Workers' Compensation Division Request for Hearing - wcd oregon 2026

1. Click ‘Get Form’ to open the Workers' Compensation Division Request for Hearing in the editor.
2. Begin by entering your requester name and address in the designated fields. Ensure all information is accurate as it will be used for correspondence.
3. Fill in the worker's name and address, along with their phone number. If applicable, include the employer’s details and any attorney information.
4. Specify the date of injury and provide the insurer claim number, WCD file number, and order number being appealed. This information is crucial for processing your request.
5. Indicate the reasons for requesting a hearing by checking all relevant boxes related to medical fees, services, treatment disputes, or other issues as outlined.
6. Finally, sign and date the form. You can then choose to mail, fax, or email your completed request using our platform’s convenient submission options.

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