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Hi
and
,
,
I have a placement for
,
Claim Number:
,
and have attached the GA WC-240a form to be sent to the treating physician for approval.
[[formData.claimsAdjusterName]]
- Please review the GA WC-240a Job Analysis form for accuracy and complete any blank fields.
- Please send it to the treating physician for approval, providing at the same time a copy to the claimant and the claimant’s attorney (if represented).
- Ensure the authorized treating physicians approve the light duty job within 60 days of their last examination.
- Once the WC-240a is approved we can set a start date, so please return the approved form to me as quickly as possible.
Once I have the approved 240a, I will provide you with the WC-240 Offer Letter. The WC-240 and all attachments will need to be provided to [[formData.employeeName]], [and counsel] at least 10 days prior to the scheduled start date.
Placement Location:
Schedule:
Job Duties:
Other tasks may be assigned within physical restrictions. Tasks are self-paced, not production oriented.
Travel Information:
(Directions will be provided with WC-240 Job Offer)
I look forward to setting a start date upon physician approval of the GA WC-240a. Please let me know if you have any questions.
Thank you!