Personal Injury Cases

If you are injured and Medicaid pays healthcare claims for that injury, ORS may contact you for more information. We will also contact the doctor or healthcare provider as well. Our goal is to understand whether someone else might be responsible to pay for the healthcare claim.

How to Respond to a Medical Injury Questionnaire from ORS

The form that ORS sends is called a Medical Injury Questionnaire. 

The form asks basic information about your injury. It also asks for information about insurance coverage, you employer, and any attorney involved in the case. 

ORS requires that you return the form within 10 days of receiving it. Mail the form to:

The Office of Recovery Services, Team 85

PO Box 45025

Salt Lake City, UT 84145-0025

If you have questions about this form, contact ORS.

What Happens after You Return the Medical Injury Questionnaire

ORS will review your responses to the Medical Injury Questionnaire.

If ORS decides that someone else should pay for the healthcare claim, we will notify you. We will also contact the attorney, insurance company, or other parties involved. 

If ORS decides that no one else is responsible for the injury, we will stop the process. You will not be notified.

Information for Attorneys

The law requires attorneys in these cases to work with ORS. 

Some of the relevant statutes include:

U.S. Code 42 U.S.C. 1396k