Which form is the Modified work agreement?

Which form is the Modified work agreement?

• A. Cf-200a
• B. Cf-66
• C. Cf-70
• D. Cf-212

Answer: (A)

The Modified Work Agreement is documented on CF-200a. This form is specifically used to outline temporary, modified duties, hours, and duration for an employee who cannot perform full duties due to an injury or medical condition. It captures exactly what tasks are allowed, the time frame, and the signatures needed from the employee, supervisor, and medical provider, ensuring a clear, safe return-to-work plan that aligns medical guidance with workplace expectations. The other forms listed are used for different administrative or medical processes and do not serve as the modified-work agreement, so they aren’t the correct choice.

The Modified Work Agreement is documented on CF-200a. This form is specifically used to outline temporary, modified duties, hours, and duration for an employee who cannot perform full duties due to an injury or medical condition. It captures exactly what tasks are allowed, the time frame, and the signatures needed from the employee, supervisor, and medical provider, ensuring a clear, safe return-to-work plan that aligns medical guidance with workplace expectations. The other forms listed are used for different administrative or medical processes and do not serve as the modified-work agreement, so they aren’t the correct choice.