Question 1
1
What type of work injury are you dealing with?
This question is required.
*
Key
A
Physical
Key
B
Psychological
Key
C
Both physical and psychological
Question 2
2
What is your current job status?
This question is required.
*
Key
A
Not working — currently off due to injury
Key
B
Still employed — on reduced hours or modified duties
Key
C
Looking for a new job
Key
D
Back at work full time
