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Oregon WCD Form 2278C: Cervical Range of Motion

Oregon's Workers' Compensation Division uses this one-page worksheet, attached to Bulletin 239, for reporting cervical spine impairment at a closing or other impairment-focused exam. The examiner records active range of motion measured with an inclinometer for flexion, extension, lateral flexion and rotation, checks each set of readings for consistency, and returns the form with the report. The insurer or the Division then rates impairment from those findings.

Who completes it

The examining physician measures and records each movement and prints a name and title, signs and dates the form. In Oregon, attending physicians such as MDs, DOs and chiropractic physicians establish impairment findings, and medical arbiters examine disputed findings.

Submitting and payment

How to submit it
Return it with the closing examination report to the insurer or self-insured employer; Bulletin 239 sets the report due within 14 days of the exam that found the worker medically stationary.
Who pays
The insurer pays Oregon providers the billed amount or the physician fee schedule amount under OAR 436-009-0040, whichever is less, and the worker cannot be billed for care on an accepted claim.

Good to know

  • WCD norms printed on the form are 60 degrees flexion, 75 degrees extension, 45 degrees lateral flexion and 80 degrees rotation to each side.
  • Flexion, extension and lateral flexion are calculated by subtracting the T1 reading from the cranial reading, then recording the maximum angle.
  • Take at least three consecutive measurements that fall within 10 percent or 5 degrees of each other, whichever is greater; up to six attempts are allowed before the findings are invalid.
  • Under Oregon law the provider measures and reports impairment; rating the disability is the job of the insurer or the Workers' Compensation Division.

Get the official form

Download the current version from the source each time; forms change without notice.

Spinal (Cervical) Range Of Motion

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

What instrument is required for Oregon spinal range of motion?

Bulletin 239 requires an inclinometer for spinal range of motion. Its appendix describes the single fluid-filled inclinometer method in detail and also accepts two inclinometers used together or an electronic device that calculates compound joint motion. WCD posts a training video on spinal range of motion measurement.

When is the cervical range of motion form used?

It accompanies a closing examination when the worker is medically stationary, or another impairment-focused exam such as a medical arbiter exam, whenever the accepted condition involves the cervical spine. Bulletin 239 directs examiners to complete the specific spinal range of motion form for closing examinations.