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J - Employee Safety & OHSA
City of Greensboro Personnel Policy Manuał
Table of Contents A B CD E F H I J K L TableofContents G
Staff will perform a fitness for duty assessment in order to provide final authorization to return
to work, regardless of the treating AMP’s release. This will allow for the protection of the
employee and to provide specific instructions regarding the return to work (i.e. medications,
restrictions, and follow-up instructions).
C. Upon the return to work of a disabled employee, the Workers’ Compensation benefits will
be paid in accordance with the Workers’ Compensation Act. For this to occur properly, the
employee’s department must again complete the NCIC Form 28 (that was started on the first
missed work-day) and forward it to the Workers’ Compensation Specialist and Administrator
indicating the employee has returned to work. The department should also retain a copy and
the employee should be given a copy. To avoid an overpayment, a NCIC Form 28 must be
submitted to the Workers’ Compensation Administrator and Workers’ Compensation Analyst
in the Human Resources Department indicating the employee has returned to work. These
forms must be completed in order to stop or adjust disability payments.
7.0 HUMAN RESOURCES CONTACT
7.1 Worker’s Compensation Analyst
7.2 Safety and Health Manager
8.0 APPENDIX, APPENDICES
Employee Injury Report (City of Greensboro) Employee Injury Report (OSHA FORM 19) If You Are Injured On The Job Procedures Medical Treatment Authorization Form Position Types (page 414) Physical Exam Components (page 411) Return to Work Form/NCIC Form 28T Workers’ Compensation Absence Recordkeeping Process Workers’ Compensation Absence Tracking - Roles and Responsibilities Workers’ Compensation City Salary Supplement