What to do if you have an injury or illness that is not related to work. Click on left side of mouse to advance to next slide

Some examples of Injuries or Illnesses which would require a Health Care Response Team release: Cancer Mental Illness Vehicle Accident Any type of surgery On crutches or in a cast Treat in the Emergency Room Any type of treatment that places restrictions on what you can do at work or at home. This list is not all inclusive, if you have any questions, please contact Sue Wright at click once to advance to next slide

click once to advance to next slide

This release must be turned in to Risk Management prior to returning to work. If you have restrictions you will have to meet with the Health Care Response Team to make sure we are able to accommodate your restrictions. As tolerated is not accepted If restrictions are given please make sure the doctor indicates a start and end date If the doctor marks full duty, no restrictions, they should not check anything in these areas Click here lps.org to find RM0036 form on the website click once to advance to next slidelps.org

How to access all Risk Management Forms

Go to the lps.org webpage and type the word “forms” in the keyword box click on left side of mouse to move through slides

In the drop down box find Risk Management, hit enter

Click on the form you want and print.

If you have any questions regarding this process please contact Risk Management at or