Get Applicability/accountability:

This guide will help you navigate the process of completing the applicability/accountability form for the return-to-work program at Florida Atlantic University. Ensuring you understand each section of the form will facilitate a smoother transition back to work following a workplace injury.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to access the applicability/accountability form and open it in your editor.
2. Begin by entering the employee's name and employee ID at the top of the form. This information helps identify the individual completing the form.
3. Fill in the department and supervisor's information. This section identifies the supervising authority and department for the employee returning to work.
4. Document the date of the work-related injury. It is crucial to reference this date as it relates to the employee's return to work status.
5. List the functional restrictions identified on the DWC-25 form. Ensure accuracy as these restrictions dictate the nature of the modified or alternate duties assigned.
6. Provide details on the assigned modified or alternate duty assignments, including the start date and work hours. This information outlines what the employee will be doing upon their return.
7. Include alternate duty department information if different from the primary position, alongside the name of the alternate duty supervisor. Clarity on supervision is essential for the transition back to work.
8. Review the conditions included in the form. Ensure the employee understands that participation in the return-to-work program is temporary and subject to performance evaluations.
9. Ensure both the employee and supervisor sign and date the form, confirming their agreement with the information and responsibilities outlined.
10. Finally, save the changes to the form. You may then download, print, or share the completed document as necessary for your records or submission to the relevant department.

Complete your documents online today to ensure a smooth transition back to work.