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.