CHECKLIST FOR REQUESTS FOR REVIEW FOR MEDICAL SEPARATION
- Has the case been reviewed with the Employee Relations Consultant?
- Are there any protected leave status issues (e.g. FMLA, CFRA, PDL)?
- Is this a worker’s compensation case, and if so, has the department been in contact with the vocational rehabilitation unit?
- Has the department engaged in the interactive process with the employee? How recently did this occur?
- Is the Request for Review signed by a manager and is it dated?
- Are all the required/relevant parts of the form completed? Are the responses appropriate?
- Are all of the relevant/required documents attached and completed?
- Job description with essential functions annotated (highlighting does not show up on copies).
- Medical information indicating either that the employee cannot return to work or can return with restrictions