At first glance, workers’ compensation appears to be straight fowrard. If you are hurt on the job, your employer or its insurance company provides you medical benefits and lost wage benefits.  You get better, and you go back to work.  But it’s not that simple. 

There are complex regulations that can fill many bookshelves, Bulletins, Board Cases, Contested Case Orders, and several offices in the Workers’ Compensation agencies.  Sometimes, getting a prescription filled, or a time loss check can be a major project.  Scroll down this page for some basic background information.

Do I need to pay a lawyer up front for help on a Workers’ Compensation Case?

No.

In Oregon, the Workers’ Compensation law controls attorney fees.  Overall, the fee agreement provides that you do not pay a fee unless a lawyer is “instrumental” in obtaining a denied benefit, or getting an increase on an underpaid benefit.  The fee is either paid by the insurance company directly, or is a percentage of the value of the increased benefit.  The State of Oregon, either through a Court, Judge, or agency official, approves all fees.

What if my claim is denied?

You have a right to appeal your denied claim.  There is a time limit, so it is a good idea to contact our office for a free consultation.  If you decide to hire us, we can file an appeal on your denial, and often times schedule the hearing closer to your home.  We can talk to your doctors, investigate your case, and determine whether you have a case to get the denial set aside.  We are paid a fee only if we prevail on the claim.  Give us a call if you have a denial.

The Insurance denied my claim, and accepted at the same time.  How does this work?

Sometimes, you may have more than one medical condition that you suffered as a result of your on the job injury.  Depending on the kind of injury you suffered, the employer or insurance company may decide that your work is not enough of the cause of your injury to make the insurance company responsible.  This often based on the opinion of an insurance company retained doctor.  If this happens, you should call us to review your denial, and let you know if you have a case.  Our first consultation is free of charge.

What benefits are available if my claim is accepted?

When you are injured on the job in Oregon, state law provides that you are entitled to certain benefits.  In the early part of your case, when you are treating with doctors, you are entitled to medical benefits.  If you are unable to work after your injury, you may be entitled to time loss, also known as temporary total disability.  If you are released for limited duty, and not earning what you earned before your injury, you may be able to apply for partial time loss, or temporary partial disability.  When your doctor says that you have reached maximum improvement, your claim may be closed, and you may qualify for other benefits, like job training, or partial disability.  Even after your claim is closed, you may be able to re-open the case if your condition is worsened.  If you think your claim should be re-opened, give us a call, and find out your options.  All initial consultations are free, so you have nothing to lose.

What is a Notice of Acceptance?

This may be the most important document in your claims file.  When an insurance carrier or an employer accepts your workers’ compensation claim, it has to send you a letter explaining what medical conditions it has accepted, and what benefits you are entitled to.  All of the benefits that we described above are limited to what the insurance company accepted.  For example, you may injure your low back lifting something heavy at work.  Your doctor may find that you have a disc injury, which can be serious, and require surgery.  However, your Notice of Acceptance may only allow benefits for a low back strain, which is entirely different.  This means that you may be underpaid on your benefits because the insurance company did not accept responsibility for all your injuries.

You can call our office for a free consultation.  If you hire us, there is no fee unless we obtain benefits you did not have, or increase the value of a benefit you do have.  Also, all fees we earn have to be approved by someone with the state agencies or courts that oversee workers’ compensation benefits and disputes.  Often we can obtain your claim file and review it at no cost.

What is a Notice of Closure?

This is a document that is often filed when your doctor has stated that you are not expected to improve with additional medical care.  It is an important documents because it tells you whether or not you are entitled to permanent partial disability, and what was paid for your lost wages.  Sometimes an insurance company may close your claim to early, or sometimes it may find you have no partial disability when you do.  Call us for a free consult.  We can request your file, and review it to see if you should appeal your claim closure.  We are paid only if we get you a benefit that was denied, or get an increase of a benefit that was underpaid.  These fees are subject to government approval, and often come out of only the increased compensation.

What is Permanent Partial Disability?

If you are permanently limited in your work ability as a result of your on the job injury, you may be entitled to a cash benefit for the loss of your work ability.  This is called “permanent partial disability,” or “PPD.”  There rules, or “rating standards” that are used to determine the value of your benefit.  Your PPD rating will appear in your Notice of Closure, and you have the right to appeal that Notice if you disagree with the amount of PPD in the Notice.  There are strict time limits for the appeal.  Call us for a free consult, and we can review your file to see if an appeal makes sense for you.  We earn a fee only if we are successful, and the fee is usually a percentage, set by law, of the increased benefit.

After my claim is closed, can I get my old job back?

Under Oregon law, you have a right to request that you be put back to work at your old job.  If you are not able to do your old job, then your employer may have to give you a job that you are physically able to do, at the same or similar pay rate.  If you are not able to return to your old job, and there are no others available, you may qualify for vocational benefit, including a job-training program.  If you make this request, and you are denied, we can help you with an appeal.  We are paid only if we win the appeal, and the carrier pays the attorney fee ordered by the Oregon agency.

Can I make a claim against someone if I was injured due to their carelessness?

This depends, but in some cases, if you are injured by a “third party,” which is someone other than your employer or a co-employee, you may have a claim separate from your workers’ compensation claim.  We handle third party claims, and are only paid on those claims if we make a recovery in your favor.  Take a look at our personal injury page for more information, and give us a call for a no fee consultation.