CASE MANAGER: FORMS & LINKS
CLHIA STD APS
Initial Disability Insurance Medical Statement (Physical + Mental)
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Occupational Fitness Assessment Form
Occupational assessments are associated with employees requiring an accommodation.
CSSEIP Occupational Fitness Form
CSSEIP Members - Occupational assessments are associated with employees requiring an accommodation.
Empire Life APS
Empire Life Attending Physician Statement Form
SSQ Attending Physician Statement MSK
Complete this APS form for new STD applications relating to MSK
CONTINUING CLAIM FOR SHORT TERM DISABILITY BENEFITS
Continuing claim for short-term disability benefits
SSQ Attending Physician Statement Mental
Complete this APS form for new STD applications relating to a mental health case.
CADA APS (CLHIA)
Attending Physician Statement Forms for CADA
CADA SAW - Cognitive + Functional Abilities Form
Cognitive and functional abilities
CADA SAW Cognitive Abilities
CADA SAW Cognitive Abilities
CADA SAW Functional Abilities
STAY AT WORK - FUNCTIONAL ABILITIES FORM
DMI-ATTENDING PHYSICIAN STATEMENT (OLD)
DMI generic APS for for short-term MSK, Mental and other disability cases