WORKERS’ COMPENSATION AND TEMPORARY DISABILITY

9.         WORKERS’ COMPENSATION AND TEMPORARY DISABILITY
900.001    Supervisor’s Accident Report Form
(2 attachments)

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900.001 – Attachment A — Instructions for Completing the State of Hawaii Supervisor’s Accident Report Form

Download (PDF, 196KB)

900.001 – Attachment B — Supervisor’s Accident Report Form

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902.001    Return to Work Priority Program (10 attachments) (rev. 10/27/03)

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902.001 – Attachment A — Administrative Directive No. 94-02, dated April 21, 1994

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902.001 – Attachment B1 — Estimated Functional Capacities Form

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902.001 – Attachment B2 — Mental Residual Functional Capacity Assessment

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902.001 – Attachment C — Light Duty Report

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902.001 – Attachment D — Sample Departmental Meeting Letter

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902.001 – Attachment E — Request for Statewide Job Search Assistance

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902.001 – Attachment F — Notification of Employee Separation

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902.001 – Attachment G1 — Flow Chart Return to Work Priority Program

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902.001 – Attachment G2 — Flow Chart Light Duty

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902.001 – Attachment G3 — Flow Chart Priority Placement

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