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