The Return-to-Work (RTW) program assists individuals with work-related illness or injury (and non work-related illness or injury, when possible) resulting in medical restrictions or lost work time. Examples of these services may include early referral for assistance in obtaining a full duty release to RTW, a release or medical approval for a transitional RTW, accommodations for modified duty, or a job analysis.
State Agency Referral Form for Field Medical and Vocational Services
The State Agency Referral Form for Field Medical and Vocational Services is another tool available for the Agency to actively participate and be proactive in the early Return-to-Work program. This one page form is easy to complete and includes an area for services requested.
Click to download the Referral Form for Field Medical or Vocational Services (PDF)
- The completed form is faxed directly to the Vocational/Medical Manager at (804) 649-2397.See Returning to Work for step-by-step instructions in our Online Guide.If you have any questions, please do not hesitate to contact the Voc/Med Manager at 804-775-0710.