WebSep 13, 2024 · Providing the employee with the Duty Status Report, Form CA-17, for each doctor’s visit and monitor the employee’s medical progress and duty status. Note: Instruct the employee to return their completed form immediately to management after each visit or immediately upon receipt from the physician. WebPrintable Ca 17 Form. Check out how easy it is to complete and eSign documents online using fillable templates and a powerful editor. Get everything done in minutes.
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WebThe CA-17 is a form which the OWCP directs both the injured worker's supervisor and his/her treating physician to complete. It is split into two sections. Side A is completed by the employee's supervisor. How long … WebThe undersigned certify that, as of July 1, 2024 the internet website of the Franchise Tax Board is designed, developed and maintained to be in compliance with California Government Code Sections 7405 and 11135, and the Web Content Accessibility Guidelines 2.1, or a subsequent version, as of the date of certification, published by the Web ... ray\u0027s jv
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WebSacramento, CA 95834-1998. Fax Number: (916) 928-6817 EMail Address: [email protected]. DMV will process the request if forms are available. Requesters will be notified if forms are not available. ... 17-6001: for FO forms: Reproduced Form 17-11001: for BOAT forms: Reproduced Form 17-15001: For MC forms: DMV … WebOct 1, 2024 · Injured workers should thoroughly review Side A of the CA-17 prior to taking it to their doctor. Because the CA-17 is a legal document, any visible alterations of a completed form may be viewed as tampering and can lead to accusations of fraud. If the supervisor’s section of the CA-17 is not filled out correctly, a new form should be … WebForm CA-17 is generally used for this purpose. If your agency can provide work within your restrictions, you are required to return to work. Most employees who suffer disabling … dr転送