Get Functional Abilities Form

Filling out the Functional Abilities Form is an essential step in documenting your functional capacity for returning to work. This guide provides a clear, step-by-step approach to help you complete the form accurately and effectively online.

Follow the steps to complete the Functional Abilities Form seamlessly.

1. Press the ‘Get Form’ button to obtain the Functional Abilities Form, and open it in your preferred online document editor.
2. Begin by filling out the employee's name and occupation in the appropriate fields. Ensure all details are accurate to avoid any delays in processing.
3. In the authorization section, provide your signature and the date to authorize your health professional to share your functional abilities information with your employer and insurance carrier.
4. Proceed to Section A, where your health care provider will complete the statement about your expected recovery date and whether rehabilitative treatment is required. They will also indicate your fitness to work status.
5. In Section B, select the appropriate functional abilities by checking the boxes that reflect your capabilities in various categories such as sitting, standing, walking, and lifting. Be honest and thorough in your selections.
6. Note any additional restrictions or comments in the designated areas, including chemical exposure or ability to operate equipment.
7. Once all sections are completed, review the entire form for accuracy. Make any necessary corrections before finalizing.
8. After ensuring all information is correct, you can save your changes, download the completed form, or print it directly.
9. Finally, fax the completed form to 905-577-8379 as instructed on the document. Ensure you keep a copy for your records.

Complete your Functional Abilities Form online today to facilitate your return to work!