WORKERS´ COMPENSATION INSURANCE FOR OREGON   800.285.8525
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Benefits

Workers injured on the job may be eligible for several kinds of benefits, including time-loss benefits, coverage of medical treatment, and more. SAIF works side by side with you and your employer to be sure you receive the appropriate care and payment.

Contents:


Overview

Time loss

If your injuries require you to miss work, you may be eligible for temporary disability benefits (also called time loss benefits) if your attending physician authorizes you to be away from work.

The formula for calculating time loss benefits is determined by the state and is described on the wage benefits page.

Medical coverage

If your claim is accepted, your medical providers will be reimbursed for treatment related to your accepted condition. (In Oregon, the amount of the payment is determined by the Oregon Workers' Compensation Fee Schedule.)

If your claim is denied, all benefits will stop. You are not eligible for benefit payments while your claim is in a denied status, except for interim medical benefits if you are also covered by a qualified health plan. Contact your adjuster if you have questions about this benefit.

Managed care organizations (MCOs)

MCOs contract with doctors and other health care providers for medical services to covered employees with work-related injuries or illnesses. MCOs emphasize quality medical care, disability management, and cost containment.

If your claim is accepted, you will generally be required to seek treatment from an MCO provider or a qualified general practitioner, family practitioner, authorized nurse practitioner, or internist with whom you have a history of prior treatment.



Benefit table

Benefit calculations for injured workers

The amount of benefits is established by the state legislature. The date of the accident determines the benefits to be paid. If you receive temporary disability, a cost of living adjustment occurs on July 1 of each year. The increase is tied to the average weekly wage in Oregon. See Benefit table below.

Remember, an attending physician or authorized nurse practitioner must verify you are physically unable to work in order to receive this benefit.

Timeline

If SAIF has received notification of the injury, the initial check will be mailed no later than 14 days from the date you inform your employer of the injury and became unable to work because of the injury (unless the claim is denied by the 14th day). Subsequent checks are mailed every two weeks.

Types of benefits

There are several types of benefits paid for replacement of wages or loss of income:

Temporary total disability (TTD)
When an attending physician or authorized nurse practitioner authorizes you to remain totally off work during your recovery, the benefits you receive are called temporary total disability. If authorized, time loss benefits are paid during the time the claim is deferred and then continue if the claim is accepted. If the claim is denied, the benefits are stopped as of the date of the denial.

The amount you receive is determined by your average weekly wage. There are minimum and maximum biweekly benefits.

Supplemental Disability
If you had additional Oregon subject jobs at the time of your injury, you may be eligible to receive additional disability payments. You must notify us about the other jobs within 30 days of our receipt of the initial claim and provide proof of wages paid on the other jobs: check stubs or payroll records.

Temporary partial disability (TPD)
As you recover from your condition, your doctor may release you to resume some work. At the time you return to transitional work, if you are not earning your pre-injury average weekly wage, you are eligible for temporary partial disability benefits. These benefits continue while you are recovering and have not been released to return to your regular work while you are not earning your full wage and your claim remains open.

Permanent partial disability (PPD)
When you are determined to be medically stationary, your claim is ready for closure. An examination is done to determine whether you have a permanent loss of use or function as a result of your injury. This permanent loss of function is determined as a percentage of whole body impairment for benefit calculations.

Permanent total disability (PTD)
If you are unable to return to any form of gainful and suitable employment held in the past, you may qualify for PTD benefits. These benefits are based on your average weekly wage at the time of the injury but are paid monthly instead of biweekly. Generally, they are for significant and serious injuries, such as paraplegia, quadriplegia, or traumatic brain injuries.

Fatal or survivor's benefits
When a worker is fatally injured on the job and leaves behind a spouse or registered domestic partner, dependent child, or other qualified beneficiary they will receive benefits if the claim is accepted. These benefits also will include a burial allowance.

Benefit table

Effective July 1, 2011
Temporary Total Disability (TTD) for workers entitled to TTD benefits on or after July 1, 2011
 Injured Worker  66-2/3% wages paid weekly
 Maximum      $2,241.10 biweekly
 Minimum   90% wages or $100 biweekly, whichever is less
Permanent Partial Disability (PPD) Dates of injury or after July 1, 2011
Impairment Percent of whole body impairment x 100 x Oregon Average Weekly Wage ($842.52).

Work Disability

(Cannot return to
regular work due to
the accepted condition.)
  • Percent of whole body impairment + factor for age, education and adaptability x 150 x worker's weekly wage.
  • Maximum worker wage factor = 133 percent of Oregon Average Weekly Wage ($1,120.55).
  • Minimum worker wage factor = 50 percent of Oregon Average Weekly Wage ($421.26)
Note: Workers may qualify for both Impairment and Work Disability awards.
Permanent Total Disability (Date of injury on or after July 1, 2011)
Note: Benefits based on state average weekly wage in effect at the time of injury
Injured Worker 66-2/3% wages paid monthly
Maximum   $3,664.96 / monthly
Minimum 90% wages or $217.50 / month, whichever is less.
Spouse and children after death of PTD Same as Fatal below
Fatal (Date of injury on or after July 1, 2011)
Spouse or registered domestic partner $2,443.43 / monthly
Each child $366.50 / monthly
Maximum spouse and children $4,886.49 / monthly
Each child (when no spousal benefit paid) $916.24 / monthly
Children age 18 to 23 – without a living parent $2,443.43 / monthly, while attending higher education.
Burial allowance $16,850.40 (unpaid balance paid to the worker's estate)
Remarriage allowance 36 times the spouse or domestic partner’s monthly benefit payable in a lump sum
Oregon Average Weekly Wage
  $842.52