If you get hurt on the job, regardless of who might have been at fault, you have the right to have your medical care and lost earnings covered through workers’ compensation in Oregon. You don’t have to sue anyone, including your employer, to receive benefits, but you do have to make your supervisor or someone else in management aware that you were hurt, and file a claim for benefits. If that sounds simple, that’s because it should be.
The workers’ compensation system in the state is more than 100 years old, but it has not aged gracefully. Many people, particularly injured workers and their families, find the process of filing for benefits to be complicated and difficult to navigate without the help of a lawyer. It might help to go over a few of the basic principles and procedures you will come across that protect your rights to workers’ compensation benefits.
Who is entitled to workers’ compensation?
Unless you are an independent contractor or the owner of the company, you and most other employees in the state must be covered by a workers’ compensation insurance policy obtained and paid for by your employer. There is no charge to you for being covered under workers’ compensation.
What types of injuries are covered by workers’ compensation?
All work-related injuries or occupational diseases and illnesses are covered by workers’ compensation. For example, if a sliver of metal gets into your eye while you are shaping a piece of steel with an electric grinder, you would have a claim for compensation benefits, provided the injury meets the following criteria:
- You were working at your job at the time of the accident.
- The injury was not intentionally self-inflicted.
- If you had a pre-existing medical condition, your doctor must be able to prove it was aggravated by your employment.
The scope of what types of injuries qualify as being work related might not, at first, appear obvious. For example, if your job requires travel from one jobsite to another, the injuries you suffer in a car accident while traveling between jobsites would enable you to file a workers’ compensation claim. You might also have the right to sue the driver of the other vehicle if their negligence caused the accident.
What happens when you are injured at work?
The first thing you need to do when injured at work is to report it by filing a claim. There are a few methods for filing a claim, including:
- Complete an incident or accident report as provided to you by your employer.
- Get an Oregon Form 801, Worker’s and Employer’s Report of Occupational Disease/Illness, from your employer. Fill it out and submit it to your employer, who must then submit it to the workers’ compensation insurance company.
- If you require immediate medical assistance, your doctor will have Oregon Form 827, Worker’s and Physician’s Report for Workers’ Compensation Claims. You and your doctor must complete the form, and then your doctor must submit it to the compensation insurance company within three business days.
Although you have up to 90 days to report your injury or illness, you should not delay reporting it. Your employer cannot refuse to submit the claim to the insurance company. If you believe your employer is delaying the submission of the claim, you can submit the claim to the insurance company on your own and report your employer to the state Workers’ Compensation Division.
Can you choose your own doctor to provide medical care?
Unless you are part of a managed care organization through your employer, you have the right to seek medical treatment for your injury or illness from any health care provider designated as an attending physician, such as medical doctors and doctors of osteopathy, under state law. Other types of medical practitioners, such as chiropractors, might have limitations placed on the number of visits or days of treatment they are permitted to provide to you.
How long can the insurance company take to process your claim?
The workers’ compensation insurance company has 60 days from the receipt of your claim for benefits to accept it and pay benefits or deny the claim. If your claim is denied, you should speak to an attorney to find out more about your right to request a hearing.
Benefits payable for job-related injuries include the following:
- Medical: Expenses associated with medical care you need to treat the injury are reimbursed through workers’ compensation.
- Temporary disability: If you doctor authorizes you to have time away from work while you recover from your injury, you are entitled benefits equivalent to two-thirds of your average weekly wages up to a maximum amount the state sets each year. However, your doctor might clear you to return to work with limitations on the type of work you can do or the number of hours you can work. In such a situation, your benefits would be two-thirds of the difference between your post-injury and your pre-injury weekly earnings.
- Permanent disability: If your injury or illness is so severe that you cannot fully recover, you could receive partial permanent disability or total permanent disability benefits.
Additional information about benefits, appealing decisions made by your employer’s workers’ compensation insurance company, and other concerns you might have about protecting your rights in the event you are injured on the job should be discussed with an attorney knowledgeable and experienced in workers’ compensation.