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Obtaining medical care

  • You may go to your regular health care provider, an urgent care clinic, or a hospital emergency roo​m, depending on the extent of your injury.
  • Tell the medical provider it is an on-the-job injury.
  • Remember, if the claim is ultimately denied, you and your health insurer will be responsible for the bills.

​You have a right to choose your own medical provider. If your claim is enrolled in a managed care organization (MCO), you can still choose your own doctor within the MCO.
  • Your employer and insurer cannot require you to seek care or direct your care to a specific provider.
  • You may go to your regular health care provider, an urgent care clinic, or a hospital emergency room, depending on the extent of your injury.
  • Tell the medical provider it is an on-the-job injury.

When you sign Form 801 “Report of Job Injury or Illness” and Form 827​ “Worker’s and Health Care Provider’s Report for Workers’ Compensation Claims,” you are authorizing health care providers and other custodians of the claim records to release relevant medical records. Other custodians include the workers’ compensation insurer, self-insured employer, claims administrator, and the Oregon Department of Consumer and Business Services. Your medical provider is responsible for sending the Form 827 to the insurer.
  • Your employer is not entitled to your medical records.
  • Your employer, insurer, or their representative cannot accompany you to your doctor’s appointments without your written consent.

​You are not liable for payment on medical services related to an accepted claim and injury, and a medical provider should not bill you.​

​Keep receipts for all out-of-pocket expenses. Send a written request for reimbursement with proof of claim-related expenses, as well as an explanation of limitations (mileage to health care providers, etc.) to the insurer within two years of incurring the expenses. You can use Form 3921 “Request for Reimbursement of Expenses” to request reimbursement from the insurer. ​

If your claim is denied, your health care provider is entitled to send you a copy of the bills.
  • If you appeal your denial, the provider may make no further attempt to collect payment from you until all your appeals are completed or you settle the claim.
  • If you do not appeal your denial, then your health care provider can bill you.
  • If you have health insurance, the health care provider must bill your health insurer.
  • If your claim has been denied and you do not have private health care insurance, you will be responsible for the medical bills once all appeals are exhausted.​

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