Hillsboro Oregon Notice of Closure Worksheet - Injury On or After January 1, 2005

• Category: Oregon Workers Compensation - Notices
• State: Oregon
• City: Hillsboro
• Control #: OR-2807A-WC
• Format: Word; Rich Text

Description

Notice of Closure Worksheet - Injury On or After January 1, 2005 The Hillsboro Oregon Notice of Closure Worksheet — Injury On or After January 1, 2005, is a crucial document pertaining to workers' compensation claims in the state of Oregon. This worksheet is used to provide a detailed summary of the benefits and closure information related to a specific injury that occurred on or after January 1, 2005. The primary purpose of the Hillsboro Oregon Notice of Closure Worksheet is to formally close a workers' compensation claim, ensuring that all benefits and entitlements have been accurately calculated and administered. It is essential for both the injured worker and the employer or insurer involved in the claim process. Some key components included in the Hillsboro Oregon Notice of Closure Worksheet — Injury On or After January 1, 2005, are: 1. Claimant Information: This section requires detailed identification details of the injured worker, including their name, address, contact information, and social security number. 2. Employment Details: Here, you must provide information regarding the employment status at the time of the injury, including job title, wage rate, hours worked, and the name of the employer. 3. Injury Information: This section requires a description of the injury sustained, including the date, time, and place of the accident. It should also include a detailed explanation of the specific body part affected and the nature of the injury. 4. Medical Treatment: This section requires listing all medical providers involved in the treatment of the injury. It should include the names, addresses, and contact information of the physicians, therapists, and other healthcare professionals involved. 5. Temporary Total Disability (TTD) Compensation: This part compiles the total number of weeks the injured worker received temporary total disability benefits. It also captures the dates these benefits were paid and the corresponding compensation amount. 6. Permanent Partial Disability (PPD) Compensation: This section calculates the permanent impairment rating and provides a breakdown of the compensation amount based on a predetermined schedule outlined by the Oregon Workers' Compensation Division. 7. Vocational Assistance Benefits: If the injured worker received vocational assistance, this section lists the services provided, the duration of such assistance, and any associated costs. By accurately filling out the Hillsboro Oregon Notice of Closure Worksheet — Injury On or After January 1, 2005, all parties involved can ensure the proper closure of a workers' compensation claim. Different types of these worksheets may exist for specific industries or job types, but the overall purpose remains the same — to document the closure of a claim and provide detailed information related to the injury and its subsequent benefits.

The Hillsboro Oregon Notice of Closure Worksheet — Injury On or After January 1, 2005, is a crucial document pertaining to workers' compensation claims in the state of Oregon. This worksheet is used to provide a detailed summary of the benefits and closure information related to a specific injury that occurred on or after January 1, 2005. The primary purpose of the Hillsboro Oregon Notice of Closure Worksheet is to formally close a workers' compensation claim, ensuring that all benefits and entitlements have been accurately calculated and administered. It is essential for both the injured worker and the employer or insurer involved in the claim process. Some key components included in the Hillsboro Oregon Notice of Closure Worksheet — Injury On or After January 1, 2005, are: 1. Claimant Information: This section requires detailed identification details of the injured worker, including their name, address, contact information, and social security number. 2. Employment Details: Here, you must provide information regarding the employment status at the time of the injury, including job title, wage rate, hours worked, and the name of the employer. 3. Injury Information: This section requires a description of the injury sustained, including the date, time, and place of the accident. It should also include a detailed explanation of the specific body part affected and the nature of the injury. 4. Medical Treatment: This section requires listing all medical providers involved in the treatment of the injury. It should include the names, addresses, and contact information of the physicians, therapists, and other healthcare professionals involved. 5. Temporary Total Disability (TTD) Compensation: This part compiles the total number of weeks the injured worker received temporary total disability benefits. It also captures the dates these benefits were paid and the corresponding compensation amount. 6. Permanent Partial Disability (PPD) Compensation: This section calculates the permanent impairment rating and provides a breakdown of the compensation amount based on a predetermined schedule outlined by the Oregon Workers' Compensation Division. 7. Vocational Assistance Benefits: If the injured worker received vocational assistance, this section lists the services provided, the duration of such assistance, and any associated costs. By accurately filling out the Hillsboro Oregon Notice of Closure Worksheet — Injury On or After January 1, 2005, all parties involved can ensure the proper closure of a workers' compensation claim. Different types of these worksheets may exist for specific industries or job types, but the overall purpose remains the same — to document the closure of a claim and provide detailed information related to the injury and its subsequent benefits.