Oregon Workers’ Compensation Law first originated in 1914 by the Oregon Legislative Assembly. The law now pays for workers’ medical treatment and lost wages after a successful claim. The cause for treatment or lost wages must be a work-related injury and / or illness.
Oregon employers with at least one employee, full or part-time, must carry workers’
compensation insurance or be self-insured. Workers’ compensation insurance not only protects workers but also protects employers by shielding them from liability lawsuits that might result from work-related injuries or illnesses.
According to Oregon Workers’ Compensation law, every employer with one or more part or full-time employees must have worker's compensation insurance.
However, there are a few exceptions where you don't need workers' compensation insurance:
All worker's compensation claims fall under the Worker's Compensation Division (WCD), while Oregon's compensation law contains most of the law about worker's compensation insurance. This guide will elaborate on everything you need to know about Oregon worker's compensation.
Any employees who suffer a work-related injury or illness may elect to file a claim to receive workers’ compensation benefits.
Employees must fill out the Report of Job Injury or Illness (form 801) from their employers or the Worker’s and Physician’s Report for Workers’ Compensation (form 827) from their doctors.
Once the proper form is submitted, the claim process begins. Once employers or a doctor receives a form, they must forward it to the insurer. Claims may take up to 74 days for acceptance or denial.
When claims are accepted, insurers must send a notice of acceptance. The letter must outline the medical conditions that will be covered under the claim.
When claims are denied, employees will receive a letter from the insurer explaining why the claim was denied and shall provide appeal information.
The WCD recommends that employers notify insurance companies within five days of knowledge of the claim, and even if an employee does not wish to file one, employers should still offer form 801 and maintain a copy.
Employers cannot prohibit employees from filing a claim. Employers may also offer or recommend specific doctors or care, but may not direct care in any way or require employees to use any specific doctor.
Injured Oregon employees can receive payments for time lost from work once health care providers notify insurers of the injured workers’ inability to work.
Employees won’t receive payment for the first three calendar days they are unable to work.
Exceptions include:
Employees will receive a compensation check every two weeks during the recovery period as long as health care providers verify the employees’ inability to work. These checks will continue until the employee returns to work or is considered medically stationary. Time-loss benefits are two-thirds of a worker’s gross weekly wage at the time of injury, up to a maximum set by Oregon Workers’ Compensation law.
When claims are accepted, insurers or self-insured employers will pay medical bills due to medical conditions the insurers accept in writing.
These can include reimbursement for:
Injured employees must make a written request for reimbursement and attach copies of receipts as proof.
Medical bills are not paid if:
In addition to the exemptions discussed above, other special considerations regarding Oregon Workers’ Compensation Law include the following.
If your company leases its employees, you can provide workers’ compensation contractors to your employees for a fee. In return for that fee, employers must cater for the following:
However, it is possible to reach an agreement with the contractor to provide coverage for any leased employees.
Temporary service providers are not registered by the Department of Consumer and Business Service (DCBS). Employers who hire temporary workers are only required to cater to those employees in special situations.
These include:
Employers must use a written document stating how long each temporary employee will be retained. Otherwise, temporary employees must be treated as leased employees.
Employers are required to provide workers’ compensation for temporary employees.
Having worker's compensation coverage means the difference in serious penalties and back-charged premiums from the state government. It also protects against financial problems such as employee medical expenses, legal fees, and employee lost wages.
The WCD assesses several different types of penalties for companies that are not compliant with Oregon Workers’ Compensation law.
The WCD issues standard audits to non-compliant insurers that are out of compliance with any regulations relating to the accuracy, timeliness of benefits, claim processing and reporting.
You can receive this penalty if you violate the rule of OAR 436, which relates to delayed compensation to the worker, such as:
You may be issued this penalty if you fail to comply with the director's order under ORS 656.745.
These are issued to self-insured employers who fail to comply with the OAR 436-056. You can get this penalty for several reasons.
These include failure to:
It's advisable to keep records of accidents and report work-related accidents to the workers' compensation board and the insurer within the WCD set time limit for reporting accidents.
Doing so helps avoid facing any of the above penalties. In addition, reporting the accident in time allows the insurer to release compensation and initiate treatment for the worker.
All Oregon employers that are covered under workers’ compensation law are required to display a notice of compliance poster in an easily viewable and accessible location.
An Oregon labor law poster subscription service is a great way to ensure posting requirement compliance.
While the WDC has put together an FAQ on Oregon Workers’ Compensation, the helpful information isn’t always enough.
Whether you are an Oregon-based employer applying for workers' compensation coverage for the first time or want to change your current insurer, you will need a good Oregon insurance partner network.
Scott Herson-Hord is the CEO of Great Northern Staff Administrators (GNSA), an Oregon payroll services company that specializes in serving small to mid-size businesses with administrative solutions to streamline back-office processes from benefits to human resources. Starting his career in finance and working more than 10 years as a controller for various companies, Scott leveraged this experience over the next 22 years with GNSA to become one of the pacific northwest’s foremost experts in human capital management (HCM).