Notice Of Offer Of Regular Modified Or Alternative Work (On Or After 1-1-13) {DWC AD 10133.35}

DWC - AD 10133.35 - NOTICE OF OFFER OF REGULAR, MODIFIED, OR ALTERNATIVE WORK FOR INJURIES OCCURRING ON OR AFTER 1/1/13. This is a California Division of Workers’ Compensation’s mandatory form used by claims administrators to offer suitable regular, modified, or alternative work to an injured employee after a work-related injury occurring on or after January 1, 2013. The form formally documents the job title, wage level, duration, physical demands, work location, and shift details, and confirms whether the position meets statutory requirements such as lasting at least 12 months and paying at least 85% of pre-injury wages. Employees have 30 days to accept or reject the offer, and failure to timely respond generally results in loss of Supplemental Job Displacement Benefit eligibility unless specific exceptions apply. The form also includes required notices, objection grounds, and a proof-of-service section. www.FormsWorkflow.com