Worksheet

Job Duty Comparison Sheet

Use this worksheet to compare written restrictions with actual physical tasks. It is a planning aid, not a legal filing.

Fields to fill in for Job Duty Comparison Sheet

  • Injury date, report date, and first medical visit for the job duty comparison sheet.
  • Employer, job title, supervisor, and claim administrator connected to compare written restrictions with actual physical tasks.
  • Body parts or conditions accepted, denied, or disputed in the job duty comparison sheet.
  • Current restrictions, missed work dates, and payment gaps that affect compare written restrictions with actual physical tasks.
  • Notes needed to compare written restrictions with actual physical tasks.

How to use the job duty comparison sheet

StepWhy
Write job duty comparison sheet dates firstWorkers comp disputes around compare written restrictions with actual physical tasks often turn on timing.
Attach the job duty comparison sheet sourceA document is stronger than memory when trying to compare written restrictions with actual physical tasks.
Separate job duty comparison sheet facts from opinionsAttorneys can evaluate compare written restrictions with actual physical tasks faster with clean timelines.
Update the job duty comparison sheet after each noticePayment stops, denials, and restrictions can change how to compare written restrictions with actual physical tasks.

Privacy note for Job Duty Comparison Sheet

Do not post private medical or employment details from the job duty comparison sheet publicly. Share sensitive records only with a licensed attorney, official agency, or trusted claim professional.

Before using the job duty comparison sheet for a consultation

  • Circle every missing job duty comparison sheet document rather than guessing.
  • Mark facts you know directly and facts someone else told you about compare written restrictions with actual physical tasks.
  • Keep a clean copy of the job duty comparison sheet for yourself.
  • Do not let the job duty comparison sheet replace official forms or attorney advice.