Asking the Right Questions
When an employee has a disability, it’s important to ask the right questions. Use the example form below to present these questions to the employee, allowing them to respond comfortably without feeling pressured.
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Sample Work Plan Information Request |
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Please place a checkmark next to the appropriate work placement. |
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Interim Work Placement · Sedentary activity (i.e., mainly sitting) · No requirements to lift, carry, or climb |
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Light Duties · Standing and/or sitting as required · Walking or moving from one task area to another · Limited lifting, pushing, pulling (no more than 10 kg/22 lbs.) · Limited carrying (no greater than 5 kg/10 lbs.) · No climbing |
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Medium Duties · Standing, walking, sitting as required · Limited lifting, carrying, pushing, pulling (no more than 15 kg/33 lbs.) · Limited climbing |
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Regular Duties (no restrictions) |
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List any restrictions not captured above:
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Are restrictions and limitations temporary or permanent? |
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Indicate the anticipated duration at the level indicated above by writing in a date or number of weeks below:
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Name: |
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Signature: |
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Date: |
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