4.070 - Limited Duty Assignments

Effective Date: 4/14/2014


This policy applies to all employees seeking a limited-duty assignment because of a diagnosis by a health care professional of a physical or mental disability that temporarily prevents them from performing their regularly-assigned duties.

1. Employees May Work Up to 16 Weeks on a Limited-Duty Assignment

Exception: The Human Resources Director may extend the limited-duty assignment beyond 16 weeks if the employee is not fit to return to their regular duty assignment.

Exception: The 16 week limit does not apply to pregnant employees.

2. Employees on a Limited-Duty Assignment Shall Not Work for a Secondary Employer

3. The Employment Services Lieutenant Establishes Reporting Requirements for the Limited-Duty Employee

4. Employees Require Approval From the Employment Services Lieutenant or the Human Resources Director to Return to Work in a Limited-Duty Capacity

Sergeants/supervisors will not allow an employee to work in a limited-duty capacity without the required approval regardless of the duration of the limited-duty.

4.070-PRO-1 Employee Requesting a Limited-Duty Assignment


1. Emails a request for a limited-duty assignment to the Employment Services Lieutenant and their Captain/Director/Manager (via chain of command) to include:

  • Job-related limitations
  • Expected duration of their need for a limited-duty assignment

2. Sends a completed Washington State Insurer Activity Prescription Form (APF) from their healthcare professional to the Employment Services Lieutenant.

Employment Services Lieutenant

3. Determines whether to approve the request and, if approved, finds a limited-duty assignment for the employee.

4. Creates the employees limited-duty assignment in EMT.

5. Updates the employee’s limited-duty assignment in PEDS.

6. Emails a notification to the employee, the employee’s chain of command, and the limited-duty chain of command of the limited-duty assignment.


7. Reports to their limited-duty assignment sergeant/supervisor.


8. Receives updated EMT entry and updates Versonnel.

9. Closes PEDS and EMT request.

4.070-PRO-2 Employee Returning From a Limited-Duty Assignment


1. Upon completion of their limited-duty assignment, obtains an APF signed by a healthcare professional releasing them to duty without restrictions.

  • The APF must include the date released to full duty.
  • The APF must be signed by the employee and their sergeant/supervisor before the employee returns to their regular assignment.

2. Submits the signed APF to their regular sergeant/supervisor.


3. Emails or Faxes an image of the signed APF to the Employment Services Lieutenant.

4. Sends through interoffice mail the original signed hard copy APF to the Employment Services Lieutenant.

Employment Services Lieutenant

5. Updates PEDS.

6. Creates a transfer request in EMT.


7. Receives updated EMT entry and updates Versonnel.

8. Closes PEDS and EMT request.