Subject: USPS use of U. S. Department of Labor Form CA-17, Dear President Rademacher, On this date it has come to my attention that the USPS at Milwaukee, Wisconsin, is modifying the Form CA-17. In Item 8, they have stamped in suggestive work duties. I have held the impression that no employer was allowed to tamper with the Department of Labor Forms. I thereby not only want to keep you informed of USPS actions in the field, but also want to find out if we can successfully curb the USPS practice. It appears like USPS is after the last ounce of blood. cc: W. Couillard Sincerely, Waterga US DEPARTMENT OF LABOR Exployment Standards Administration Office of Vickers' Compensation Programa DUTY STATUS REPORT PART A-SUPERVISOR 1. NAME AND ADDRESS OF THE MEDICAL FACILITY OF PHYSICIAN AUTHORIZED TO PROVIDE MEDICAL SERVICES Goldberg Medical Clinic 3531 W. Burleigh Street Milw, Wisc 53210 .2. EMPLOYERS NAME (Last, first, middel Arroyo, Alex 3. DATE OF INJURY (Ma, day, year) 10-30-76 4 OCUPATION 5. SOCIAL SECURITY NUMBER IF THE EMPLOYEE IS FIT FOR NEITHER FULL OR LIGHT DUTY, GIVE A BRIEF REPORT AND PROGNOSIS INSTRUCTIONS TO PHYSICIAN This employee has been referred to you for treatment of an on the job injury. The attached Forms CA-17 must be completed in duplicate after treatment. Original of this report must be given to the employee for return to his supervisor. If diagnosis indicates the employee cannot perform« his regular duties on the following day please state what a duties he may perform. The welfare of the employee is of utmost concern. Since this employee will be paid his regular wages without being charged to any type leave we are interested in returning this employee to work in some capacity without aggravating his condition.] We have many light duty assignments available such as the following: For carriers we have duties which do not require walking, standing or lifting. We also have some duties of a sedentary nature. For clerks we have duties where they distribute mail while sitting on a rest bar. There is no lifting involved. We also have some duties of a sedentary nature. For mailhandlers we have duties that requires light lifting and some duties of a sedentary nature. The employees supervisor may contact you regarding light duty assignments. Please cooperate with him as he can assist you in returning employee to a gainful endeavor.y U.J. POSTAL SCAVICE EMPLOYEL (Fool, Middie und Last Name) LIMITED DUTY ASSIGNMENT SOCIAL SECUNITY RUBEN Dear Doctor: You are presently examining the above named employee for an on-the-job injury and hissne: normal everyday duties are described on the reverse, if the employee is unable to perform hizfiter regular duties we ask that you complete this form in as much detail as possible to allow us to safely provide this employee with meaningful work. • If the employee is unable to perform his normal duties the j'ostal Service may be able to provide other suitable work within his physical limitations. Please check in Item below the duties the employee inay personn. • If you stated on Form CA-17, Duty Status Report, that the employee is able to perform limited duty, please complete Item B below. After completion, kindly return CA-17 together with this form using the enclosed self addressed envelope. U.S. DEPARTMENT OF LABOR Employment Standards Adininistration Office of Workers' Compensation Programs DUTY STATUS REPORT PART A SUPERVISOR 1. NAME AND ADDRESS OF THE MEDICAL FACILITY OR PHYSICIAN AUTHORIZED TO PROVIDE MEDICAL SERVICES 8. IS THE EMPLOYEE ABLE TO PERFORM LIGHT WORK? YES NO IF YES, DESCRIBE BRIEFLY THE PHYSICAL LIMITATIONS WHICH ARE DUE TO THE INJURY. Please indicate the employee's limitations by completing the reverse of this form.. 9. IF THE EMPLOYEE IS FIT FOR NEITHER FULL OR LIGHT DUTY, GIVE A BRIEF REPORT AND PROGNOSIS |