OR 2839 2023-2025 free printable template
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Workers Compensation Division
Request for Hearing
Please type or print. Not all information will apply to every case. Complete all areas that apply.
Requester name and address:Worker name and address:Phone:
Fax:
Employers
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People Also Ask about
What is the form for workers comp claims in Oregon?
Fill out Form 801 “Report of Job Injury or Illness” and turn it in to your employer. Your employer should send it to its workers' compensation insurance carrier within five days of your notice. Your employer should provide you this form.
What is the Oregon workers Compensation Bulletin 111?
This bulletin provides updated benefit rates based on an increase in the Oregon average weekly wage. Additionally, the instructions for the remarriage or domestic partner allowance are updated to reflect changes to ORS 656.204, due to passage of House Bill 4086 in 2022, effective Jan. 1, 2023.
What is an 801 form Oregon?
To browse FormTitleCategory801Report of Job Injury or IllnessFirst report of injury801sReporte de Lesión o Enfermedad en el TrabajoFirst report of injury
What is the 90 day rule for workers compensation in Oregon?
Oregon's Workers' Compensation Act is no different. If you suffer an industrial injury, statute provides that “notice of an accident resulting in an injury or death shall be given immediately by the worker or beneficiary of the worker to the employer, but not later than 90 days after the accident.” ORS 656.265(1)(a).
What is the workers comp rate in Oregon 2023?
In 2023, this assessment is 2.2 cents per hour worked. Employers and employees split the cost. Employers report and pay the WBF assessment directly to the state with other state payroll taxes.
Is my job protected while on workers comp in Oregon?
Oregon law protects employees who are injured on the job. Workers cannot be discriminated against because of workplace injury or illness. That means your job should be protected if you are injured on the job. Most Oregon employers are prohibited from discriminating against employees because of workplace injuries.
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What is OR 2839?
OR 2839 is a tax form used in Oregon for reporting certain types of income and deductions.
Who is required to file OR 2839?
Individuals and businesses in Oregon that meet specific income thresholds or have certain tax situations are required to file OR 2839.
How to fill out OR 2839?
To fill out OR 2839, you need to gather pertinent financial information, complete the form with your income and deductions, and submit it to the Oregon Department of Revenue.
What is the purpose of OR 2839?
The purpose of OR 2839 is to ensure that taxpayers report their taxable income and claim eligible deductions accurately for state tax purposes.
What information must be reported on OR 2839?
The information that must be reported on OR 2839 includes total income, deductions, tax credits, and any other relevant financial details as specified by the form.
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