Workers Compensation
Due to the mostly informal training processes, hot kitchens, and long hours workers, especially kitchen workers, can get injured pretty easily. Most of the time the injuries sustained are minor. Common injuries are burns, cuts and strains but if a worker needs medical treatment (say your finger was caught in a coffee grinder or you chop the end of your finger off) they can file a workers compensation report to cover medical costs.
Workers’ compensation laws provide money and medical benefits to a worker who has an injury as a result of an accident, injury or occupational disease on-the-job. It is a “no-fault” system intended to benefit the worker and employer alike though many employers dispute claims. The worker receives money (usually on a weekly or biweekly basis) and medical benefits in exchange for forfeiting the common law right to sue the employer. Independent contractors are not considered “workers” and are not eligible for workers compensation for injuries incurred on the job-site.
How to File a Claim:
• Notify your employer about your job-related injury or illness as soon as possible.
• Ask your employer to give you Form 801, “Report of Job Injury or Illness,” and complete Form 801.
• Ask your employer the name of its workers’ compensation insurer.
• Get medical treatment from a health care provider of your choice and tell your provider that you were injured on the job. Your employer cannot choose your health care provider for you.
• Your health care provider should ask you to complete Form 827, “Worker’s and Physician’s Report for Workers’ Compensation Claims.”
Filing a Claim with a Doctor/Hospital:
If you go to a doctor after being injured, tell your doctor you were hurt on the job. You and your doctor should complete Oregon Form 827, Worker’s and Physician’s Report for Worker’s Compensation Claims. Doctors and hospitals are required to report job-related injuries to your employer’s workers’ compensation insurer (the company from which your employer has purchased workers’ compensation insurance) within 3 working days.
Your Employer’s Responsibilities:
Your employer must send your workers’ compensation claim (Form 801) to their insurer within 5 days of being notified of your injury. It is illegal for employers to do anything to keep workers from filing injury claims including intimidation or threats of job loss.
Employers must not:
• … make workers sign statements agreeing not to file a claim.
• …require you to say the injury occurred somewhere other than at work.
• …pressure you to not file an injury claim form by agreeing to pay the medical bills.
• …require workers to sign up as independent contractors, partners, or corporate officers for the purpose of avoiding workers’ compensation requirements.
The Insurer’s Responsibilities:
The insurer must accept or deny your claim within 60 days from the day you file the 801 form claim with your employer.
If your claim is denied, the insurer will tell you about your appeal rights in the denial letter they send to you.
If your claim is accepted, the insurer will send you a “Notice of Acceptance.” This notice will list the medical conditions accepted for coverage by the insurer. If you believe that a condition has been left off the notice, or the notice is otherwise incomplete or incorrect, you must notify the insurer of the error in writing.
The insurer will pay time-loss authorized by your doctor. You won’t have to repay time-loss benefits if your claim is denied. However, if your claim is denied within two weeks of the date you reported the claim to your employer, you will not receive time-loss payments.
Denial of Claim:
Claims are often denied in which case it is prudent for large claims that you hire a lawyer especially if these common situations occur:
• The employer denies you were injured on the job
• The carrier has denied benefits
• You cannot get medical treatment
• You are not getting paid
• The adjuster promises benefits or care which never arrives
• An attorney for the employer or insurance company contacts you and wants to take a deposition
• You want to sue a third person- You begin to represent yourself and you encounter someone on the other side who is particularly difficult and is trying to take advantage of your lack of legal experience
The information contained in this section was collected from WorkersCompensation.com
