Oklahoma Workers Compensation Questionnaire

State:
Multi-State
Control #:
US-Q1038
Format:
Word; 
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Description

This form addresses important matters that may effect the legal rights and obligations of the parties in a workers' compensation matter. This questionnaire enables those seeking legal help to effectively identify and prepare their issues and problems. Thorough advance preparation enhances the attorney’s case evaluation and can significantly reduce costs associated with case preparation.



This questionnaire may also be used by an attorney as an important information gathering and issue identification tool when forming an attorney-client relationship with a new client. This form helps ensure thorough case preparation and effective evaluation of a new client’s needs. It may be used by an attorney or new client to save on attorney fees related to initial interviews.


The Oklahoma Workers Compensation Questionnaire is an essential document used in the state of Oklahoma to gather crucial information related to workers' compensation claims. This detailed questionnaire serves as a means to collect information about the circumstances of an employee's injury or illness sustained while performing job-related duties. By utilizing relevant keywords, one can create a comprehensive description of the Oklahoma Workers Compensation Questionnaire. Some important terms to include are: 1. Oklahoma Workers Compensation: Refers to the laws, regulations, and processes established in the state of Oklahoma to provide coverage and benefits to employees who suffer from work-related injuries. 2. Questionnaire: A set of structured questions designed to gather specific information about an individual's injury, medical condition, work environment, and other relevant factors. 3. Injury or Illness: Covers any physical harm, mental or emotional distress, or occupational diseases that occur due to workplace activities or conditions. 4. Claim: The process through which an employee seeks compensation for a work-related injury or illness. 5. Employee Information: Personal details of the injured worker, including name, address, contact information, social security number, employment history, and job title. 6. Accident Details: In-depth description of the events surrounding the accident, such as the date, time, location, witnesses, and a narrative explaining how the incident occurred. 7. Medical Treatment: Comprehensive details regarding the medical treatment received, including healthcare providers, specialists, hospitals, clinics, prescription medications, and any rehabilitation or therapy received. 8. Health History: Gathering information about the worker's pre-existing medical conditions or previous injuries, which may have an impact on the current claim. 9. Employment Details: Inquiring about the worker's department, supervisor, start and end dates, job responsibilities, and any prior workers' compensation claims. 10. Benefits Requested: Determining the specific benefits the worker is seeking, such as medical expenses, wage replacement, disability benefits, vocational rehabilitation, and any related expenses. Different types of Oklahoma Workers Compensation Questionnaires may exist based on the nature of the claim or the specific industry involved. For example: 1. Initial Claim Questionnaire: Used when an employee files an initial workers' compensation claim, covering general information about the incident and injury. 2. Occupational Disease Questionnaire: Designed for cases where the employee's condition is a result of prolonged exposure to hazardous substances or environments. 3. Vocational Rehabilitation Questionnaire: Utilized in cases where the worker requires assistance in returning to suitable employment following the injury, such as job retraining programs or adaptive equipment. In summary, the Oklahoma Workers Compensation Questionnaire is a detailed form used to collect information regarding work-related injuries or illnesses. It aims to gather essential details about the incident, medical treatment, employment history, and other pertinent factors. Different types of questionnaires may exist to cater to specific types of workers' compensation claims in Oklahoma.

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Fortunately, Oklahoma law mandates that you still receive your Workers' Compensation benefits until you have recovered or reached the point where further recovery is no longer expected, even if your employment is terminated.

Upon the effective date of HB2367, the PPD limit was increased from $323 per week to $350 per week, and $360 per week effective July 1, 2021. wage of the deceased employee or 100% of the state's average weekly wage, whichever is less.

For Permanent Total Disability (PTD) and Death, the maximum rate is $953.18 per week for work-related injury, illness, or death occurring during the period beginning January 1, 2022 and ending December 31, 2022. 85A O.S. § 45(D) (PTD), and 85A O.S. § 47 (death benefits).

When you are injured on the job and you are unable to work for more than 7 calendar days, you are eligible for weekly benefits amounting to 70% of your average weekly wage, up to the maximum set by law. The maximum is equal to the state's average weekly wage.

Fact-Checked Statute SectionTitle 85, et seq.Time LimitsNotice to employer: 30 days (§ 85A-68) 2 years from the date of most injuries, 1 year for occupational diseases (§ 85A-69)Benefit Waiting Times85 O.S. Rule 14 Waiting Period: 7 days Retroactive After: 21 daysMental Injury CoverageLimited (§ 85A-2)

When you are injured on the job and you are unable to work for more than 7 calendar days, you are eligible for weekly benefits amounting to 70% of your average weekly wage, up to the maximum set by law. The maximum is equal to the state's average weekly wage.

$11.3 million workers comp settlement for an injured nanny (California) In 2018, a 29-year-old woman working as a nanny in Los Angeles suffered a catastrophic brain injury while accompanying her employers on a ski trip in Colorado to take care of their five-year-old son.

The highest workers' comp rates by state jurisdiction are: Wyoming: $1.78. Alaska: $1.74. Hawaii: $1.69. Montana: $1.64. South Carolina: $1.55. Idaho: $1.47.

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(Fill Out and File Your Affidavit of Exempt Status Online by Clicking This Link) · CC-Form 36C, Cancellation of Affidavit of Exempt Status. CC - Form 40 ... This is a guide to Oklahoma workers' compensation law and rules. It is based on laws and rules in effect in 2015. Laws and rules can change by acts of the ...Counselor Services- Via phone (855) 291-3612 (In-state toll free) (405) 522-5308 or by email at counselors@wcc.ok.gov. Records Searches and Copy Requests- File ... Mar 14, 2022 — This is a guide to Oklahoma workers' compensation law and rules. It is based on laws and rules in effect in 2019. Laws and rules can change ... Claim for Compensation: You may file a claim for compensation with the Commission to protect your rights. The claim must be filed within the time fixed by law. How do I file a workers' compensation claim with the Court? ... questions about their rights and responsibilities under the Oklahoma workers' compensation laws. How do Employers obtain workers' compensation coverage? In Oklahoma, most employers must cover their employees with workers' compensation insurance. Fill out application form completely. If questions are not applicable, enter “N/A ... Have you ever filed a workers' compensation claim? □ Yes. □ No. If yes ... (c). If an employer is found to have improperly terminated temporary compensation, the Commission may require the employer to file a new CC-Form-13 Request for ... To help protect employers, insurers also cover your legal costs if an injured worker sues you. Is Workers' Compensation Insurance Required in Oklahoma? In the ...

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Oklahoma Workers Compensation Questionnaire