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You keep IP ownership of your information
1. Patient Information: Employee's full name, date of birth, and relevant identification information
2. Employer Information: Company name, address, and contact information
3. Physician Information: Name, contact information, and medical license number of the treating physician
4. Medical Clearance Statement: Clear statement indicating whether the employee is cleared to return to work
5. Return to Work Date: Specific date when the employee is cleared to resume work
6. Work Capacity: Indication of full duty or modified duty status
7. Authorization and Signatures: Signature lines for physician, date, and any required patient authorization for release of information
1. Work Restrictions: Detailed list of specific work restrictions if returning with modified duties
2. Accommodation Requirements: Specific workplace accommodations needed for safe return to work
3. Duration of Restrictions: Timeframe for how long work restrictions or accommodations should remain in place
4. Follow-up Appointments: Schedule of required follow-up medical evaluations
5. Workers' Compensation Information: Include if the return to work is related to a workplace injury claim
6. Gradual Return to Work Schedule: Detailed schedule for gradually increasing work hours or duties
7. Specific Job Task Analysis: Detailed analysis of job tasks the employee can/cannot perform
1. Schedule A - Physical Capacity Evaluation: Detailed assessment of physical capabilities and limitations
2. Schedule B - Workplace Accommodation Plan: Specific details of required workplace modifications or accommodations
3. Schedule C - Progressive Return to Work Schedule: Detailed timeline and steps for gradual return to full duties
Healthcare
Manufacturing
Construction
Professional Services
Retail
Education
Technology
Transportation
Mining
Agriculture
Public Sector
Financial Services
Hospitality
Energy
Telecommunications
Human Resources
Occupational Health and Safety
Risk Management
Operations
Legal
Benefits Administration
Employee Relations
Disability Management
Workers' Compensation
Medical Services
Human Resources Manager
Health and Safety Coordinator
Occupational Health Nurse
Return to Work Coordinator
HR Business Partner
Benefits Administrator
Risk Manager
Department Manager
Supervisor
Disability Management Specialist
Employee Relations Manager
Workers' Compensation Coordinator
HR Director
Operations Manager
Chief Human Resources Officer
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ұԾ’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; ұԾ’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it