Oklahoma Physician Disclosure Statement

State:
Oklahoma
Control #:
OK-SKU-0819
Format:
PDF
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Description

Physician Disclosure Statement

The Oklahoma Physician Disclosure Statement is a document required by the Oklahoma Medical Board in order to obtain a license to practice medicine in the state. It requires that the physician disclose any past or current criminal or professional misconduct, and any other information that may be relevant to the practice of medicine in Oklahoma. This document must be submitted and reviewed by the Board before the license is issued. There are two types of Oklahoma Physician Disclosure Statements: the Initial Physician Disclosure Statement and the Renewal Physician Disclosure Statement. The Initial Physician Disclosure Statement must be completed by all applicants for a license to practice medicine in Oklahoma and is valid for the duration of the license. The Renewal Physician Disclosure Statement must be completed by all license holders prior to license renewal and is valid for 10 years. Both documents must be reviewed and approved by the Board before a license can be issued or renewed.

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FAQ

All Oklahoma employers are required to carry workers' compensation insurance. Oklahoma's workers' compensation system covers medical expenses and lost wages resulting from work-related injuries and illnesses.

Consider contacting your insurance company to make a First Report of Injury before you file a claim via CC-Form 3. (All Forms submitted to the Commission shall be in black print on white paper. Please do not use colored forms.)

Independent contractors are not employees under Oklahoma workers' compensation law. Many employers are under the mistaken impression that a single action or practice can grant them exemption from workers' compensation law.

The employee will be reimbursed within 60 days of receipt of the form.

The form is listed under Affidavit of Exempt Status on the Case OK website. The cost for an Affidavit of Exempt Status is $50.00 plus a $1.00 online processing fee. Please note the Workers' Compensation Commission will not accept checks for the Affidavit of Exempt Status Fee.

The law states that nearly every employer is required to carry workers' compensation coverage. In some circumstances, certain employees in Oklahoma may be exempt from workers' comp coverage, such as: Sole proprietors. Members of a limited liability company (LLC) who own at least 10% of the capital.

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Oklahoma Physician Disclosure Statement