SAIF works with employees and employers to ensure that the employee receives the appropriate care and payment.
Workers whose injuries require them to miss work are eligible for wage compensation, called "time loss benefits," if the attending physician authorizes them to be away from work. The formula for calculating time-loss payments is determined by the state and is described on the benefit table
If your employee is owed time-loss benefits, you will be asked to provide wage information. The wage request form will help you report your employee’s gross wages for the 52 weeks preceding the date of the injury.
If a claim is accepted, the medical providers will be reimbursed for necessary treatment related to the injury. (In Oregon, the amount of the payment is determined by the Oregon Workers' Compensation Fee Schedule.)
Managed care organizations (MCO)
MCOs contract with doctors and other health care providers to provide medical services to covered employees with work-related injuries or illnesses. MCOs emphasize quality medical care, disability management, and cost containment.
If a claim is accepted and enrolled into the MCO, the employee will be required to seek treatment from an MCO provider or a qualified general practitioner, family practitioner, or authorized nurse practitioner with whom the worker has a history of prior treatment.
Claim disposition agreements (CDAs)
Injured workers may elect to negotiate a settlement to their claim, where they waive certain rights in exchange for a specified amount of money. Medical treatment for the worker will continue to be paid after a CDA.