CASE MANAGER: FORMS & LINKS
Occupational Fitness Assessment Form
Occupational assessments are associated with employees requiring an accommodation.
No Member Fee - CSBTNo Member Fee - Op ExpensesNo Member Fee - Private ER
CSSEIP Occupational Fitness Form
CSSEIP Members - Occupational assessments are associated with employees requiring an accommodation.
No Member Fee - CSBTNo Member Fee - Ops ExpensesNo Member Fee - Private ER
SSQ Attending Physician Statement MSK
Complete this APS form for new STD applications relating to MSK
$129 if Member Paid
CONTINUING CLAIM FOR SHORT TERM DISABILITY BENEFITS
Continuing claim for short-term disability benefits
$129 if Member PaidNo Member Fee
SSQ Attending Physician Statement Mental
Complete this APS form for new STD applications relating to a mental health case.
$129 if Member Paid
DMI-ATTENDING PHYSICIAN STATEMENT (OLD)
DMI generic APS for for short-term MSK, Mental and other disability cases
$129 if Member Paid