Form 801 oregon is the official paper that starts a workers’ comp claim in Oregon. You, the injured worker, fill out your part and give it to your employer. Its full title is the Report of Job Injury or Illness. Your employer then sends it to the insurer within 5 days. If you are hurt and worried about money, this form is your first real step toward help. It is shorter and simpler than it looks.
What the Form 801 Oregon Is For
The form has one main job. It puts your injury or illness on record in writing. Without it, the insurer may not know a claim exists. As a result, it can be hard to get medical bills paid or wage-loss benefits started. The form covers sudden injuries, like a fall or a cut. It also covers illnesses that build up over time, like hearing loss or a repetitive strain injury.
Think of the form 801 oregon as your official notice. It records what happened, when, where, and which body part was hurt. For example, if you hurt your back lifting boxes, you describe that in plain words. You do not need legal language. In most cases, a short, honest, specific account works best. The Oregon Workers’ Compensation Division publishes the form for free.
| Item | Details |
|---|---|
| Form number | Form 801 |
| Form title | Report of Job Injury or Illness |
| Who files | The injured worker, with the employer, to start a claim |
| Where it goes | To your employer, who sends it to the insurer within 5 days |
| Agency | Oregon Workers’ Compensation Division |
| Fee | No filing fee for workers (confirm with the agency) |
| Official PDF | Form 801 official PDF |
Who Files the Form 801 Oregon and When
You start the process. You fill out the worker section and sign it. Then you give it to your employer. Your employer fills out their section. However, you should not wait for your employer to bring it up. If they do not hand you a copy, ask for one. You can also print the form yourself from the state website.
Timing matters a lot. Oregon law sets a limit on how long you have to tell your employer about a work injury. There is also a longer outside limit for filing a claim at all. We are not listing those day counts here. Confirm them with the Oregon Workers’ Compensation Division before you act. The safest plan is simple: report it right away, even if the injury seems minor.
Some workers worry that filing will get them in trouble. That fear is common and understandable. Typically, reporting a real work injury is a protected step. If you feel pressured not to report, write down what was said and when. You can learn more about your rights on our Oregon workers comp requirements page.
How to Fill It Out and Where to Send It
The form has a worker section and an employer section. In your section, you list your name, contact details, and job. Then you describe the injury or illness. Say the date, the time, the place, and exactly what happened. Name every body part that hurts. For example, write “right wrist and right shoulder,” not just “arm.” If a coworker saw it happen, list their name.
Small mistakes cause most problems. Here are the common ones to avoid:
- Leaving out a body part that starts hurting later
- Writing a vague description, like “hurt at work”
- Forgetting to sign and date the worker section
- Guessing at the date instead of checking
- Not keeping a copy for yourself
Always keep a copy of your form 801 oregon. Take a phone photo if you have nothing else. You give the completed form to your employer, not to the state. Some employers use their own online system, while others still use paper. Either way, ask for a copy of what was sent. You can download the blank official Form 801 PDF anytime. Other state forms are on the Oregon Workers’ Compensation Division forms page.
What Happens After You File
Once the insurer gets the form 801 oregon, it reviews your claim. The insurer will look at your report, your employer’s section, and your medical records. Then it decides whether to accept or deny the claim. You should get that decision in writing. In most cases, you will also need to see a doctor. Your doctor fills out a separate medical report that supports your claim. For a full walkthrough of each step, see our guide on how to file a Oregon workers comp claim.
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If something goes wrong, you have options. However, a denial is not always the final word. You may be entitled to ask for a review or a hearing. Our page on the Oregon workers comp board explains how disputes are handled. For questions about the form itself, contact the Oregon Workers’ Compensation Division through its official website. Every case is different, so confirm your next step with the agency and a licensed attorney.
Frequently Asked Questions
Can I fill out the form 801 oregon if my employer refuses to give me one?
Yes. You can print the official PDF from the Oregon Workers’ Compensation Division website. Fill out your section, sign it, and give it to your employer in writing. Keep a copy and note the date you handed it over.
Does filing the form 801 oregon cost anything?
No filing fee is charged to workers for this form. It is a free state form. If anyone asks you to pay to file it, confirm with the Oregon Workers’ Compensation Division before you pay anything.
What if I forgot to list an injury on my form 801 oregon?
Tell your employer and the insurer in writing as soon as you notice. Also tell your doctor so it appears in your medical records. Typically, it is better to update the record quickly than to wait. Confirm the best way to add it with the agency or a licensed attorney.
Form 801 oregon: Quick Recap
If you remember one thing about form 801 oregon, make it this: the rule is set by the state (or the federal program), not by the insurer, and the official source is linked above. Every figure on this page about form 801 oregon should be confirmed with the agency before you act on it.
Questions about form 801 oregon that this page does not answer are usually answered for free by the state workers’ comp agency’s information line — and, for a disputed claim, by a licensed attorney in a first consultation.
See your state’s exact numbers
What you are owed depends on your state’s benefit caps and deadlines. Start with your state’s settlement and claim guides for the exact figures.
Sources & How to Verify
The figures on this page come from official government and industry sources. Workers’ comp benefit caps, deadlines, and rules change, so always confirm the exact figure with your state’s workers’ comp board or a licensed attorney before acting. Settlement estimates are illustrative, and every case is different.
- Your state workers’ comp board, division, or commission: the official source for your state’s exact caps, deadlines, and forms — search “[your state] workers compensation board”
- U.S. Department of Labor (OWCP): dol.gov — federal workers’ compensation overview
- NCCI: ncci.com — workers’ comp rating and benefit data
- Social Security Administration: ssa.gov — benefit-cap and SSDI offset data
- Insurance Information Institute: iii.org — neutral workers’ comp background
Content last reviewed October 2026. If you notice an outdated figure, please contact us.
Related Guides
- Oregon Workers Comp Board
- How to File a Oregon Workers Comp Claim
- Oregon Workers Comp Requirements
- Workers Comp Settlements by State (All 50)
- Workers Comp Claims by State (All 50)
- More in This Category
- Settlements by Injury
- Benefits Explained
- Workers Comp Glossary
Informational only — not legal, medical, or financial advice. Workers Comp Explained is an independent educational resource, not a law firm, insurer, or medical or financial advisor, and this page does not provide legal, medical, or financial advice. Workers’ compensation benefits, deadlines, and rules vary by state and change over time, and settlement estimates are illustrative only. Always confirm the exact figure and any deadline with your state’s workers’ compensation board and a licensed attorney before you act.