Types of benefits

If your workers’ compensation claim is accepted, you may be eligible for a range of benefits designed to support your recovery and return to work. You can learn more about each of these benefits below and talk with your claims adjuster about any questions you may have. 

Medical

If your claim is accepted, the insurer should pay for all of the following:  

• Medical treatment related to your on-the-job injury  

• Prescription drugs  

• Transportation, meals, and lodging necessary to attend medical appointments, with some limitations  

Your health care provider should not bill you for medical services. Your provider should directly bill the workers’ compensation insurer. The pharmacy may be able to directly bill the insurer for prescriptions. 

If you are required to pay for your prescriptions out of pocket, you have up to two years from the date the expenses were incurred to send a written request for reimbursement with proof of expenses (copies of receipts) to the insurer. The insurer has 30 days to request more information or reimburse you for your out-of-pocket expenses 

Temporary disability  

If your health care provider authorizes you to take time off work or to do modified work that causes you to lose wages, you may receive time-loss payments from the insurer. 

Payment for time lost from work is called temporary total disability (TTD) or temporary partial disability (TPD) and is based on your gross average weekly wage at the time of injury. The insurer may calculate your average weekly wage by averaging the wages you earned, with your employer at injury, over the 52 weeks before your injury. 

• Time-loss payments will equal two-thirds of your gross average weekly wage.  

• Oregon has a minimum and maximum amount payable to an injured worker that is adjusted every year. 

Permanent disability 

At closure, if you have a permanent loss of use or function (you have not returned to normal or preinjury status), you may be eligible for permanent partial disability (PPD). 

The PPD is based on a formula set by law and is not a settlement. The amount will depend on the severity of the disability, is determined by your medical provider, and is calculated as a percentage of whole body impairment. 

• Permanent partial disability impairment benefits are awarded when you have reduced range of motion, strength, or sensation, or if you have surgery. 

• If you are permanently disabled from returning to your regular work you could receive these benefits in addition to impairment benefits. These benefits take into consideration your age, education, job skills, and the nature of your regular work. 

If you can't return to any form of gainful and suitable employment on a permanent basis due to your injury, you may qualify for permanent total disability (PTD) benefits for as long as you remain totally disabled. These benefits are based on your average weekly wage at the time of the injury. 

Vocational assistance  

Your doctor may decide you aren't able to return to your regular job permanently. If your employer is unable to accommodate your permanent restrictions, you may be eligible for additional benefits, including vocational services and/or the Preferred Worker Program. 

Vocational assistance may involve help in finding work with your current skills or it may mean retraining for a new job. Vocational assistance may include any of the services, goods, allowances, and wage-loss payments used to assist you in returning to work. 

If you have permanent work restrictions due to your injury, a review of your eligibility for retraining or other employment assistance may occur. You have the right to request an eligibility evaluation for vocational services. 

If you have any questions about these benefits, please contact your claims adjuster. 

Preferred Worker Program (PWP)  

The Preferred Worker Program provides financial incentives to employers who hire injured workers with permanent disabilities. The Oregon Department of Consumer and Business Services (DCBS) will notify you if you are eligible, or you can contact DCBS directly at 800.445.3948. You can also contact your SAIF adjuster. 

Learn more about how PWP is a true win-win that provides benefits for qualifying injured workers and employers.