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Insurer Notice of Closure Summary - Oregon 2026

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The document is a Notice of Closure for a workers' compensation claim, detailing the necessary information about the insurer, worker, employer, and claim status. It includes sections for verifying the timeliness of claim closure, reporting time-loss benefits, and providing vocational information. The document emphasizes the importance of accurate information and instructs the worker to report any discrepancies.

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Click ‘Get Form’ to open the Insurer Notice of Closure Summary in the editor.
Begin by entering the insurer's name, address, and phone number at the top of the form. Ensure accuracy as this information is crucial for communication.
Fill in the worker's legal name, date of injury, and their address. This section is vital for identifying the claim accurately.
Indicate whether the claim was closed timely by selecting 'Yes' or 'No'. This helps determine compliance with closure timelines.
Complete sections regarding time loss and medical costs. Report total weeks and/or workdays paid since the date of injury for both TTD and TPD.
Provide preferred worker and vocational information. Select appropriate options for return to work type and employment status to ensure eligibility for benefits.
Finally, certify that all information is true by signing and dating at the bottom of the form before submitting it.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I lose my health insurance while on workers comp in Oregon?

You will not be paid for the first three days you miss work unless you are hospitalized or unable to return to work for at least 14 days. If your doctor releases you to any kind of work in the first 14 days after you are injured, you will not be paid for the first three days missed.

Who pays Oregon WBF taxes?

Most employees working in Oregon pay into Paid Leave and are covered, no matter the size of their employers business. If the business you work for has fewer than 25 employees on average, your employer doesnt have to pay the employer portion of contributions.

What is the 90 day rule for workers comp in Oregon?

While your employer can legally terminate your health insurance after you file a workers comp claim for a few reasons, retaliation isnt one of them. Employers know that retaliation is illegal, so they may try to disguise the actual reason for dropping your insurance.

Who is exempt from Oregon WBF tax?

According to Oregon workers comp rules, employees have up to ninety days after an accident to report an injury. The employer then has five days to file a claim with their insurance company. If approved, the worker gets financial support based on their weekly earnings.

Who is exempt from Oregon WBF?

Workers Benefit Fund (WBF) assessment is administered by the Department of Consumer and Business Services. This is an assessment on the payroll earned by all workers subject to Oregon workers compensation law, or non-subject workers the employer chooses to cover with workers compensation insurance.

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Who is exempt from Oregon paid family leave tax?

Your business may be exempt from the program if you offer one of the following company-sponsored retirement plans: 401(a) - Including a 401(k) 403(a) - Qualified annuity plan. 403(b) - Tax-sheltered annuity plan.

Insurer Notice of Closure Summary - Oregon 2026

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Got questions?

Can I lose my health insurance while on workers comp in Oregon?

Who pays Oregon WBF taxes?

What is the 90 day rule for workers comp in Oregon?

Who is exempt from Oregon WBF tax?

Who is exempt from Oregon WBF?

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Who is exempt from Oregon paid family leave tax?

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