The Oregon IME Observer Form is a document that is used by physicians, lawyers, and other health care professionals in the state of Oregon to report on their observations of a patient during an independent medical examination (IME). The form is designed for recording information related to the patient's medical history, physical and mental condition, and the results of any tests conducted during the examination. The form can also include a summary of the physician's findings and recommendations. There are three types of Oregon IME Observer Form: Standard, Complex, and Developmental. The Standard Form is used for routine Times, while the Complex Form is used for more in-depth examinations that require additional information to be documented. The Developmental Form is used for pediatric Times. All three forms are available for free download from the Oregon Department of Consumer and Business Services website.
Oregon IME Observer Form
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To browse FormTitleCategory801Report of Job Injury or IllnessFirst report of injury801sReporte de Lesion o Enfermedad en el TrabajoFirst report of injury
Worker's compensation form completed when the patient first seeks treatment for a work-related illness or injury. It does not contain a signature line. It is filed with State Worker's Compensatin Board/Commission.
Authorization to release medical records By signing this form, you authorize health care providers and other custodians of claim records to release relevant records to the workers' compensation insurer, self-insured employer, claim administrator, and the Oregon Department of Consumer and Business Services.
The Form 43 is to be completed by the respondent (employer/workers' compensation insurance carrier) to notify the Administrative Law Judge, the claimant (employee/decedent), and all parties to the claim of its intention to deny the compensability of all or part of the claimant's claim to workers' compensation benefits.
This bulletin provides updated benefit rates based on the Oregon state average weekly wage. This bulletin replaces Bulletin No. 111 dated . July 1, 2023, through June 30, 2024, the SAWW used to compute workers' compensation benefits is $1,295.86.
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.