Oregon Workers Compensation Attorneys Can Help you!

What Happens if I am Injured on the Job?

When you are hurt on the job and you file your “Report of Job Injury or Illness” Form #801  in a workers compensation claim, the process should go smoothly until you receive your final Oregon workers compensation determination order.  In reality, many problems can arise throughout the process of filing an Oregon workers compensation claim, including but not limited to:

  • Your workers compensation claim can be denied.
  • Your Workplace Injury can be denied because of a preexisting condition.
  • Your workers’ compensation time-loss payments wrongly cut off.
  • Medical bills related to your on the job injury are not paid.
  • Your Oregon workers compensation claim can be closed without an award of disability.

You can download “What happens if I’m hurt on the job?  A guide to Oregon’s workers’ compensation benefits, rights, and responsibilities”.

oregon-workers-compensation-lawyerIt is a good idea to talk to a Workers Compensation Lawyer to find out what your rights are.  We work with some of Oregon’s best workers compensation attorneys.  We will get the necessary information from you and pass it on to a very qualified workers compensation lawyer who will then contact you.

 

 

Oregon Personal Injury Attorney Locations: Eugene | Portland | Bend | Roseburg | Medford | Grants Pass

Oregon Workers’ Compensation: Benefits, Rights, and Responsibilities.

How to File a Claim for a worker’s compensation injury:

  • Tell your employer as soon as possible about your work place injury.

When you are injured on the job you should report your workplace injury to your direct supervisor right away or to whomever you have been instructed to report injuries.  It is advisable to make the report right away and no less than 30 days from when your on the job injury occurred.

  • Ask your employer for Form 801, “Report of Job Injury or Illness.” Complete the “worker” portion of the form and return it to your employer

Use Oregon’s form # 801 to report your workplace accident or injury and file a workers compensation claim (the preferred way).  Your employer is required to provide this to you within 5 days of being informed of your workplace injury.  You can also obtain Form  # 801 by calling Oregon’s Ombudsman office.  It is advisable to seek legal advice form an experienced Oregon workers’ compensation attorney prior to completing this accident form or being referred to a doctor.  Employers are notorious for referring injured workers to industrial accident or injury clinics that tend to underestimate the seriousness of injuries and provide extremely optimistic prognosis.  The workers’ compensation attorneys at Dwyer Williams Potter Attorneys can make help you avoid mistakes that may compromise your workers’ compensation claim.

  • Get name and number of the workers’ compensation insurer from your employer
  • Obtain medical treatment from a healthcare provider of your choice and tell your provider that you were injured at work. Your employer cannot choose your healthcare provider for you.
  • Your first healthcare provider should ask you to complete Form 827, “Worker’s and Physician’s report for Workers’ Compensation Claims.”
  • Keep copies of all forms for your records

Make sure to keep copies of all of these forms and any medical treatment paperwork for your records.  It is important to provide all of these documents to your Oregon workers’ compensation attorney who can help make sure that complicated workers’ compensation forms are completed correctly.

How to Obtain Medical Treatment for your work place injury.

  • If your  workers compensation claim is accepted the insurer only has to pay for medical treatment related to the accepted conditions listed on your “Notice of Acceptance”
  • If your workman’s compensation claim is denied you may have to pay for your medical treatment
  • The insurance company may enroll you in a managed care organization (MCO) at any point; an MCO is an organization that contracts with an insurer to coordinate medical services to injured workers.
  • If your insurer is covered by an MCO contract, the insurer may enroll you with the managed care organization at any point proceeding your injury. You may be required to select an MCO healthcare provider from a list of providers the insurer sends with your enrollment notice

 If I Cannot Work as a result of my on the job injury, Will I Receive Payments for Lost Wages?

Workers’ Compensation Benefits

Workman’s compensation provides the following:

  • The benefits include payment of your medical bills and payment of your lost wages at a rate of 66 2/3 percent of your gross wages.   Your average wages are calculated over a 52-week period or less, then that number is divided by the number of weeks you worked and multiplied by .66.
  • Your mileage to and from the doctors can be paid at approximately $.39 per mile.
  • If workers cannot return to their job, then sometimes vocational training is available.

Your health care provider must authorize your absence from work.  In the first three days in Oregon that you do not return to work, you will not be paid unless you are off work for 14 consecutive days or hospitalized overnight as an inpatient within those first 14 days.

In computing time-loss benefits, the insurance company will use your average weekly wage. Oregon has a minimum and maximum amount payable to injured workers that is adjusted every year.

If your claim is denied in the first 14 days from the date you reported it, you will not be paid for any lost wages.

Workers’ Compensation Claim Status

What is an Interim Period?

There is a period between when your employer is first informed of your accident to when the workers’ compensation insurance company decides to accept or reject your claim.  This is called the “interim period” .   During this time frame, the insurer will pay only for limited medical treatment.

Acceptance or Denial of a Claim

The insurance company has 60 days to accept your claim.  If your claim is accepted, the insurer will send you a “Notice of Acceptance” listing the specific medical conditions accepted for workers compensation benefits.  The insurance company only has to pay for medical treatment related to the accepted conditions listed on your “Notice of Acceptance”.

The insurance company may enroll you in a managed care organization (MCO) at any point; an MCO is an organization that contracts with an insurer to coordinate medical services to injured workers.  If your insurer is covered by an MCO contract, they may enroll you with the MCO after your accident or injury.  You will usually be sent a list of providers with an enrollment notice.

Workers’ Compensation Medical Treatment

  • You have the right to privacy at medical examinations
  • During the interim period, the insurer will only pay for limited medical treatment, including: diagnostic services required to identify appropriate treatment or to prevent disability; medication required to alleviate pain; services required to stabilize your claimed condition and to prevent further disability
  • If your claim is denied and you do not have health insurance, you may be responsible for payment of your medical treatment
  • The term “attending physician” is used in the workers’ compensation system to designate the physician who is responsible for authorizing time-loss benefits and for overseeing the medical care you receive for your work injury.

What If My Healthcare Provider recommends elective surgery?

Elective surgery is surgery other than emergency surgery. Before scheduling elective surgery, the healthcare provider must notify the insurer, who may request a second opinion. If the insurer disagrees about the need for surgery, the insurer must ask the Workers’ Compensation Division to review the request for surgery in order to determine whether or not the surgery is appropriate.

Independent Medical Examination

An independent medical examination is a medical exam of an injured worker by a physician other than the worker’s attending physician at the request of the insurer. The insurer may require you to attend up to three medical examinations with healthcare providers they choose. If you fail to attend the exam, you may be penalized 100$ or your workers’ compensation benefits may be stopped.

Independent medical examination providers:

  • Will not provide treatment
  • Will only prepare a report based on examining you in order to answer questions asked by the insurance company about your injury or occupational disease
  • May perform a physical or work-capacity evaluation

Returning to Work After an Injury

What Are My Rights When Returning to Work?

Most Oregon employers with more than 20 workers are required to return an injured worker to the worker’s job or another suitable job after the worker is released to work. The insurer will send you written notice when your healthcare provider releases you to go back to work. Within seven calendar days receiving this notice, you must ask your employer for your job or another suitable job, or you will lose your right to be reinstated with your employer.

If you return to modified or light duty work at a lower rate of pay or with fewer hours, you will receive time-loss (temporary disability) payments for the part of your wages you are missing.

What Reemployment Assistance is Available from the Workers’ Compensation Division?

The Oregon Employer-at-Injury Program helps workers stay on the job or get back to work with the employer-at-injury. Due to your injury, your employer may be eligible for benefits to assist in returning you to light-duty work while your claim is open. The Oregon Preferred Worker Program helps injured workers get back to work by providing benefits to the employer-at-injury or any other employer in the state of Oregon. If you are eligible for the Preferred Worker Program, you will receive an identification card and program materials shortly after your claim is closed.

Workers’ Compensation Claim Closure

What is a Notice of Closure?

Disabling claims are “open” or “active” while you are recovering from your injury and “closed” or “inactive” when you are medically stationary. Your claim will also be closed if your injury is no longer the major cause of your disability or need for treatment, or if you fail to attend medical appointments. The following important documents will be sent to you by your insurer once your claim is closed:

  • A legal document called a “Notice of Closure”, which closes your claim and lists the periods for which time-loss benefits were authorized. It also indicates how much permanent disability you may have, as well as how to appeal the closure of your claim
  • An “Updated Notice of Acceptance at Closure” that lists the medical conditions the insurer has accepted
  • A brochure, “Understanding Claim Closure and Your Rights,” which explains your appeal rights and the types of care covered by the insurer after claim closure

As a general note, after your time-loss payments end, you may be entitled to unemployment benefits. You must apply within four weeks of the date of the notice ordering claim closure in order to see if you qualify for a special “base-year extension.”  If the Notice of Closure indicates permanent partial disability (PPD), this indicates your injury resulted in a condition that has not returned to its normal or pre-injury status. Permanent disability payments are based on a formula set by law, and the amount depends on the severity of the disability and whether or not you received overpayment of benefits. Keep in mind that permanent disability award payments are due to start 30 days from the mailing date of closure. If your award is $6,000 or less, the insurer will pay you a lump sum; if it is more, the insurer will make monthly payments to you. Also, you may ask the insurer to pay you a lump sum; however, if you apply for and accept lump-sum payment of any part of your permanent disability award, you give up your right to appeal the amount of the award.

Permanent total disability (PTD), on the other hand, means you are permanently unable to perform gainful and suitable employment. You will receive monthly disability payments as long as you remain totally disabled. The insurer will reexamine your claim at least every two years to see if you remain unable to work.

If you disagree with the Notice of Closure, you must write to the Workers’ Compensation Division within 60 days of the mailing date printed on the Notice of Closure.

Helpful Tips for Worker’s Compensation Claims in the State of Oregon

  • If you fail to take action or if you miss a deadline to appeal claim decisions, you may lose your right to worker’s compensation benefits
  • Attend all medical appointments
  • Contact your employer immediately when your healthcare provider releases you back to work
  • Keep in contact with your doctor and inform your employer about your work restrictions. If your employer offers you a modified job or light duty, you must cooperate with their efforts to return you to work
  • The Oregon State Employment Act (OSEA) codifies the common-law duty to provide safe places of employment. The purposes of the OSEA are to assure safe and healthful working conditions for every working man and woman in Oregon; preserve Oregon’s human resources; and, to reduce the expenses and human suffering which are created by occupational injury and disease.
  • Every employer must furnish employment and a place of employment which are safe and healthful for employees. The OSEA requires employers and owners to not “construct or cause to be constructed or maintained any place of employment that is unsafe or detrimental to health.”
  • In addition to recovery for physical injuries, mental injuries are also compensable if attributable to the employer’s negligence.

Can I Sue My Employer Directly?

If the employer has workers’ compensation insurance, you generally cannot sue your employer even if the accident is the fault of the employer.  However, if your employer does not have workers’ compensation insurance and your employer is at fault for your accident, you can sue your employer directly.  If the accident occurs as a result of a third party, that is another company (not your employer), you can sue that third party.  For example, you may suffer a construction site accident or injury as a result of negligence by another employee or from a defective crane or in an industrial plant due to defective machinery.

In either case, you may both sue for personal injury damages against the third parties that are at fault and pursue a workers’ compensation claim against your employer.  The personal accident or injury claim against third parties will typically permit more significant damages but requires proving fault.

Oregon Workplace Personal Injury Attorneys

The Oregon Personal Injury law firm Dwyer Williams Potter Attorneys has physical law offices conveniently located throughout the state of Oregon.  Our office locations: Bend | Eugene |Portland | Roseburg  | Grants Pass | Medford  and serve the following cities in the State of Oregon: Albany, Ashland, Bend, Brownsville, Central Point, Corvallis, Creswell, Eugene, Grants Pass, Klamath Falls, Medford, Myrtle Creek, Portland, Redmond, Roseburg, Salem, Springfield.