CNESST Assignation temporaire (2001): Work Assignment

Quebec employers must use this CNESST form to temporarily assign work to an injured worker before the injury is consolidated. The employer describes one or two proposed assignments, and the treating health professional records temporary functional limitations and answers the three section 179 LATMP questions. An assignment can only go ahead if the professional answers yes to all three for a proposal.

Who completes it

The employer completes sections A to F (worker, employer, one or two proposed jobs, salary option, signature). The treating health professional (professionnel de la santé qui a charge) completes sections G to J: temporary limitations, validation of each proposal, and signature with permit number.

Submitting and payment

How to submit it
Return the completed form to the employer, who must submit it to CNESST even if you did not approve the proposed assignments; employers with a CNESST file number prepare it in MonEspace CNESST.
Who pays
The CNESST guide states that the treating professional who completes the form is paid under the agreement on remuneration for medico-administrative services (entente sur la rémunération des services médico-administratifs).

Good to know

  • If you authorize the first proposal, you do not give an opinion on the second; if you refuse it, state which temporary limitation is not respected and why, then assess the second.
  • Temporary limitations are not permanent ones: they can fluctuate with the injury, and the last page lists examples for upper limbs, spine, lower limbs and psychological injuries.
  • Information given on this form, including temporary limitations, cannot trigger the LATMP medical evaluation procedure or be contested, according to the CNESST guide.
  • A worker who disagrees with your opinion can use the procedure in sections 37 to 37.3 of the occupational health and safety act and need not do the work until a final decision.

Get the official form

Download the current version from the source each time; forms change without notice.

Assignation temporaire d'un travail

Temporary Work Assignment

Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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Frequently asked questions

What are the three questions on the CNESST temporary assignment form?

Under section 179 of the LATMP, you answer whether the worker is reasonably able to do the proposed work, whether it is without danger to their health, safety and physical and psychological integrity given the injury, and whether it is favourable to their rehabilitation. Only a yes to all three allows that assignment to proceed.

Can an employer assign temporary work without the treating professional's approval?

No. Section 179 of the LATMP says an employer cannot temporarily assign work unless the treating health professional has recorded a favourable opinion on the form prescribed by CNESST. CNESST's forms page also says employers must use this form and that other documents are not accepted.

What kind of work can be offered as a temporary assignment?

The form says the assigned work must be a productive activity that contributes directly to the business, done on the usual or a reduced schedule. Examples include another existing job, a set of tasks from different stations, a newly created productive job, or the worker's own job with lighter hours, load, pace or fewer tasks.