Free Oregon Workers Comp Forms

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143 Forms found in Oregon — Workers Comp — Page 1 of 3
Title Last Updated
Tax Compliance Certification (Attachment C) August 3, 2015
Termination Of Workers Compensation Coverage To Client Of Worker Leasing Company October 1, 2014
Vocational Closure Report October 1, 2014
Vocational Assistance Certification Program Individual Certification Under OAR 436-120 October 1, 2014
Vocational Assistance Certification Program Authorization Of Vocational Assistance Provider October 1, 2014
Workers Compensation Payroll And Assessment Quarterly Report Retrospective Rating Plan October 1, 2014
Workers Compensation Payroll And Assessment Quarterly Report Retrospective Rating Plan (5-12) October 1, 2014
Workers Compensation Payroll And Assessment Quarterly Report Normal Plan October 1, 2014
Workers Compensation Payroll And Assessment Quarterly Report Normal Plan (5-12) October 1, 2014
Self Insurer Report Of Losses Non Experience Rating Period October 1, 2014
Self Insurer Report Of Losses Experience Rating Period October 1, 2014
Indemnity Agreement By Parent Corporation For Wholly-Majority Owned Subsidary October 1, 2014
Group Self Insured Indemnity Agreement October 1, 2014
Exemption Provision Waiver October 1, 2014
Endorsement To Self Insured Group Application October 1, 2014
Claims Reserved In Excess Of Self-Insured Retention October 1, 2014
Request For Workers Compensation Division Claim File Information October 1, 2014
Request To Change Attending Physician Or Authorized Nurse Practitioner October 1, 2014
Request For Hearing October 1, 2014
Preferred Worker Program Quarterly Claim Cost Reimbursement Request October 1, 2014
Preferred Worker Job Offer Letter October 1, 2014
Visual Impairment October 1, 2014
Physician Assistants Statement Of Certification October 1, 2014
Notice Of Intent To Form A Managed Care Organization October 1, 2014
Elective Surgery Notification October 1, 2014
Request Ror Reimbursement Of Expenses October 1, 2014
Medical Billing Data EDI Trading Partner Profile October 1, 2014
Insurers Notification Of Business In Oregon October 1, 2014
IME Observer Form October 1, 2014
Subpoena To Compel Production of Individually Indentifiable Health Information October 1, 2014
Subpoena To Compel Production October 1, 2014
Response To Issues October 1, 2014
Request For Board Review October 1, 2014
Cost Bill Form October 1, 2014
Employer-At-Injury Program (EAIP) Reimbursement Request Form October 1, 2014
Workers Benefit Fund Assessment Corrections And Changes Notification October 1, 2014
Application To Become A Self Insured Employer Group-Private Employers October 1, 2014
Application To Become A Self Insured Employer Group-Governmental Subdivisions September 30, 2014
Application For Self Insurance September 30, 2014
Application For Worker Leasing Company License September 30, 2014
Request For Hearing And Specification Of Issues September 30, 2014
Claim Disposition Agreement September 30, 2014
Announcement Of CDA Approval Order September 30, 2014
A Guide for Workers Recently Hurt on the Job April 8, 2013
Workers Compensation Payroll And Assessment Quarterly Report Normal Plan June 18, 2012
Service Companys Notification Of Business June 18, 2012
Request For Workers Compensation Claims-History Service December 13, 2011
Workers Compensation Insurer Premium Assessment Report To Department Of Consumer And Business Services November 4, 2011
Preferred Worker Wage Subsidy Agreement November 4, 2011
Preferred Worker Moving Assistance Agreement November 4, 2011