| Title |
Last Updated |
| Cost Bill Form |
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 |
| Request For Hearing And Specification Of Issues |
September 30, 2014 |
| Announcement Of CDA Approval Order |
September 30, 2014 |
| A Guide for Workers Recently Hurt on the Job |
April 8, 2013 |
| Preferred Worker Wage Subsidy Reimbursement Request |
July 11, 2012 |
| Request For Release Of Medical Records For Oregon Workers Compensation Claim |
July 11, 2012 |
| Workers And Physicians Report For Workers Compensation Claims |
July 11, 2012 |
| Workers Compensation Payroll And Assessment Quarterly Report Normal Plan |
June 18, 2012 |
| Request For Workers Compensation Claims-History Service |
December 13, 2011 |
| Preferred Worker Wage Subsidy Agreement |
November 4, 2011 |
| Preferred Worker Employment Purchase Agreement |
November 4, 2011 |
| Workers Compensation Insurer Premium Assessment Report To Department Of Consumer And Business Services |
November 4, 2011 |
| Preferred Worker Moving Assistance Agreement |
November 4, 2011 |
| Preferred Worker Employment Purchase Agreement (Worksite Creation) |
September 9, 2011 |
| Preferred Worker Employment Purchase Agreement (Placement Assistance) |
September 9, 2011 |
| Medical Forms Order Form |
April 7, 2011 |
| Surety Bond |
April 7, 2011 |
| Trading Partner Agreement Filing Guaranty Contracts Through Electronic Data Interchange after July 1, 2009 |
April 7, 2011 |
| Range Of Motion And Deformity-Deviation - Amputation And Sensation Of Upper Extremity |
April 7, 2011 |
| Naturopaths Statement Of Certification |
April 7, 2011 |
| Spinal (Thoracic) Range Of Motion |
November 12, 2010 |
| Spinal (Lumbar) Range Of Motion |
November 12, 2010 |
| Spinal (Cervical) Range Of Motion |
November 12, 2010 |
| Shoulder Range Of Motion |
November 12, 2010 |
| Lower Extremity Range Of Motion |
November 12, 2010 |
| Preferred Worker Employment Purchase Agreement (Worksite Creation Employer At Injury) |
August 28, 2010 |
| Preferred Worker Employment Purchase Agreement (PreEmployment Purchases) |
August 28, 2010 |
| Upper Extremity Range Of Motion Deformity Deviation Amputation And Sensation |
June 30, 2010 |
| Application For Independent Medical Exam-Medical Service Provider Authorization |
June 30, 2010 |
| Request For Approval Of Training Program By Vocational Rehabilitation Counselor |
April 14, 2010 |
| Insurer Telephone Number To Get Oregon Claims Processing Location Information |
April 14, 2010 |
| Workers Compensation Division Subscription Service |
August 28, 2009 |
| Guaranty Contract Between Insurer And Department Of Consumer And Business Services |
August 3, 2009 |
| Claim Reserve Worksheet |
February 11, 2009 |
| Nurse Practitioner Statement |
November 7, 2008 |
| Return To Work Plan Training |
October 29, 2008 |
| Return To Work Plan Direct Employment |
October 29, 2008 |
| Trading Partner Agreement Filing Guaranty Contracts Through Electronic Data Interchange |
October 29, 2008 |
| Request For Administrative Approval |
October 29, 2008 |
| Oregon Proof of Coverage EDI Insurer Profile |
October 29, 2008 |
| Report Of Gross Annual Income |
October 29, 2008 |
| Preferred Worker Program Quarterly Claim Cost Reimbursement Request |
October 29, 2008 |
| Preferred Worker Wage Subsidy Agreement (Employer At Injury) |
October 29, 2008 |
| Preferred Worker Program Obtained Employment Purchase Agreement (For Employer At Injury) |
October 29, 2008 |
| Preferred Worker Obtained Employment Purchase Agreement |
October 29, 2008 |
| Application For Approval Of Lump Sum Payment Award |
October 29, 2008 |
| Worker Request For Claim Classification Review |
August 20, 2008 |
| Tax Compliance Certification (Attachment B} |
August 13, 2008 |
