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In an attempt to answer frequently asked questions relating to the enforcement of Gov. Kate Brown’s
Executive Order 20-12 “Stay Home, Save Lives,” the Workers’ Compensation Division (WCD) is offering guidance about workers’ compensation issues.
This webpage will be updated as more information becomes available.
Oregon Workers' Compensation COVID-19 claims data |
COVID claims by insurer and industry
A: Yes, the division is maintaining all current services and expects minimal disruptions. We are prioritizing the health of our staff members and helping to flatten the curve of the pandemic by having our employees work remotely, staggering work schedules, canceling in-person events, and avoiding nonessential travel. Most of our physical locations are closed to the public. However, contact us to make arrangements if something needs to be delivered in person.
A: We understand some stakeholders have closed their physical work locations and their employees are not able to access U.S. mail or fax to send required information to the division. In this limited circumstance, we will work with stakeholders to set up a process to transmit information by secure email to the division. To enable this process, please email email@example.com or call 800-452-0288 (toll-free).
A: The division cannot waive statutory requirements. However, the division will consider the impact of COVID-19 in areas where the director has discretion to penalize or take action against an employer, worker, insurer, self-insured employer, service company, medical provider, or others.
All parties are encouraged to communicate with the division ahead of time if you cannot meet timelines, such as providing a timely response to inquiries. Where possible, the division will determine whether an extension or procedural waiver should be granted on a case-by-case basis, including whether COVID-19 is considered “good cause” or “reasons beyond a worker’s control,” where applicable. If there are specific areas of concern, please send them to firstname.lastname@example.org and we will review them.
A: Claims processors should document their claim files to explain why certain actions or inactions are happening. The division will consider these documented impacts when reviewing disputes and claims processing decisions for possible penalties or sanctions. We encourage as much reasonable flexibility and cooperation as possible. All parties should document their actions during this situation. For example, providers should include information in chart notes.
A: Effective September 21, 2020, the division published permanent rules adopting the increased payment rates that were first adopted through temporary rules for telephonic and online digital evaluation/assessment and management services provided on or after March 8, 2020. This will allow providers to maintain their increased capacity to serve patients by telephone and online digital means.
A: The division’s rules do not restrict the services that may be provided through telehealth or the provider types that may use these services. However, all services, regardless of the form of communication, must also be appropriate for the services provided.
A: Questions about the fee schedule or telehealth can be sent to email@example.com or call 503-947-7606.
A: If you are unable to see your medical provider, communicate as soon as possible with your claims adjuster and medical provider to inquire about telehealth options.
If you are scheduled for an independent medical exam, but are unable to attend, contact the Workers’ Compensation Division’s Benefit Consultation Unit at
800-452-0288 (toll-free) or firstname.lastname@example.org to discuss your options.
A: Every claim is unique, based on the facts of the case and the laws, and rules applicable to the circumstance. In general:
A: For other questions about specific situations, including how to address temporary disability when workplaces are closed due to COVID-19 restrictions, please contact email@example.com.
A: Yes. The Workers’ Compensation Division (WCD) and ARU are fully operational and processing issues, including appeals (reconsiderations) of Notices of Closure.
A: The law entitles workers to appeal their claim closure within 60 days of the Notice of Closure and to request an arbiter exam. ARU is required by law to process this request.
A: ARU does not have authority to waive the Oregon laws for completion of the reconsideration review within the prescribed time frames.
A: Many of the arbiter doctors and facilities are continuing to offer in-person examinations.
A: The examining doctors and facilities are following safety guidelines from the Centers for Disease Control and the Oregon Health Authority as directed by the governor.
A: You should contact ARU at 503-947-7816 as soon as possible and before your scheduled examination to discuss your situation. If all parties consent, ARU may defer the reconsideration proceedings and the arbiter examination in limited circumstances. The ARU reviewer will contact the parties to see if they agree to postpone the process. We will notify you of the decision.
A: OAR 436-055-0070(4) gives claims examiners a 12-month grace period to renew their certification. During that 12-month grace period, between an examiner’s three-year period expiring and their 24 credits being obtained, an examiner would still be “certified” under the rules. For example, examiners whose certifications expire on March 31, 2020, have until March 30, 2021, to complete the 24 credits. In this example, the their new certification period (with another 24 credits required) would still start April 1, 2020, so the examiners would need to ensure they do not count the grace period “catch up” toward that new certification period. Online training and classes may be used to satisfy the credit requirement.
A: The division no longer has DVDs available (many of them were getting outdated), but we still have a few videos available. The first two groups (independent contractor vs. subject worker and provider training) are each worth one hour if you watch all of the modules. The third option, What happens if I’m hurt on the job? is worth a half hour of training credit. These videos will count towards general claims examiner Continuing Education Credit Units (CEUs). Please track these hours and communicate with your employer.
Workers’ Compensation Division 350 Winter St. NE P.O. Box 14480 Salem, OR 97309-0405
800-452-0288 (toll-free) 503-947-7585 (general questions) 503-947-7810 (central reception)
Please call or send specific questions to:
Building Codes Division
Division of Financial Regulation:
Ombudsman for Injured Workers
Small Business Ombudsman
Submit current excess policies according to OAR 436-050-0170:
Getting the worker back to work at modified duty can save you money and benefit the worker. Under modified duty, if the worker receives full pay, your insurance carrier pays the worker nothing, and time-loss costs stop. This will decrease the effect the claim will have on future insurance costs. Also, the sooner the worker returns to work, the better the chance of a more complete recovery. There are some restrictions on what an employer may offer as modified work. Refer questions to your insurer.
You have the option of reimbursing the insurer up to the amount published annually in Bulletin 345. These reimbursed costs cannot be used for experience-rating calculations. The insurer must notify you of this option before the start of the policy year. If you want to participate in this program, you must respond in writing. You may opt to participate later, but the insurer must agree to your participation date.
You can contact the worker and keep in touch throughout the claims process. Let the worker know you are concerned with his or her well-being. Keep communication lines open, and you and your employee will not likely become adversaries.
When filing Form 801 to report an injury to your insurer, you may attach a sheet to the 801, expressing any concerns that the claim might be suspicious or fraudulent. Be specific about your concerns, and provide documentation to back them up.
This applies only to self-insured employer groups. Submit documentation that validates the balance of the group’s common claims fund by March 1 (see OAR 436-050-0300):
The employer may request that the common claims fund be combined with the existing security deposit by March 1.
If you have reason to believe that an injured worker’s condition may have been caused by prior employment, you can request a Paying Agent Order under ORS 656.307 to bring a previous employer into the proceeding. However, the worker must have filed a claim for the same condition with the prior employer for an order to be considered.
Security deposits are updated March through December (see OAR 436-050-160, 180, and 185):
You have the right to request a hearing on any action taken involving a worker’s right to compensation or the amount of the compensation. Send the request in writing to the Workers’ Compensation Board.
The Workers’ Compensation Division may require self-insured employers to complete a claims reserve audit on their annual report of losses. The purpose of the claims reserve audit is to ensure each self-insurer’s claims are valued appropriately for use in deposit, experience rating, and retrospective rating calculations used to secure claim liabilities in the event of a default or insolvency.
The claims reserve audit methodology includes:
California Division of Workers' Compensation
1515 Clay St. 17th floor
Oakland, CA 94612
Industrial Commission of Arizona
Industrial Commission ALJ Division
800 W Washington St.
Phoenix, AZ 85007-2922
Idaho Industrial Commission Employer Compliance Department P.O. Box 83720 Boise, ID 83720-0041
Oregon has a formal agreement with Idaho which affects how claims are handled when workers are hired in one state and injured in the other.
Employers must accept notice of a claim from a worker and report that injury to their insurance company within five days. If the worker needs no medical treatment or is given only first aid, there is no need to notify the insurer. A record of this injury should be maintained for a year. If, however, the employer later learns that the injury has worsened and requires medical attention from a licensed practitioner, the employer must report the injury within five days by using Form 801.
All self-insured employers and employer groups must submit a report of all claim losses by March 1 of each year.
This information is used to help determine the following:
Employers and employer groups that do not provide the information in accordance with Bulletin 209 may be subject to civil penalties and revocation of self-insurance certification.
Report of losses forms may be submitted using any of the following methods:
Workers' Compensation Board of Indiana (WCBI) 402 W. Washington St. IGCS Room: W196 Indianapolis, IN 46204
800-824-COMP (toll-free) 317-232-3808
We are currently reviewing our reciprocity information for this state. If you are an Oregon employer, we recommend you contact the state’s workers’ compensation agency before beginning work in Indiana.
You can contact the injured worker’s physician at any time and ask for the conditions under which the worker can return to work. You have a right to keep abreast of the worker’s condition or to facilitate an early return to a modified or regular job, with the physician’s approval. The worker must participate in his or her physical rehabilitation to the fullest extent possible.
Submit audited financial report or statement according to OAR 436-050-0175:
Louisiana Workforce Commission Office of Workers' Compensation P.O. Box 94040 Baton Rouge, LA 70804-9040
We are currently reviewing our reciprocity information for this state. If you are an Oregon employer, we recommend you contact the state’s workers’ compensation agency before beginning work in Louisiana.
Arkansas Workers' Compensation Commission 324 S Spring St. P.O. Box 950 Little Rock, AR 72203-0950
800-622-4472 (toll-free) 501-682-3930
We are currently reviewing our reciprocity information for this state. If you are an Oregon employer, we recommend you contact the state’s workers’ compensation agency before beginning work in Arkansas.
To submit a renewal or new contract, see OAR 436-050-0210:
Workers' Compensation Board
General Counsel's Office
27 State House Station
Augusta, ME 04333
Florida Department of Financial Services Division of Workers' Compensation
200 East Gaines St.
Tallahassee, FL 32399-4220
Kentucky Department of Workers' Claims Prevention Park 657 Chamberlin Ave. Frankfort, KY 40601
502-564-5550Department of Workers' Claimshttps://labor.ky.gov/comp/Pages/default.aspx
In your insurance contract, you give the right to process and settle claims to your insurance company. However, your insurance company is working for you. If you want to know what is happening on a claim, call your insurer or your agent. Let them know you want to cooperate in any way necessary to get the injured worker back to work. The sooner the worker is returned to work in any capacity, the better the odds of a successful rehabilitation.
Minnesota Labor and Industry
Special Compensation Fund - Insurance verification
443 Lafayette Road
St. Paul, MN 64229
Workers' Compensation Commission
10 East Baltimore St.
Baltimore, MD 21202-1641
Mississippi Workers' Compensation Commission
P.O. Box 5300
Jackson, MS 39296-5300
Workers' Compensation Division
P.O. Box 14480
Salem, OR 97309-0405
Bureau of Workers' Compensation
1171 South Cameron St.
Harrisburg, PA 17104-2501
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