Get Physical Capability Form - Healthlink

Filling out the PHYSICAL CAPABILITY FORM - HealthLink online is an important step in assessing a person's work capabilities and limitations. This guide provides clear instructions to help users complete the form accurately and efficiently, ensuring all necessary information is included.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to access the PHYSICAL CAPABILITY FORM and open it in the editing interface.
2. Fill in the date and the patient's name at the top of the form. Ensure that this information is accurate as it is essential for record-keeping.
3. Contact CompManagement for precertification of any outpatient testing. Include the employer’s contact information and the necessary details as specified.
4. Indicate the patient's work capability by checking the appropriate box: ‘Patient is unable to work’, ‘Patient may return to work’, or specify any restrictions.
5. For each category of work (Heavy, Medium, Light, Sedentary), check the relevant lifting capacity that applies to the patient. Be clear and honest about the patient's capabilities.
6. Complete the section regarding the patient's ability to perform various activities such as sitting, standing, bending, twisting, climbing, and others. Mark the frequency of each task.
7. Indicate the patient’s ability concerning hand functions such as grasp, pincer grip, and repetitive movements. Specify the dominant hand where applicable.
8. If applicable, fill in the treatment plan and any other instructions or limitations dictated by the physician. Include the diagnosis and the date of the next appointment.
9. Finally, the physician must sign the form, including the date of maximum medical improvement (MMI) and any restrictions if necessary. Review the entire form for accuracy before submission.
10. Once completed, save changes, and download, print, or share the form as required.

Complete your documents online efficiently by following these steps.