Keeping it SIMPLE for small business

"I hoped this day would never come."

These words are probably thought or spoken by all small business owners when they file their first workers' compensation claim.

You chose your small business because you enjoyed the kind of work, the location, the independence, or interacting with people — not because you wanted to be an expert in workers' comp. The last thing you need is to get lost in a maze of insurance forms, terms you don't understand, and time wasted on the phone.

That's why SAIF has put together a group of claims adjusters, based in our Portland office, who are devoted solely to serving the needs of small business customers throughout the state of Oregon. (SAIF generally defines a small business as any policyholder with an annual premium of $20,000 or less.)

The team's 19 adjusters, some of whom speak Spanish, work closely with support staff, vocational coordinators, and a nurse consultant who are also dedicated to small business claims. The small business claims team enjoys taking a hand-holding approach and providing personalized service to employers. This is our commitment to small businesses.

The claims team works with a group of return-to-work consultants who also specialize in the needs of small businesses. Close communication between these two groups helps keep the process moving quickly for injured workers.

Need workers' comp help for your small business? Call us at 800.285.8525

The basics

Be bold: Call us if you have a question about anything.

Be quick: If an employee seeks medical attention for a work-related injury or condition, file an injury report (Form 801) as soon as possible.

Stay connected: Experience has shown that if employers stay engaged with both SAIF and the injured worker, it works out better for everybody.

Follow the money: Take advantage of programs such as Return-to-Work, Employer-at-Injury (EAIP), and Preferred Worker (PWP), all of which offer assistance to workers and employers who want to create modified work for their injured employees eager to return to work.

Follow that claim

Different claims require different kinds of service. In order for SAIF to provide the level of service that each claim requires, we research each claim to make sure it gets to the person who can help the most. Many claims proceed from adjusters who determine compensability to those who manage the claim itself. Here are the different adjusters who may be involved with your claim:

• Fast Track: All claims start here. The Fast Track team reviews all incoming claims to determine whether they can be accepted right away or if they need to go to a compensability adjuster. Minor injuries without time loss that clearly occurred on the job can be accepted right away and sent to a medical-only claims specialist (MMT). Claims involving time-loss, injuries to the back, neck, joints, or ligaments are directed to a compensability adjuster.
• Compensability adjuster: Determines whether an injury is "compensable" — essentially whether or not it was work-related. If so, the claim is sent to either an MMT claims specialist or a disabling adjuster.
• MMT claims specialist: Reviews and approves medical bills and manages accepted claims up to $5,000 that have neither time-loss nor permanent disability.
• Disabling adjuster: Manages claims that involve time-loss, permanent disability, or non-time-loss injuries to the back, neck, joints, or ligaments.
• Third-party adjuster: Works to recover claim costs from any third party involved, such as a driver who negligently struck your employee while he or she was working.
• Disability adjuster: Calculates and awards permanent disability on claims where the worker does not experience total recovery from the injury.
• Critical claims adjuster: Manages complex or serious claims, which may involve fatalities, serious burns or infections, exposure to mold or chemicals, electrocution, major trauma, and mental health issues.