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Oregon Occupational Injury and Illness Survey Tables and Appendices Calendar Year 2005 Information Management Division Oregon Department of Consumer & Business Services December 2006 CY 2005 OREGON

How to fill out oregon occupational injury and

How to Fill Out Oregon Occupational Injury and:

Obtain the necessary forms:

1. Visit the Oregon Workers' Compensation Division website and download the Oregon Occupational Injury and Illness Report Form (Form 801).
2. Make sure you have access to a printer and sufficient copies of the form.

Gather relevant information:

1. Collect all pertinent details regarding the injured employee, such as their full name, contact information, and social security number.
2. Obtain the employee's job title, department, and supervisor's name.
3. Note the date, time, and location of the injury or illness incident.

Describe the injury or illness:

1. Clearly document the specifics of the injury or illness in the designated section of the form.
2. Include details such as the body part affected, the nature of the injury, and any contributing factors or events leading up to the incident.

Provide additional information:

1. Answer all questions on the form about the circumstances surrounding the injury thoroughly and accurately.
2. If there were any witnesses to the incident, include their names and contact information.
3. If the employee received any medical treatment, specify the healthcare provider's name, address, and phone number.

Fill out the employer section:

1. Provide your company's legal name, address, and relevant information.
2. Identify the appropriate workers' compensation insurance carrier by including their name, address, and policy number.

Submission of the form:

1. Retain a copy of the completed form for your records.
2. Submit the completed report to the Oregon Workers' Compensation Division within the specified timeframe, typically within five days of being notified of the injury or illness.

Who Needs Oregon Occupational Injury and:

Employers in Oregon:

All employers in Oregon are required by law to keep records of occupational injuries and illnesses using the Oregon Occupational Injury and Illness Report Form.

Injured employees:

1. Oregon employees who experience work-related injuries or illnesses need the Oregon Occupational Injury and Illness Report Form to initiate the workers' compensation process.
2. Filling out this form accurately and promptly ensures that their claim is properly documented and that they receive the benefits they are entitled to.

Note: It is always recommended to consult the official Oregon Workers' Compensation Division website or seek legal advice to ensure compliance with current regulations and procedures regarding the filling out of the Oregon Occupational Injury and Illness Report Form.

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What is oregon occupational injury and?

The Oregon Occupational Injury and Illness Survey (OIIS) collects data on work-related injuries and illnesses in Oregon.

Who is required to file oregon occupational injury and?

Employers in Oregon who have three or more employees are required to file the Oregon Occupational Injury and Illness Survey.

How to fill out oregon occupational injury and?

Employers can fill out the Oregon Occupational Injury and Illness Survey online through the Oregon Department of Consumer and Business Services website.

What is the purpose of oregon occupational injury and?

The purpose of the Oregon Occupational Injury and Illness Survey is to gather data on work-related injuries and illnesses to help improve workplace safety and health.

What information must be reported on oregon occupational injury and?

Employers must report information on any work-related injuries or illnesses that occur among their employees, including the nature of the injury or illness, the date it occurred, and the occupation of the affected employee.