Oregon Workers’ Compensation Benefits: How to File Your Claim

Important: We updated this article in October 2023 to make sure all info below is both current and correct. Oregon law determines how most people apply and qualify for workers’ comp benefits. If you have a work-related injury or illness, then you may qualify for Oregon workers’ compensation. See the steps to file below, plus insights into Oregon workers’ compensation system statistics from 2017 to 2021.

Which Oregon Employees Have Workers’ Compensation Insurance Coverage?

In general, most Oregon employers must provide workers’ compensation coverage. Oregon state law says this coverage applies to all full-time and part-time workers starting on day one of employment. The only Oregon employees automatically exempt from this workers’ compensation insurance coverage are:

• Sole proprietors
• Independent contractors
• Domestic employees in a private residence (i.e., cleaners, home healthcare workers, gardeners, home remodelers, nannies, and housekeepers)
• Casual laborers earning less than $500 during any 30-day period
• Limited liability company officers and members
• Federal employees
• Corporate officers who own at least 10% of the company’s stock and serve as board members for their employers

Finally, injured workers with self-inflicted wounds or who are intoxicated at the time are financially responsible for their own medical expenses.

Workers’ Compensation Insurance Coverage: What Benefits Can You Get?

There are four types of benefits any worker can qualify for if their employer has workers’ comp insurance coverage:

• Temporary Total Disability (TTD) – This pays a portion of your lost wages if you’re too injured or sick to work in the short term. However, your doctor expects you to fully recover from your injury.
• Temporary Partial Disability (TPD) – This means you need at least 2 weeks to recover from your workplace injury or illness. Oregon employers must partially replace your lost wages until you can start working again.
• Permanent Partial Disability (PPD) – This means you cannot return to the same level of work as you did before filing for workers’ comp. State law orders insurance providers to pay claims worth $6,000 or less in one lump sum payment. Insurance companies that settle claims for more than $6,000 usually make monthly payments at 4.35x the current weekly TTD rate.
• Death benefits – Death benefits typically involve a lump sum settlement as well as coverage for funeral expenses.

How to File A Claim for Oregon Workers’ Compensation Benefits

Follow these steps when you’re ready to file your Oregon workers’ comp claim:

1. Notify your employer about your work related injury or illness right away.

Your employer should then give you Form 801, Report of Job Injury or Illness to fill out. Then, your employer must submit this form to the company’s insurer within the next five days.

2. If you need emergency medical care, go to the closest ER and tell the attending physician your injury is work related.

Medical providers must help you complete Form 827, Worker’s and Health Care Provider’s Report for Workers’ Compensation Claims. They should send this form to your employer’s workers’ compensation insurer within 72 hours.

3. Your employer’s workers’ compensation insurer must either accept or deny your claim within 60 days.

Then, the insurer must notify the Oregon Workers’ Compensation Division within 14 days after deciding what to do with your claim.

4. Can’t work due to your work related injury or illness? Then your workers’ comp doctor must notify your employer’s insurer.

Your first three days off are always unpaid until after your 14th day off for an on-the-job injury or illness. After that waiting period, you’ll receive lost-wage benefits for those first three days off work with an accepted claim. Oregon calculates workers’ comp payments using the state’s average weekly wage. In 2023, the most workers’ comp pay any injured worker can receive is $1,723.49 per week.

5. Denied claim? You have 60 days to appeal with the workers’ compensation insurance company for your employer.

Your employer’s insurer will mail you a denial letter explaining the reason why they denied your claim and how to appeal. Most workers’ comp claim disputes take 18-60 calendar days for the WCD to reach a claim disposition agreement. If you disagree with their claim decision, you have 30 days to request a hearing before the Oregon Workers’ Compensation Board.

Since every Oregon workers’ compensation claim is unique, your own experience may vary. If you don’t seek medical treatment or file either Form 801 or Form 827 within one year, you may lose your right to workers’ compensation. For more information on workers’ compensation insurance requirements for Oregon business owners, read the WCB’s Frequently Asked Questions brochure.

Oregon Workers’ Compensation Division Statistics and Trends

The annual workers’ compensation report from the Bureau of Labor Statistics (BLS) contains program data for most U.S. states. It lists total workers’ comp claims filed, how many employees missed work or received job restrictions, and job sector-specific data. Our chart below shows how Oregon workers’ compensation claims changed from 2017 to 2021:

As you can see, workers’ comp claims rose until the 2020 pandemic restrictions began for Oregon businesses. In addition, you’ll note that service workers account for 3 in every 5 claims filed during this period (57%-61%). What’s more interesting to see is how many workers received job restrictions, transfers, or changed positions. In most states, that number represents no more than half of total workers’ compensation insurance claims filed in any given year. Here, however, it’s closer to 64% of claims, on average.

That means that about 3 in every 5 Oregon employees filing workers’ comp claims qualified for lost wage benefits. In other words, Oregon employers paid those workers 66.6% of their average paychecks every two weeks until they returned to work. Employees with minor workplace injuries will only qualify for medical workers’ comp. This means your company’s insurer only makes payments for medical services. However, those approved claims don’t include wage-loss payments.

How to Get Free Expert Workers’ Comp Insurance Claim Help At Home

Several factors can lead an employer’s insurer to deny valid claims, such as preexisting health conditions. Failing to appear at a required independent medical exam is another common reason for denied claims. Another issue? Oregon business owners illegally classifying employees as independent contractors.

Why not sign up for a free phone call from a workers’ compensation attorney near you to discuss your claim? It’s the best and fastest way to get help that applies to your specific claim. If an insurer denies your claim, then a lawyer can handle your appeal.

Since all workers’ comp lawyers work on contingency, you pay $0 for legal help unless you get paid first. And if you do win, you’ll only pay one small fee once your employer’s insurer awards you benefits.

Want to speak with a nearby claims expert for free? Click the button below to start your free online benefits quiz now and see if you may qualify:

Get Your Free Benefits Evaluation