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    Shelly Cochran   
503-947-7623   

Workers’ compensation forms by category

Assessment forms

Closure and related forms

Employer-at-Injury Program

First report of injury

Insurer and Self-Insurer

Medical

Preferred Worker Program

Proof of coverage; insurer

Request for WCD claim file information

Requests to WCD for review of a decision or resolution of a dispute

Self-insured employer

Subscription service

Vocational rehabilitation

Worker leasing companies - application for license and proof of coverage

Workers' Compensation Board

 Form No. 440-

Revision date

Title and description
Associated
Bulletin
(if any)
Assessment Forms
Closure and related forms
Employer-at-Injury Program
First report of injury
Insurer and self-insurer
Medical
Preferred Worker Program
Proof of coverage; insurer
Request for WCD file information
Requests to WCD for review of a decision or resolution of a dispute
Self-insured employer
Subscription service
Vocational rehabilitation
Worker leasing companies - application for license and proof of coverage

Workers’ Compensation Board

   

See the Board's Web site for bulletins

 
If you have questions about the information contained in this document, please contact Shelly Cochran, 503-947-7623.

 

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