Text Size:   A+ A- A   •   Text Only

    Shelly Cochran   
503-947-7623   

Workers’ compensation forms by category

Assessment forms

Closure and related forms

Employer-at-Injury Program

First report of injury

Insurer and Self-Insurer

Medical

Preferred Worker Program

Proof of coverage; insurer

Request for WCD claim file information

Requests to WCD for review of a decision or resolution of a dispute

Self-insured employer

Vocational rehabilitation

Worker leasing companies - application for license and proof of coverage

Workers' Compensation Board

 Form No. 440-

Revision date

Title and description
Associated
Bulletin
(if any)
Assessment Forms
Closure and related forms
Employer-at-Injury Program
First report of injury
Insurer and self-insurer
Medical
Preferred Worker Program
Proof of coverage; insurer
Request for WCD file information
Requests to WCD for review of a decision or resolution of a dispute
Self-insured employer
Vocational rehabilitation
Worker leasing companies - application for license and proof of coverage

Workers’ Compensation Board

   

See the Board's website for bulletins

 

If you have questions about this webpage, please contact Shelly Cochran, 503-947-7623.