Physical Demands Task Assessment Date: Task title: Analyst: Task duration (hours/day): With breaks: Yes / No Overtime (avg. hours/week): Task description Postures Hours at one time Total hours per day Stand Sit Walk Drive Lift/carry None Occasional Frequent Constant Height of Distance 0% 0-33% 34-66% 67-100% lift of carry 1-10 lbs 11-20 lbs 21-50 lbs 51-100 lbs 100 lbs
Physical Demands Task Assessment Task title: Date: Analyst: Task duration (hours/day): With breaks: Yes / No Overtime (avg. hours/week): Task description Postures Hours at one time Total hours per day Stand Sit Walk Drive Lift/carry None 0% Occasional 0-33% Frequent 34-66% Constant 67-100% Height of lift Distance of carry 1-10 lbs 11-20 lbs 21-50 lbs 51-100 lbs 100 lbs
02%20Return%20to%20Work%20Kit-Small.docx