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Oregon Kate Brown, GovernorDepartment of Consumer and Business Services Workers Compensation Division 350 Winter St. NE PO Box 14480 Salem, OR 973090405 18004520288 5039477810 www.wcd.oregon.govWORKERS COMPENSATION MEDICAL FORMS ORDER FORM Your name: Company name: Address: Phone: ()QuantityForm titleForm #Workers and Health Care Providers Report for Workers Compensation Claim440827*Reporte del Trabajador y del Proveedor Mdico para Reclamaciones de Compensacin
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How to fill out oregon state workers compensation

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How to fill out oregon state workers compensation

01
Obtain the correct forms from the Oregon Workers' Compensation Division website or your employer.
02
Fill out the Employee Claim Form (Form 801) carefully, ensuring all personal information is accurate.
03
Describe the work-related injury in detail, including the date, time, and nature of the injury.
04
Obtain your employer's section to be completed, where they confirm the work-related nature of your injury.
05
Review your completed form for accuracy, making sure no sections are left blank.
06
Submit the form to your employer or the insurance company handling your workers' compensation claim.
07
Keep a copy of the submitted form and any correspondence for your records.

Who needs oregon state workers compensation?

01
Workers who suffer job-related injuries or illnesses while performing their duties.
02
Employees of businesses that are required to carry workers' compensation insurance in Oregon.
03
Individuals seeking compensation for lost wages, medical costs, or rehabilitation due to work-related incidents.
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Oregon state workers' compensation is a system that provides wage replacement and medical benefits to employees who are injured or become ill as a result of their job. It is mandated by state law.
All employers in Oregon with one or more employees are required to file for workers' compensation coverage. This includes full-time, part-time, and temporary workers.
To fill out Oregon state workers' compensation, employers must complete a Form 801 or Form 827, which includes details about the employee, the injury, and how it occurred. These forms can be submitted online or by mail.
The purpose of Oregon state workers' compensation is to ensure that employees who are injured at work receive necessary medical treatment and financial support while they recover, without having to prove fault.
Information that must be reported includes the employee's personal details, a description of the injury or illness, the date and time of the incident, circumstances surrounding the event, and any witnesses to the incident.
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