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Longshore claims

If you’re a longshoreman or harbor worker, you will need to file federal forms from the U.S. Department of Labor, because federal workers’ comp laws apply.

A claim is considered a longshore claim because federal law applies rather than state law. So, if you are a longshoreman or harbor worker, you will need to file federal forms from the U.S. Department of Labor, Office of Workers' Compensation Programs (OWCP).

The OWCP is charged with the oversight of longshore workers and ensures that appropriate benefits are paid promptly.

Longshore workers 

The U.S. Longshore and Harbor Workers' Compensation Act (LHWCA) provides workers' comp benefits to workers (other than crew members of a vessel) injured on, or upon, the navigable waters of the U.S. or on "any adjoining pier, wharf, dry dock, terminal, building way, marine railway, or other adjoining area customarily used by an employer in loading, unloading, repairing, or building a vessel."

Go to the LHWCA claim form

Prescription drugs 

The prescription drug benefits for you are the same as those for Oregon injured workers whose claims are managed by SAIF. See Pharmacy services for more information.

Choosing a doctor

You are allowed to select your initial medical provider. To change providers, you must submit a request to SAIF or OWCP. 

Benefits

Average weekly wage 

Your payment amount for time away from work (known as "time loss") is based on your gross average weekly wage (AWW) from the 52 weeks before you were injured.

You will receive two-thirds (66 2/3 percent) of your AWW. By law, all workers' comp insurance companies must pay this percentage. However, there are exceptions:

  • If you have other income, your time-loss payment may be prorated.
  • If your AWW is below the minimum or above the maximum, your percentage of AWW will not be two-thirds.

Three-day wait 

The three-day waiting period is similar to a deductible. It's usually deducted from the first time-loss check and is initiated when you miss work time or lose wages.

The three-day wait is applied to all injured workers who qualify for time-loss benefits. You are allowed to use sick leave, vacation, or another type of leave to compensate for the three days.

Reimbursements 

You may be eligible for reimbursement for mileage traveled to and from medical appointments. The mileage rate for federal claims is based on the standard U.S. government rate.

The claim process 

Claims adjusters must make a decision to accept or dispute your claim within 14 days of the date your employer knew of the claim.

Returning to work 

If you are offered modified work (approved by your physician), your benefits will be affected if you do not accept it.

Closure 

Once you reach "maximum medical improvement" status, your physician will determine if you sustained permanent disability.

  • Scheduled disability: Compensation for permanent disability or loss of use of the arm, hand, fingers, leg, foot, toes, ears (hearing) or eyes (vision), is paid for a specified number of weeks. This is commonly called "Scheduled PPD" and is payable even if you are able to return to work. The schedule and the number of weeks of compensation payable for each body part are listed in the Longshore Act.
  • Unscheduled disability occurs if you are unable to return to your job at the time of injury. Compensation for permanent loss of wage-earning capacity is payable when the injury causes permanent disability to other parts of the body not listed in the schedule of the Longshore Act.

The disability must limit your ability to earn wages. An unscheduled PPD benefit is paid at two-thirds (2/3) of your loss of earning capacity, calculated on the difference between your average weekly wage (what you earned at the time of injury) and what you are able to earn after the injury.

If you have no disability when you reach maximum medical improvement, your claim will automatically close.

Modification

If you experience a worsening of your injury after your claim is closed, you have one year from the date the last compensation payment was made to request modification of your claim. Contact your SAIF adjuster to make the request.

From saif.com

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