Oregon Workers’ Comp For Employers and Workers

Employers recently got good news with the announcement from the Oregon Department of Consumer and Business Services of a continuation in the seven-year trend of declining premiums for the workers’ compensation insurance they must carry. The department emphasizes that the savings for employers does not come at the expense of injured workers, who continue to have access to comprehensive medical care and reimbursement for earnings lost while they are out of work recovering from their injuries. As employers enjoy a reduction in the cost of workers’ compensation, an understanding of how the system works and knowing what to say and do when workers must seek medical treatment may ensure that they continue to receive the care and benefits they deserve. 

A brief history of workers’ comp in Oregon 

It may be hard to imagine that a time existed when workers injured on the job had to pay for their medical care. Before workers’ compensation became effective in Oregon in 1914, the only way for injured workers to be reimbursed for lost wages and medical costs was by filing a lawsuit against their employers. Unless they could prove negligence on the employer’s part in what was usually a long and drawn-out process, they could not recover damages. 

The original workers’ compensation system in Oregon was a voluntary one, with employers being given the option to join and contribute to the newly created Industrial Accident Fund. The incentive for employers agreeing to participate in the system was a prohibition against lawsuits by injured workers. Instead of suing their employer, workers would make a claim against the fund. 

Legislation over the years has expanded the Oregon system to make it mandatory for most employers in the state to insure their employees. An employer may obtain coverage by purchasing a workers’ compensation policy offered by any of the private insurance companies authorized to issue the policies in Oregon.

Giving up the right to sue

In exchange for giving up the right to sue their employers, Oregon workers received the right to obtain the following benefits simply by filing a claim for compensation through their employer’s workers’ compensation insurance: 

  •       Medical treatment.
  •       Prescription medications.
  •       Transportation to and from appointments for medical care.
  •       Lost wages incurred while unable to work due to injury.
  •       Long-term disability
  •       Death benefits payable to dependents of deceased worker.

A worker files a claim for benefits by immediately letting a supervisor or other representative of the employer know of the work-related injury or illness. Formal notification is by an official Form 801, Report of Job Injury or Illness, that an injured worker completes and submits to the employer. 

What happens at a doctor’s office may affect a worker’s claim for benefits 

The fact that Oregon requires employers to provide workers’ compensation insurance for employees does not mean that claims are not carefully scrutinized to verify a claimant’s eligibility for benefits. What a person says and does in connection with visits to the doctor for treatment may determine whether an insurance carrier denies the claim. Things to be cautious about when visiting with a doctor for treatment include the following: 

  •       Do not delay seeking medical treatment: Delays in seeking medical treatment for an injury or illness claimed to be related to work could cause an insurance company to question the severity of the injury or its relationship to a person’s workplace. 
  •       Be honest about the injury with the doctor: Workers should not allow concerns about losing their job prevent them from being honest when describing pain or physical limitations caused by the injury suffered at work. Employers cannot take adverse action against a worker for filing a claim for workers’ compensation benefits. Failing to be candid with a doctor about the extent of an injury could limit the benefits a worker receives. 
  •       Follow the instructions of the doctor and continue treatment: Even though a worker is entitled to be compensated for time lost from work due to the injury, the desire to return to work could make a person miss medical appointments or attempt to return to work against the advice of the doctor. Stopping treatment or returning to work too soon could jeopardize future benefits if a worker must stop working and seek medical treatment for the same injury. 

Keeping accurate and thorough records of the medical care they receive, the medications prescribed for them, physical therapy appointments, and other aspects of their recovery from a work-related injury or illness may prove helpful should a claim for benefits be denied.

Consult with a workers’ compensation lawyer

One of the rights a person has for making a claim for benefits under the Oregon workers’ compensation system is access to legal advice and guidance from an attorney. A worker in need of representation from a Bend workers’ compensation lawyer to challenge a denial or handle other issues related to a claim may do so without incurring the cost of legal fees.

Leave a Reply

Your email address will not be published. Required fields are marked *