Get Dwc Ad Form 1013333 Description Of Employees Job Duties Draft 2doc - Dir Ca

This guide aims to help users effectively complete the DWC AD Form 1013333, which outlines an employee's job duties for the purpose of assessing their ability to return to work. By following the provided steps, users will ensure all necessary information is accurately filled out in an online format.

Follow the steps to complete the DWC AD Form 1013333 online.

1. Press the ‘Get Form’ button to access the form, which will open in your online editor.
2. Begin by entering the employee's name in the designated section, including last name, first name, and middle initial.
3. Fill in the employer's name in the appropriate field.
4. Input the claim number in the designated area.
5. Provide the job address where the employee performs their duties.
6. Enter the job title of the employee.
7. Indicate the usual hours worked per day and per week.
8. In the 'Description of job responsibilities' section, describe all the duties performed by the employee in detail.
9. Select one option from the choices of Regular Duty, Modified Duty, or Alternative Work to classify the employee's job status.
10. For the activity frequency section, check the hours required per day for each listed activity such as sitting, walking, and other physical activities.
11. For the lifting and carrying requirements, indicate the frequency of lifting and carrying based on the outlined options, and specify the weight ranges.
12. Respond to the questions regarding any hazards or special requirements by indicating 'yes' or 'no' where applicable.
13. Provide any necessary comments from both the employee and employer in their respective comment sections.
14. Complete the employer contact name and title, and ensure the employer representative and employee sign and date the document before submission.
15. Once all fields are filled out, save changes, and choose to download, print, or share the completed form.

Complete your DWC AD Form 1013333 online today!