How Does Oregon Workers’ Compensation Work – Do You Qualify?

If you suffered a work-related injury resulting in grave losses you cannot afford to pay yourself, it’s vital to know Oregon’s workers’ compensation laws.

It’s unfair for employees to pay for such injuries, and Oregon addressed those concerns through their workers’ comp regulations.

You may qualify for medical treatment, wage replacement, or permanent disability compensation if you suffered injuries or illnesses from your job. Oregon workers’ comp may also provide death benefits to dependents of workers who passed away as a result of their employment.

It’s difficult to enact a solid claim without a workers’ comp attorney by your side. A legal professional who knows all of Oregon’s workers’ comp laws is invaluable to the success of your claim.

This legal guide can help summarize key details about how Oregon workers’ compensation works, but for more targeted advice, you may need an attorney.

What Conditions are Covered Under Oregon Workers’ Comp Benefits?

Any injury or condition that occurred at the workplace or because of work duties is covered. This could include an injury from a sudden accident, like a wound or a knee injury. It could also include an injury from repetitive motion, such as carpal tunnel syndrome in a worker’s wrist.

The main objective of a successful Oregon workers’ compensation claim is to pay for medical bills resulting from the injury. This includes reimbursement for prescription medications, transportation, meals, lodging, and other expenses up to a maximum established rate.

IMPORTANT: Injured or ill workers must make a written request for reimbursement and attach copies of receipts.

Not only are medical expenses compensable, but a variety of conditions as well under Oregon workers’ compensation law, such as:

• Lost wages
• Rehabilitation costs
• Death benefits

Time-Loss Benefits

If you lose more than three days of work, your employer must pay you lost wages on an accepted workers’ comp claim in Oregon. These payments are called “time loss benefits” or temporary disability.

If you have work restrictions placed on you by your doctor, take that documentation to your employer. Your employer can provide you with light duty work that you are capable of performing. Or, if the employer chooses, you can stay home and the insurer will pay you time-loss benefits.

Who Qualifies for Oregon Workers’ Comp?

Almost all employers must carry workers’ compensation insurance for their employees or be self-insured, due to ORS § 656.027.

The main exceptions to Oregon workers’ comp include independent contractors and some corporate officers and business owners.

Who is Exempt from Oregon Workers’ Comp Laws?

Oregon workers’ comp law names the types of employers that are not required to have workers’ compensation insurance coverage, including:

• Certain corporate officers
• Partners and family-member business owners
• Independent contractors

Steps to Report Your Oregon Workers’ Comp Claim

Employers from private industry reported 50,600 nonfatal workplace injuries and illnesses in Oregon in 2022. Injured employees in Oregon receive benefits payments regardless of who was at-fault for an accident.

In exchange for these benefits, an employee cannot bring civil action against the employer for pain and suffering or other damages.

There are various mandatory steps you have to follow if you want to start your workers’ comp claim. Avoid the various mistakes you may encounter when starting your claim, and consult an attorney if you need direct assistance.

1. Notifying Your Employer

Tell your employer right away if you suffer a work-related injury or illness. Your employer will have a form you can use to file the claim, called an “801 form.” You can also file a claim through your doctor with an “827 form.”

2. Requesting Additional Conditions

If your doctor finds additional medical conditions from your workplace injury, you must send a written request to your insurer. The insurer has another 60 days to accept or deny these additional conditions. If accepted, those conditions become part of your claim.

3. Receiving Your Benefits

An insurer must accept or deny a claim within 60 days and notify the state’s Workers’ Compensation Division (WCD) within 14 days of acceptance or denial. When an insurer accepts your claim, they must send you a Notice of Acceptance letter explaining your covered medical conditions.

Employer Penalties for Not Having Workers’ Comp Benefits

If your employer failed to carry Oregon workers’ compensation for your injuries, they may face hefty fines as a result.

The amount they’re charged is twice the amount of premiums they should have paid, minimum to $1,000. Continuing to hire workers without coverage may result in penalties up to $250 per day of noncompliance. Repeat offenses may result in court injunctions and jail time if repeated.

IMPORTANT: It is also unlawful for your employer to fire you or discriminate against you for filing a claim. Contact the Workers’ Compensation Division by calling 800-452-0288 if your employer retaliates against you for filing a claim.

Is Oregon a No-Fault State?

Yes, the Oregon workers’ compensation system is a no-fault system. This means approval of a claim is not dependent on proving the employer or worker was negligent. The main determiner to an approved workers’ comp claim is proving whether your injury started due to work. 

Oregon Workers’ Compensation Settlement Amounts

The amount you gain from an Oregon workers’ compensation settlement varies depending on the costs of your injuries. The average temporary disability claims costs paid for resolved accepted disabling claims in 2020 was $20,970.

When you disagree with the insurer about whether you have a valid workers’ compensation claim, you and the insurer may agree to a cash settlement. If you agree to a cash settlement, you give up all rights to future benefits besides those you accepted.

Workers’ Comp Statute of Limitations in Oregon

Workers must file their Oregon workers’ compensation claim within one year after the date of your work-related injury or illness. If you fail to file within the statute of limitations, you risk 

Within 60 days of giving notice to your employer, the insurance company must classify your disability to accept or deny the claim. The insurer must report all accepted or denied claims to the Workers’ Compensation Division within 14 days of their decision.

Oregon’s 90-Day Rule

The workers’ compensation 90-day rule requires employees to report a work injury within 90 days to receive funding. Also, Oregon employers must protect employees’ jobs and positions if the employee has been employed for more than 90 consecutive days.

What if Your Oregon Workers’ Comp Case was Denied?

If the insurance company denies your claim or their settlement doesn’t cover your injuries, you can respond with an appeal.

When an insurer denies a claim, it must send the worker a letter explaining why the claim was denied. It must also provide information to the worker about the right to appeal to the Hearings Division of the Workers’ Compensation Board (WCB).

How Much is an Oregon Workers’ Comp Settlement?

The amount of your workers’ comp time-loss benefits depends on your average weekly wage. It’s calculated as the average of all the wages, overtime, commissions, room and board, and other monetary compensation during the last 52 weeks of your employment.

Once the insurer calculates your average weekly wage, it will pay you two thirds of that amount in time loss. Time loss is paid every two weeks. You do not pay taxes on these payments. Your benefits last until you reach maximum medical improvement and can return to work in Oregon.

How an Oregon Workers’ Comp Attorney Can Help You

Navigating the Oregon workers’ compensation system while maximizing your chances for approval is challenging, so don’t tackle this alone. LegalASAP partners with 500+ law firms with thousands of attorneys across the United States. We can help you find a local workers’ comp attorney in Oregon who will help you file your claim.

Time is crucial when filing for workers’ comp, so fill out this short evaluation form, and we will contact you as soon as possible.