| Title |
Last Updated |
| Invasive Medical Procedure Authorization |
August 12, 2008 |
| Request For Hearing And Specification Of Issues |
August 5, 2008 |
| Request For Administrative Review Of Medical Issues |
April 18, 2007 |
| Subpoena (To Compel Attendance And Testimony At Hearing) |
February 26, 2007 |
| Workers Compensation Payroll And Assessment Quarterly Report Normal Plan (5-06) |
December 20, 2006 |
| Workers Compensation Payroll And Assessment Quarterly Report Retrospective Rating Plan (5-06) |
December 20, 2006 |
| Carriers Own Motion Recommendation |
December 20, 2006 |
| Rescinding Notice Of Closure |
December 20, 2006 |
| Notice Of Closure Worksheet |
December 20, 2006 |
| Notice Of Closure |
December 20, 2006 |
| Notice Of Closure |
December 20, 2006 |
| Notice Of Closure (Permanent Total Disability Reduction) |
December 20, 2006 |
| Insurer Notice of Closure Worksheet (Dates Of Injury On Or After January 1 2005) |
December 20, 2006 |
| Correcting Notice Of Closure |
December 20, 2006 |
| Irrevocable Standby Letter Of Credit |
November 3, 2006 |
| Irrevocable Standby Letter Of Credit |
October 20, 2006 |
| Request For Reimbursement From Retroactive Program |
October 20, 2006 |
| Release To Return To Work |
September 12, 2006 |
| Vocational Reimbursement Request |
July 11, 2006 |
| Job Analysis For Worksite Modification - Attachment A |
July 11, 2006 |
| Diskette Order Form Oregon Workers Compensation Payments |
July 11, 2006 |
| Notice Of Voluntary Reopening Own Motion Claim |
July 11, 2006 |
| Reopened Claims Program Reimbursement Request |
July 11, 2006 |
| Supplemental Disability Benefits Quarterly Reimbursement Request |
July 11, 2006 |
| Notice Of Closure Own Motion Claim |
July 11, 2006 |
| Preferred Worker Program Worksite Modification Agreement (For Employer At Injury-Limited To 2500) |
May 18, 2006 |
| Supplemental Disability Election Notification |
May 12, 2006 |
| Preferred Worker Worksite Modification Agreement (Limited To $2500) |
May 12, 2006 |
| Security Agreement And Notice To Intermediary |
May 11, 2006 |
| Memorandum Of Understanding (Alternative Type Of Security Deposit) |
May 11, 2006 |
| Cancellation Notice |
May 11, 2006 |
| Endorsement To Guaranty Contract |
May 11, 2006 |
| Reinstatement Of Guaranty Contract |
May 11, 2006 |
| Physician Authorization Of Supplemental Disability |
May 11, 2006 |
| Insurer Notice Of Closure Summary |
May 11, 2006 |
| Medical Fee Dispute Resolution Worksheet |
May 11, 2006 |
| Surety Rider |
May 11, 2006 |
| Irrevocable Standby Letter Of Credit |
May 6, 2005 |
| Medical Fee Dispute Resolution Request |
May 6, 2005 |
| Preferred Worker Program Substantial Modification Determination |
May 6, 2005 |
| Worker Requested Medical Examination Statement Of Interest |
May 6, 2005 |
| Spinal Range Of Motion |
May 6, 2005 |
| Analysis Of Upper Extremity Use For Office Activities |
May 6, 2005 |
