essential functions worksheet- sonoma county, california（基本功能表——索诺玛县,加利福尼亚）.doc

Essential Functions Worksheet FAQ’s and Instructions for Completion of the Form Q. What is the purpose of the Essential Functions Worksheet (EFW)? A. The County utilizes EFWs in a number of ways: Job Bulletins for hiring, Post-Offer Pre-Employment physicals, Fitness For Duty examinations, Disability Retirement determinations, Temporary Transitional Duty cases, ADA Reasonable Accommodation cases, Worker’s Compensation cases, and Long Term Disability eligibility. Q. If one assignment in a job class performs an essential function such as billing and another assignment does not, is billing listed in the essential function? A. Yes. The EFW reflects the whole job class. Assignments specific to one individual should be listed using a range of hours that the task requires in a week. For example, if billing is done by one individual for 10 hours a week, the range would be listed as 0-10. Zero would represent everyone who does not do billing, and 10 would represent the task hours for the individual assigned to handle billing. Q. Do you ever need to fill out more than one EFW for a job class? A. Yes, if the requirements of a position vary significantly from those of other positions in the class. For example, a Public Health Assistant who inspects swimming pools should have a different EFW from a Public Health Assistant who performs HIV test counseling. Q. What are the “Medical Provider Use Only” areas used for? A. These areas will be completed by a medical provider when evaluating an employee for a post-offer pre-employment physical and/or for an injury or medical condition. Instructions for Completion of the EFW Form The form may be revised as needed. 1. Essential Functions: List all essential functions in the first column, including details on the critical physical, mental and emotional factors. These details assist medical providers in evaluating an employee’s ability to perform each essential function and/or to set work restrictions, where appropriate. Rows may