Physician Certification form DOA AD-WC 4 within 48 hours of first treatment. Employee needs emergency transport and is not able to complete forms. Supervisor or designee completes Form WC-12, DOA 6058, DOA 6436, and DOA 6437 and sends it to Worker's Compensation coordinator right away. Call employee and review IER and within 48 hours.
Supervisor checks back with employee throughout the shift.
With Restrictions Review Physician Certification report as soon as received. If current job cannot be changed, look for tasks within work unit, then section, department or campus. Worker's Compensation coordinator, in coordination with UWSA, should call or write doctor if you have questions about employee's limits or abilities to perform assigned tasks. Send copies of all documentation to Worker's Compensation coordinator. Employee signs the RTWA and is given a copy.