Physician's Report of Work Ability MEDICO-14

Instructions

The MEDCO-14 is a physician's report of work ability. This form provides the injured worker and employer with important physician information regarding the injured workers' ability to work and specific instructions to aid in recovery.

1. The physician of record or treating physician must complete this form every time the injured worker is seen and is under any work restrictions, off work, or working with accommodations.
   
   This form is not required if the injured worker is permanently disabled or is not under any work restrictions.
2. This is a two-part form.
   1. Give one copy to the injured worker at the time of the office visit.
   2. Fax a copy to the appropriate MCO.
   3. If requested, a copy may be sent directly to the employer.
      Note: If the injured worker is employed by a self-insuring employer, complete this form and fax or mail directly to the self-insured employer.
3. The Request for Temporary Total Compensation (C-84) is most often used to report that an injured worker is temporarily totally disabled from work due to the injury and is requesting compensation benefits. However, the Physician's Report of Work Ability (MEDCO-14) may also be used to extend compensation.
4. Any other physician generated document may be used, provided that the substitute document contains, at a minimum, the date elements that are on the MEDCO-14.

There are several options available if the employer is not able to make accommodations for the injured workers' restrictions. The injured worker may continue to receive temporary total compensation or be eligible for other types of compensation. The physician should communicate with the MCO to determine if the employer can accommodate other types of return-to-work options including:

• Transitional work - Work that uses real job duties for a specified period of time (generally not exceeding two or three months) to help injured workers progress to their original jobs.
• Modified work - Work in which physician barriers that may keep the injured worker from performing essential job functions are adapted, altered or removed.
• Light duty - In which the job requirements are performed at reduced physical capabilities. Job tasks may be temporary or permanent.
• Alternative work - Work for injured workers who are permanently restricted from their original jobs, but have other abilities and can be employed.

Talk to the MCO if you feel the injured worker would benefit from vocational rehabilitation services.

Click here for the Physician's Report of Work Ability form.

The American Academy of Orthopedic Surgeons and the American Association of Orthopedic Surgeons believe that safe early return-to-work programs are in the best interest of patients. Studies have demonstrated that prolonged time away from work makes recovery and return to work progressively less likely. Return to work in light duty, part-time or modified duty programs is important in preventing the reconditioning and psychological behavior patterns that inhibit successful return to work and in improving quality of life for the injured worker.