Or. Admin. R. 436-001-0019
(1) A request for hearing on a matter within the director’s jurisdiction must be filed with the division no later than the filing deadline. Filing deadlines will not be extended except as provided in section (7) of this rule.
(2) A request for hearing must be in writing. A party may use the division’s Form 2839, “Workers’ Compensation Division Request for Hearing,” available on the division’s website at http://wcd.oregon.gov/forms/Pages/forms.aspx. A request for hearing must include the following information, as applicable:
(a) The name, address, and phone number of the party making the request;
(b) Whether the party making the request is the worker, insurer, medical provider, employer, any other party, or an attorney on behalf of a party;
(c) The number of the administrative order being appealed;
(d) The worker’s name, address, and phone number;
(e) The name, address, and phone number of the worker’s attorney, if any;
(f) The date of injury;
(g) The insurer’s or self-insured employer’s claim number;
(h) The division’s file number; and
(i) The reason for requesting a hearing.
(3) Requests for hearing may be filed in any of the following ways:
(a) By mail, to the following address:
WCD Hearings
Workers’ Compensation Division
P.O. Box 14480
Salem, OR 97309-0405.
(b) By hand-delivery, to the following address:
WCD Hearings
350 Winter Street NE, 2nd floor
Salem, OR 97301.
ORS 656.726(4) & ORS 84.013
ORS 656.704
WCD 5-2022, minor correction filed 06/14/2022, effective 06/14/2022
WCD 12-2021, minor correction filed 10/27/2021, effective 10/27/2021
WCD 4-2018, amend filed 03/15/2018, effective 04/01/2018
WCD 9-2015, f. 12-10-15, cert. ef. 1-1-16
WCD 7-2012, f. 11-16-12, cert. ef. 12-28-12
WCD 3-2009, f. 12-1-09, cert. ef. 1-1-10
WCD 1-2008, f. 6-13-08, cert. ef. 7-1-08
Renumbered from 436-001-0155, WCD 7-2005, f. 10-20-05, cert. ef. 1-2-06
WCD 3-2004, f. 3-5-04 cert. ef. 4-1-04
WCD 8-1998, f. 8-10-98, cert. ef. 9-15-98
WCD 7-1996, f. & cert. ef. 2-12-96
WCD 6-1995(Temp), f. & cert. ef. 7-14-95