Light Duty Agreement Form

When an employee is injured on the job, they may be unable to perform their usual duties until they fully recover. In such cases, an employer may issue a light duty agreement form, also known as a transitional duty agreement. This form outlines the employee`s temporary job duties and responsibilities until they are fully recovered and able to resume their regular job functions.

A light duty agreement form is an essential part of a company`s workers` compensation program. It is designed to protect both the employer and employee during a worker`s recovery period. By providing the employee with temporary light-duty tasks, the employer can ensure that the worker continues to make a valuable contribution to the organization while they recover. Additionally, it helps the employee maintain a sense of normalcy and purpose during a difficult time.

The form typically includes the following information:

1. Employee information: This includes the employee`s name, department, job title, and identification number.

2. Injury information: This section includes details about how the employee was injured, the date of the injury, and the body part affected. It should also list any medical restrictions or limitations placed on the employee by a doctor.

3. Light-duty job description: This section outlines the specific job duties and responsibilities that the employee will be performing during their recovery period. It should include a detailed description of the job tasks, the expected duration of the light duty assignment, and the level of supervision required.

4. Employee expectations: The form should clearly outline the employee`s expectations during the light duty assignment. This may include attendance requirements, work hours, and performance expectations.

5. Employer responsibilities: The agreement should also provide details on the employer`s responsibilities during the light duty assignment. This may include providing the necessary training, equipment, and materials needed for the job, as well as monitoring the employee`s progress.

It`s important to note that a light duty agreement form is not a permanent change to an employee`s job duties. Once the employee has fully recovered, they will resume their regular job functions.

In conclusion, a light duty agreement form is a crucial part of a company`s workers` compensation program. It ensures that employees who are injured on the job can continue to contribute to the organization while they recover. By following the guidelines outlined in the agreement, both the employer and employee can work together to ensure a successful recovery and return to work.