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CONSTRUCTION CONTRACTORS BOARD PO Box 14140 Salem OR 973095052 5033784621 www.oregon.gov/CCBCHANGE MY WORKERS COMPENSATION STATUS (NOTIFICATION OF CHANGED CONTRACTOR LICENSE STATUS per ORS 701.035
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How to fill out change my workers compensation

01
Step 1: Obtain the necessary forms from your employer or the workers' compensation board.
02
Step 2: Read the instructions carefully and familiarize yourself with the information required.
03
Step 3: Provide accurate and detailed information about the incident or injury that occurred at work.
04
Step 4: Include any supporting documentation such as medical records, witness statements, or photographs.
05
Step 5: Complete all sections of the form, ensuring you provide all the requested information.
06
Step 6: Review and double-check the completed form for any errors or missing details.
07
Step 7: Submit the filled-out form to your employer or directly to the workers' compensation board.
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Step 8: Keep a copy of the completed form for your records and follow up to ensure it has been received.
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Step 9: Cooperate with any further investigations or evaluations that may be required.
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Step 10: Seek legal advice or assistance if you encounter any difficulties during the process.

Who needs change my workers compensation?

01
Individuals who have suffered a work-related injury or illness are the ones who typically need to fill out a workers' compensation claim form.
02
Employees who are covered by workers' compensation insurance and have experienced an on-the-job injury or developed a work-related illness should file a claim.
03
Employers may also need to submit change requests to workers' compensation policies if there are changes in the employment status, such as new hires, terminations, or changes in job duties.
04
In some cases, legal representatives or family members may need to assist individuals who are incapacitated or unable to complete the form themselves.
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Change my workers compensation refers to the process of updating information related to workers' compensation insurance, such as updating employee details or policy information.
Employers who have workers' compensation insurance are required to file changes to their policy, such as updating employee information or policy details.
To fill out change my workers compensation, employers need to contact their insurance provider or broker and provide the necessary information for the update.
The purpose of change my workers compensation is to ensure that all information related to workers' compensation insurance is accurate and up to date.
Information such as employee details, policy updates, and any changes in coverage need to be reported on change my workers compensation.
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