Workers compensation board request 2026

1. Click ‘Get Form’ to open the workers compensation board request in the editor.
2. Begin by entering your name and address at the top of the form. This information identifies you as the requester.
3. Fill in the date of injury and claim number. Ensure that only one claim number is entered per form for clarity.
4. Provide your phone number and Social Security number if applicable, followed by the WCD file number.
5. List your attorney's name along with their Oregon State Bar Number, if you have legal representation.
6. Complete the employer and insurer sections with their respective addresses and contact details.
7. Select the reason for requesting a hearing by checking the appropriate boxes. Be sure to attach any necessary documentation.
8. Indicate whether an interpreter is needed and answer additional questions regarding hearing requirements.
9. Sign and date the form at the bottom, ensuring all required fields are completed before submission.

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