Information Page For Injured Employee {440-3283}

A GUIDE FOR WORKERS RECENTLY HURT ON THE JOB. This form is issued by the Oregon Workers' Compensation Division to help workers understand the steps they need to take after suffering a job-related injury or illness. The guide explains how to file a claim by notifying both the employer and a health care provider, completing Form 801 from the employer, and Form 827 from a medical provider. It outlines a worker’s right to choose their own health care provider and lists the types of practitioners who may provide treatment. The guide also covers potential limitations on medical treatment and the requirements for receiving wage-loss benefits, such as the need for written authorization from a health care provider. It highlights conditions under which the first three days of missed work may or may not be compensated and encourages workers to stay in communication with their employer regarding modified-duty opportunities. If a claim is denied, the worker may be responsible for medical costs. Lastly, the guide provides contact information for the Ombuds Office for Oregon Workers and the Workers’ Compensation Resolution Section for those needing help, and it includes a statement about the collection and use of Social Security numbers under applicable state and federal laws. www.FormsWorkflow.com