Notice Of Offer Of Regular Work For Injuries (Between 1-1-05 And 12-31-12) {DWC AD 10118}

DWC - AD 10118 - NOTICE OF OFFER OF REGULAR WORK FOR INJURIES OCCURRING BETWEEN 1/1/05 - 12/31/12, INCLUSIVE. This is a California Division of Workers’ Compensation form used by employers or claims administrators to offer an injured employee a return to their usual and customary job for injuries occurring between January 1, 2005, and December 31, 2012. The offer must be based on medical evidence from the treating physician, QME, or AME indicating the employee can resume their pre-injury position. The form details the job title, wages, work location, shift, job duration, and return-to-work date. Employees must accept, reject, or object to the offer within 20 calendar days or they waive objections to location or shift. Acceptance or rejection may affect permanent disability payments by ±15%. The form includes notices, employee response options, and dispute-resolution instructions. www.FormsWorkflow.com