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Get KY Sedgwick Claims Management Services Assessment For Return To Work 2013-2024

Work. Assessment for Return to Work Employee: Date of Last Appointment: Claim #: Next Office Visit: Job Title: Return to work full duty without restrictions effective: The patient is released to work with the following restrictions effective: through: Will treating provider allow restrictions to be lifted without an additional exam? If no, please provide date of exam in which re-evaluation will take place: In an 8 hour day, indicate the amount of weight (lbs) the patient can: N.

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