Oregon Workers Compensation Insurance Companies - Oregon requires employers with one or more employees to carry workers' compensation insurance. The Oregon Accident Fund Corporation (SAIF) is a not-for-profit workers' compensation insurance company established to oversee workplace safety and guarantee workers' compensation benefits to employees. The SAIF system is designed to prevent and reduce employee injuries, provide benefits such as medical treatment, guide injured employees to recovery, help employees return to work safely and as quickly as possible, and protect employers from legal action in the event of a workplace accident. doing. . illness or injury.
When an employer applies for workers' compensation insurance, SAIF may consider it necessary for the employer to seek protection from the Industrial Accident Fund. This depends on the financial situation of the employer. If the SAIF believes that the financial situation of the business is unsafe, the SAIF will require a deposit as security for the annual premium payment.
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Employers must make deposits to keep their workers' compensation insurance active and deposit as annual premiums into the SAIF. The deposit is an amount equal to six months salary of the employer. If the employer cannot afford to pay this deposit, or if they choose not to make the annual deposit, they will have to take out a SAIF Employers Bond.
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According to Oregon Revised Statutes Chapter 656, SAIF workers' compensation employer bonds are used to protect employers from unpaid wages, medical expenses and potential lawsuits.
Based on specific bond criteria, Jet must determine all business-related details before approving a bond application. Call our office at 855-296-2663 to begin the eligibility process.
The SAIF workers' compensation worker's bond amount is determined by the company's annual premium deposit, financial risk of the business and business history. Under Chapter 656, the bond fee must be between 2 and 7.5% of the bond amount. In order for a workers' compensation insurance license to remain in good standing, bonds must be continuously active.
The original signed and sealed bond must be submitted to the SAIF Workers' Compensation Division. The address is as follows: Oregon has strong workers' compensation laws to protect almost all workers except manual laborers, domestic workers, police, firefighters, and railroad, air and trucking workers.
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The law covers all workplace injuries and illnesses, including mental illness, and compensation can cover both medical expenses and loss of income.
However, under certain circumstances, workers' compensation claims can be denied in Oregon. The Oregon Workers' Compensation Board will review any disputes arising from claim denials.
The insurance company and the employer win when an Oregon workers' compensation claim is denied.
An employer does not want to increase the insurance premium due to a valid claim and directly benefits if the insurance company is not obliged to pay the claim. That's why they're looking for anything they can to get their Oregon workers' compensation claim dismissed.
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Late filing is one of the most common reasons insurance companies deny workers' compensation claims in Oregon. A late application after an employee has been fired or left voluntarily is especially suspicious to the insurer.
The insurer may see the delay as an opportunity to prove that the injured worker was dishonest about the extent or nature of his injuries.
To prevent an insurance company from using delay as an excuse for denial, an injured employee should file their workers' compensation claim as soon as possible after suffering a work-related injury.
In Oregon, to receive workers' compensation, an injured worker must report the injury to the employer within 90 days of the workplace accident. In case of occupational disease, the worker is obliged to report it within one year after establishing the connection between the disease and his work.
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If a worker misses the reporting deadline, they may lose their workers' compensation benefits. It is best to report a workplace injury as soon as possible to ensure the claims process.
Oregon law requires that the employee report the injury in writing. Injured workers typically file Form 801 (Report of Occupational Injury or Illness). The form can be obtained from your employer or downloaded from the Oregon Department of Workers' Compensation website.
In addition, the employee may provide a written and signed report that must explain when, where, and how the injury occurred.
After a work injury in Oregon, you or your legal representative should identify and contact any co-workers or others who may have witnessed the accident.
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If you don't have a third party who can corroborate your version of how the accident happened, this allows the insurance company to claim that the accident did not happen as you described and they will deny your claim.
If an accident happens while you are alone, you cannot change that fact. But you can still strengthen your claim by hiring an experienced Oregon workers' compensation attorney and getting a professional opinion from a doctor who can verify that your on-the-job injuries match your version of how the accident happened.
Your Oregon workers' comp claim may be dismissed if you did something to contribute to the accident. For example, if you were drunk at the time of the accident, the insurer may not accept your claim because your drunkenness may have caused the accident.
Sometimes, flagrant or reckless disregard of established safety rules or failure to use safety equipment can be used as evidence to dismiss an employee's claim. These issues can be contentious, and in such cases, you will need legal advice from a qualified and experienced Oregon workers' comp attorney to pursue your claim.
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In some cases, the employer may try to find inconsistencies in your version or try to claim that your injuries were caused by a pre-existing condition and not a workplace accident. Employers can sometimes argue that your accident is outside the scope of your employment.
After a workplace injury, your best course of action is simply to speak with the people directly involved in the accident claim process. If you share your story with colleagues who may misunderstand or forget what you're saying, it can work against you.
The insurer or employer may then use the various options others may offer about your accident. You should allow an Oregon workers' compensation attorney to speak for you and communicate with your insurance company and employer as needed.
Oregon workers' compensation law allows you to choose your own doctor or choose one from your insurer's managed care organization. During the first medical appointment, the doctor must fill out Form 827 (Employee and Physician Report on Restroom Requirements) and submit it to the insurance company.
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You must provide your doctor with specific and detailed information about how your injuries occurred and what symptoms you may have. Insurance companies rely heavily on your original medical records to evaluate your claim.
Exaggerating or understating your symptoms during a doctor's appointment may result in your claim being denied.
An Oregon insurance company has the right to review your accident-related medical records even if you believe that discovery of your medical records would affect your privacy. They are also entitled to information about any pre-existing medical conditions that may affect your claim.
If you fail to meet such documentation requirements, your insurer may use it as grounds to deny your workers' compensation claim in Oregon.
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If your Oregon workers' compensation insurance company refuses to pay you, you must file an appropriate appeal and have the state review the decision. However, you only have a limited time to file this claim from the date the claim was rejected.
Sometimes you may have to take the case to a formal courtroom. When you take your case to Oregon District Court, the judge will look at the entire case in a new light. If you win the appeal, you will also get interest on the judgment.
Importantly, remember to file your appeal within 60 days of receiving the insurer's denial letter. ("Good cause" may have exceptions, but the scope of the exception is very narrow).
To submit your appeal for a hearing, you must send a letter to the address listed on the denial letter. Choose a reliable and knowledgeable Oregon workers' comp attorney who can help you complete your hearing request form, focusing specifically on the issues you are complaining about.
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While Oregon law gives workers the right to appeal a denial, it's not an easy process. The insurance company will oppose the appeal and aggressively prepare for their arguments.
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