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Click ‘Get Form’ to open the Oregon Return to Work document in the editor.
Begin by entering the date at the top of the form, followed by your name as the worker. Fill in your counselor's name and phone number, along with the WCD file number.
Next, provide details about your vocational rehabilitation organization, including its name and city. Don't forget to include your insurer's information and claim number, as well as the date of injury.
In section one, outline your vocational objectives clearly. Then, specify the types of training you will undergo and include relevant Standard Occupational Classification codes.
Indicate the start date and projected end date for your training. Also, mention your expected weekly return-to-work wage and identify the training facility or employer.
If applicable, attach a copy of any on-the-job training contract. Complete section three by detailing any other services required under OAR 436-120-0510.
Finally, ensure all parties involved sign and date their respective sections at the bottom of the form before submission.
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