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Form 801

801 form oregon 2026

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The document provides detailed instructions and guidelines for filing a Workers' Compensation Claim Form 801 in Oregon. It outlines the responsibilities of both workers and employers regarding claim submission, medical treatment, and reporting requirements. The form includes sections for personal information, injury details, and employer information, emphasizing the importance of timely reporting to avoid claim denial. Additionally, it explains the process for receiving medical care and wage benefits following a work-related injury or disease.

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Click ‘Get Form’ to open the 801 form in our editor.
Begin by filling out the worker section. Enter your legal name, home phone, date of birth, and Social Security number as required.
Indicate your education level by entering the number of years completed. If applicable, check 'Yes' for hospitalization and provide details about your injury.
Specify the nature of your injury and identify the affected body parts. Be sure to include the actual date of the accident or when medical attention was first needed.
In the employer section, complete items such as the employer's legal business name, BIN, and FEIN. Ensure all relevant information is accurate to avoid delays.
Finally, review all entries for accuracy before signing. Once completed, submit the form as instructed on our platform.

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