Oregon workers' compensation benefits process

Oregon Workers’ Compensation Benefits: How to File Your Claim

State law determines how most people apply and qualify for workers’ comp benefits. If you get hurt or sick while doing your job, then you may qualify for Oregon workers’ compensation. See the steps to file for benefits below, plus statistical insights into Oregon’s program history from 2015 to 2019.



Which Oregon Employees Are Exempt from Workers’ Compensation Coverage?

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

  • Sole proprietors
  • Independent contractors
  • Domestic workers 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

How to File Your Oregon Workers’ Compensation Claim

Follow these steps when you’re ready to apply for Oregon workers’ compensation benefits:

  1. Notify your employer about your injury immediately after your workplace accident. 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 treatment first, go to the closest ER and tell the doctor your injury or illness is work-related. Ask the provider to help you fill out Form 827, Worker’s and Health Care Provider’s Report for Workers’ Compensation Claims. That doctor should send this form to your employer’s insurer within 72 hours after treating you.
  3. Your employer’s 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. If you can’t work due to your injury, then your doctor must notify your employer’s insurer. Your first three days off are always unpaid until after your 14th day off due to your workplace injury. After that waiting period, you’ll receive lost-wage benefits for those first three days off work.
  5. Denied benefits? You have 60 days to appeal your claim’s denial. Your employer’s insurer will mail you a letter explaining why they denied you benefits and how to appeal that decision. Most claim disputes take 18-60 calendar days for the WCD to resolve. If you disagree with the WCD’s decision, you have 30 days to request a hearing before the 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, read the WCB’s Frequently Asked Questions brochure.

Oregon Workers’ Compensation Statistics

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 employment sector-specific data. Our interactive chart below shows how Oregon workers’ compensation claims changed from 2015 to 2019:

 

As you can see, workers’ comp claims rose steadily during this five-year timeframe. However, it’s important to keep these numbers in perspective. At their 2019 peak, total workers’ comp claims represent just 1.4% of Oregon’s total population. In addition, you’ll note that service-industry workers account for 3 in every 5 claims filed during this period (59%-62%). 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 claims filed in any given year. Here, however, it’s closer to 58%, on average.

That means that about 3 in every 5 Oregon employees filing for workers’ comp qualified for lost-wage benefits. In other words, those workers got paid two-thirds of their average paychecks every two weeks until they recovered enough to start working again. Employees with minor injuries typically only qualify for medical workers’ comp, which only covers your doctor’s bills and not any lost wages.

You May Qualify for Legal Assistance

Insurers can deny valid claims for many different reasons, such as pre-existing health conditions. Failing to appear at an employer-required independent medical exam is another common reason for denied claims. 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 confidential legal advice that applies to your specific situation. Whether you already got denied benefits and want help filing your appeal or simply have questions, this phone call won’t obligate you to do anything else.

Since all workers’ comp lawyers work on contingency, you pay $0 for legal assistance if you don’t win a cash settlement. And if you do win, then you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

Get Your Free Benefits Evaluation