fill this RTW plan with the help of following case.

Graduated Return-to-Work (GRTW) Plan \begin{tabular}{|l|l|l|} \hline Dake of report inprom & If revised, indicate the revision number and which week(s) from the initial plan have been revised \\ Revision number & Week number(s) \\ \hline \end{tabular} Worker and claim information \begin{tabular}{|l|l|l|l|} \hline \begin{tabular}{|l|l|l|} \hline Wovker's last name & First name & Middle initial number \\ \hline Arew(s) and nature of injury accopted on this daim & Date of injury (my-mr-dd) \\ \hline Claim owner and job titie & & Attending physician \\ \hline \end{tabular} \\ \hline \end{tabular} Employer and job information company s name The claim owner has confirmed that the RTW plan will be conducted on the following basis Employer pays the worker for hours worked during the RTW plan Insurance co. pays the worker during the RTW plan Insurance co./Employer pays the worker during the RTW plan Add or remove weeks as appropriate to the worker's injury-specific RTW plan. Each new week should include all of the rows (e.9., copy and paste the entire week 1 section at the bottom of the table). Click here to enter limitations Comments (if applicable) \begin{tabular}{|c|l|l|l|l|l|l|l|} \hline Week & Monday & Tuesday & Wednesday & Thursday & Friday & Saturday & Sunday \\ \hline 2 & Week of click here to enter a date. & & & & NA & NA \\ \hline Hoursatwork & shours & & & & \\ \hline \end{tabular} (R18/12) Page 2 of 4 Graduated Return-to-Work (GRTW) Plan Job tasks to perform Click here to enter duties Click here to enter duties Limitations (if applicable) x has been advised to adhere to the following limitations: Click here to enter limitations Click here to enter limitations Comments (if applicable) Comments (if applicable) \begin{tabular}{|c|l|l|} \hline Weak & Mondny & Tuesday \\ \hline 3 & Week of Click here to enter a \\ \hline Hourswork & s hours \\ \hline & JobtaskstoperformClickheretoenterduties \\ \hline \end{tabular} Click here to enter duties Limitations (if applicable) x has been advised to adhere to the following limitations: Click here to enter limitations Click here to enter limitations Comments (if applicable) Add more weeks as required: Additional comments Copies to Note: At minimum, a copy of the RTW plan should always go to the injured worker, the physician(s), the employer, and WorkSafeBC or the insurance carrier. worker Physician (do not specty) Copies to Note: At minimum, a copy of the RTW plan should always go to the injured worker, the physician(s), the employer, and WorkCSafeBC or the insurance carrier. Worker Physician (do not sopach) Employer (seatin) other (ssenthy indude the signatures of all key stakeholders to this plan, and date signed. Night Shift Stock Aman works the night shift at the local home renovations/hardware store. His job is to bring inventory from receiving to the floor. He is also required to bring down product from the overhead bins, so that the sales associates can stock store displays during the day. While most of Aman's work is done on the lift truck, he also climbs store ladders to bring boxes of product down from the overhead bins. This week, two of Aman's coworkers have called in sick with the flu, leaving the team short staffed. In order to meet deadlines, Aman stepped up the pace. He is up for a promotion and wanted to look good for the boss. Several hours into his shift, Aman was on a ladder, bringing down paint from the overhead bins. The box was about 55lbs. As Aman set the box on the floor, he twisted his back and felt a sharp pain. He immediately reported the injury to first aid and booked off work. He will be able to try a graduated return to work in two weeks. Graduated Return-to-Work (GRTW) Plan \begin{tabular}{|l|l|l|} \hline Dake of report inprom & If revised, indicate the revision number and which week(s) from the initial plan have been revised \\ Revision number & Week number(s) \\ \hline \end{tabular} Worker and claim information \begin{tabular}{|l|l|l|l|} \hline \begin{tabular}{|l|l|l|} \hline Wovker's last name & First name & Middle initial number \\ \hline Arew(s) and nature of injury accopted on this daim & Date of injury (my-mr-dd) \\ \hline Claim owner and job titie & & Attending physician \\ \hline \end{tabular} \\ \hline \end{tabular} Employer and job information company s name The claim owner has confirmed that the RTW plan will be conducted on the following basis Employer pays the worker for hours worked during the RTW plan Insurance co. pays the worker during the RTW plan Insurance co./Employer pays the worker during the RTW plan Add or remove weeks as appropriate to the worker's injury-specific RTW plan. Each new week should include all of the rows (e.9., copy and paste the entire week 1 section at the bottom of the table). Click here to enter limitations Comments (if applicable) \begin{tabular}{|c|l|l|l|l|l|l|l|} \hline Week & Monday & Tuesday & Wednesday & Thursday & Friday & Saturday & Sunday \\ \hline 2 & Week of click here to enter a date. & & & & NA & NA \\ \hline Hoursatwork & shours & & & & \\ \hline \end{tabular} (R18/12) Page 2 of 4 Graduated Return-to-Work (GRTW) Plan Job tasks to perform Click here to enter duties Click here to enter duties Limitations (if applicable) x has been advised to adhere to the following limitations: Click here to enter limitations Click here to enter limitations Comments (if applicable) Comments (if applicable) \begin{tabular}{|c|l|l|} \hline Weak & Mondny & Tuesday \\ \hline 3 & Week of Click here to enter a \\ \hline Hourswork & s hours \\ \hline & JobtaskstoperformClickheretoenterduties \\ \hline \end{tabular} Click here to enter duties Limitations (if applicable) x has been advised to adhere to the following limitations: Click here to enter limitations Click here to enter limitations Comments (if applicable) Add more weeks as required: Additional comments Copies to Note: At minimum, a copy of the RTW plan should always go to the injured worker, the physician(s), the employer, and WorkSafeBC or the insurance carrier. worker Physician (do not specty) Copies to Note: At minimum, a copy of the RTW plan should always go to the injured worker, the physician(s), the employer, and WorkCSafeBC or the insurance carrier. Worker Physician (do not sopach) Employer (seatin) other (ssenthy indude the signatures of all key stakeholders to this plan, and date signed. Night Shift Stock Aman works the night shift at the local home renovations/hardware store. His job is to bring inventory from receiving to the floor. He is also required to bring down product from the overhead bins, so that the sales associates can stock store displays during the day. While most of Aman's work is done on the lift truck, he also climbs store ladders to bring boxes of product down from the overhead bins. This week, two of Aman's coworkers have called in sick with the flu, leaving the team short staffed. In order to meet deadlines, Aman stepped up the pace. He is up for a promotion and wanted to look good for the boss. Several hours into his shift, Aman was on a ladder, bringing down paint from the overhead bins. The box was about 55lbs. As Aman set the box on the floor, he twisted his back and felt a sharp pain. He immediately reported the injury to first aid and booked off work. He will be able to try a graduated return to work in two weeks