Report of Job Injury or Illness - 801 form X801 Form and Form 3283-2025

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  1. Click ‘Get Form’ to open the Report of Job Injury or Illness - 801 form in the editor.
  2. Begin by entering the date of injury or illness in the designated field. This is crucial for your claim.
  3. Fill in your personal details, including your legal name, birthdate, and mailing address. Ensure accuracy for effective communication.
  4. Provide information about your injury or illness, including specifics about what caused it and any relevant details regarding witnesses.
  5. Complete the employer section with their legal business name and contact information. This helps streamline the claims process.
  6. Review all entries for completeness and accuracy before signing. Your signature confirms that the information provided is true to the best of your knowledge.

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Employment laws vary, but generally, employers cannot fire employees solely due to injury without considering disability protections. If terminated, employees may apply for unemployment benefits; denials often occur if the injury is non-work-related.
Fill out Form 801 Report of Job Injury or Illness and turn it in to your employer. Your employer should send it to its workers compensation insurance carrier within five days of your notice. Your employer should provide you this form.
​ Complete Form 801, Report of Job Injury or Illness, available from your employer and Form 827, Workers and Health Care Providers Report for Workers Compensation Claims, available from your health care provider. How do I get medical treatment?
All medical service providers must give a copy of Form 3283 and Form 827 to the patient. (2) New or Omitted Medical Condition. A patient may use Form 827 to request that the insurer formally accept a new or omitted medical condition.
What Not to Say to a Workers Comp Doctor Avoid Downplaying Your Injury: Dont minimize your pain or discomfort. Dont Speculate on Recovery Time: Do not make guesses about how quickly you will recover. Stay Away from Absolute Statements: Do not use words like always or never when describing your symptoms.

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Every employee is subject to the WBF assessment. The law defines the following as employees: All paid workers for whom the employer is required by Oregon law to provide workers compensation insurance coverage; and.
1. Ensure Immediate Medical Care Assess the Severity: Quickly assess the severity of the injury. Provide First Aid: If the injury is not life-threatening but still requires attention, ensure that the worker receives appropriate first aid on-site or is taken to a medical facility for treatment.

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