Your rights
- You have the right to file a workers' compensation claim for injuries or occupational illnesses that occur on the job.
- You have the right to seek medical treatment. This may be by your own doctor or a doctor of a managed care organization (MCO), depending on your employer's workers' compensation insurance policy. You may still treat with your own doctor rather than a doctor of an MCO if your doctor agrees to the terms of the MCO contract and has been approved by the MCO.
- You have the right to choose your attending physician. You may select an initial attending physician and may change physicians two additional times. Approval by SAIF or the Oregon Workers' Compensation Division is required for more than three worker choices.
- You have the right to return to work if you are released for work by your doctor.
- You have the right to return to your job or to another suitable job once your doctor releases you to work (if your employer has more than 20 employees). However, you must ask your employer for your job or another suitable job within seven calendar days (sooner if your union contract or employer's personnel policies require it).
- You have the right to disability (time-loss) pay if you are partially or totally disabled due to your injury or illness.
- If you do not agree with the insurer's decision about your claim, you have the right to appeal the decision. You have the right to be represented by an attorney at no cost for attorney's fees. An attorney will explain any costs you might have to pay.
- You have the right to enter into a claim disposition agreement (CDA) on an accepted claim. In a CDA, you give up your rights to certain benefits for an agreed-upon sum of money.
- You have the right to pursue a cash settlement with the insurance company when you disagree with the company about whether you have a valid workers' comp insurance claim.
- Request reimbursement for out-of-pocket expenses such as prescriptions or mileage driven to and from your medical provider appointments. Submit these requests to us within two years of the service date. Download the Request for Reimbursement of Expenses form (F-3056) in or (F-3056s) .
- You have the right to find out the name of your employer's workers' compensation insurer. If you need help call the Workers' Compensation Division at 888.877.5670.
Questions about your rights
If you are unsure of your rights or have questions about how your claim is being handled, experts on workers' compensation law at the Workers' Compensation Division can help.
Ombudsman for Injured Workers
The ombudsman is an independent advocate for injured workers.
Your responsibilities
- Report incidents to your employer or supervisor immediately. Incidents must be reported no later than 90 days.
- If you need to seek medical care, fill out a form 801 with your employer and a form 827 with your doctor or nurse.
- Keep your medical appointments and follow your attending physician's or authorized nurse practitioner's instructions.
- Maintain contact with your employer so she may assist you with returning to work as soon as you are physically capable of doing so.
- Keep us informed about your condition so we may pay your benefits in a timely manner.
- Read all letters and notices about your claim carefully and pay special attention to instructions about medical appointments and time limits. Contact us if you have any questions about your claim or benefits.
- Respond to requests for information in a timely manner. Many laws have clear timeframes for response on your part. Failure to respond by the due date may affect your claim.
- Provide your claim number to any medical provider who treats you for your accepted condition so they may bill us in a timely manner.
- Request reimbursement for out-of-pocket expenses such as prescriptions or mileage driven to and from your medical provider appointments. Submit these requests to us within two years of the service date. Download the Request for Reimbursement of Expenses form (F-3056) in or (F-3056s) .
- If you believe we need to accept a new or different medical condition, please put your request in writing and state the condition you want us to accept. We cannot accept surgical procedures or treatment-it must be a medical condition. If you aren't sure what to do, don't hesitate to call us.
- Keep copies of all letters you send and receive regarding your claim.
- Contact your employer immediately when your doctor releases you for work.
- Don't worry. We have been around for more than 90 years and we're here to help you with the process.
Our commitment
If you follow through on your responsibilities, you can expect SAIF to do the following.
- Make a decision about whether to accept or deny your claim usually within 60 days of your reporting the claim to your employer. If your claim is denied, SAIF will tell you about your appeal rights in the denial letter. If your claim is accepted, SAIF will send you a "Notice of Acceptance" that lists the medical conditions accepted for benefits.
- Maintain contact with your employer in order to assist you with returning to work as soon as you are physically capable of doing so
- Pay benefits due in a timely manner
- Respond to requests for information in a timely manner
- Maintain the privacy of your claim information and records
Consequences
There are possible consequences for not following through with your responsibilities. Your benefits could be suspended, reduced, or in some cases denied, if you:
- Fail to cooperate with the investigation of your claim.
- Do not attend a mandatory medical examination without good cause.
- Do not cooperate with the treatment deemed necessary for your recovery by your attending physician.
- Do something that your doctor feels is hampering your recovery and you do not stop when warned of the consequences of the activity.
- Refuse an offer of suitable employment that has been approved by your attending physician.