Belte r r a Cor p or at ion S afety M an ual D oc I D C H S M BE L 2 0 1 7 Pa g e 4 76 of 53 8 M ED I C A L PR OF E SSI ON A L I N F OR M A T I ON N OT I C E Doc u m e n t Identif icat ion F R M 021 P age Nu m b e r 1 of 1 Doc u m e n t C r e ation Dat e J a nua r y 1 2013 Im p le m e n tat ion Dat e J a nua r y 1 2013 TO The Attending P h y sicia n Da te De a r M e dica l P rof e ssi ona l R E Empl o y e e Na me Oc c upa ti on B e lt e r ra C orpor a ti on ha s a poli c y to su pport r e c ov e r y a ft e r ill ne ss or inj ur y whe re it is appr op ria te b y gr a dua ll y int roduc ing the e mpl o y e e ba c k int o the w ork e nvi r o nment Our S uit a ble E mpl o y ment P ro g ra m e na bl e s e mpl o y e e s with i njurie s or ill ne sses to pe rf orm m odifie d duti e s a nd or modi fie d hour s of w ork without sa c rif icin g their s a fe t y or we ll be in g unti l t he y a re a ble to r e turn to t he ir full re g ul a r duties Attac he d fo r y our r e view is t he P h y si c a l De m a nd Ana l y sis or J ob De sc ripti on of thi s e mpl o y e e s re gular job duti e s P lea se a dvise us a s to wha t aspe c ts of the j ob our e mpl o y e e c a n sa f e l y pe r for m and a n e sti ma ted tim e of re c ove r y I f thi s job is not a pprop ria te w e r e que st t ha t y ou c ompl e te the P h y sici a ns P h y sica l Assessment R e p ort infor mi ng us of ou r e mpl o y e e s c u rr e nt c a pa bil it ie s a nd e sti mate d pe riod of re c ove r y S h ou l d ther e b e an y c osts assoc iate d w ith p r ovi d in g thi s in f or m ation t h e r e sp on sib il ity o f p ay m e n t lie s w ith the C om p an y T h an k you f or you r c o op e r ation Your t r u ly J OT I KA C HA N D C orpor a te H e a lt h S a fe t y a nd I nju r y Ma na ge me nt C oordina tor 1609 De rw e nt W a y De lt a B C V3M 6K 8 M 604 540 0044 P 604 549 6056 f 604 5496059 e jc h an d b e l te r rac a Be lt e rra Co rp o ra ti o n w w w b e lt e rra ca