Timeline of an Oregon Workers' Compensation Claim
What Will Happen After a Work Injury?
Step 1: Filing Your Claim
Your Oregon workers' compensation claim begins the day you are injured or the first day you seek treatment for the injury.
Deadline for Filing Your Workers' Compensation Claim
Injury versus Occupational Disease?
If you were injured at work, you have 90 days to file a claim. You can also file within one year as long as the employer knew about the injury. If you have an occupational disease (i.e., a condition that develops over time such as carpal tunnel syndrome or hearing loss), you have one year from when a medical doctor first told you the condition was work related to file your claim.
Step 2: Acceptance or Denial
Once you have filed your claim, the workers' compensation insurer has 60 days to accept for deny the claim. They will send you a written letter indicating if the claim is accepted or denied. At this point, you will want to consider whether you need an attorney. If the claim is accepted for the condition you are treating for and all your benefits are being paid, you probably do not need a workers' compensation attorney.
Reasons you might need a workers' compensation lawyer:
1. The claim is denied. If your claim is denied you have 60 days to appeal the denial. You will need an attorney to assist with the appeal. If you have a denial, it is best to contact an attorney immediately so you do not miss the deadline.
2. The claim is accepted but you are not being paid your benefits. If the claim is accepted but you are not receiving the proper amount of time loss, or other benefits are not being paid, you will want to talk to a Portland workers' compensation attorney.
3. The claim is accepted but not for the right condition. This is very common and should be a red flag. For example, an insurer will very often accept a knee strain when the actual injury is a meniscus tear. It appears you claim is accepted, but the insurer is actually only agreeing to pay for benefits related to the accepted strain. This means you would have no workers' comp rights or benefits related to the surgery to repair the meniscus or miss time off work due to the surgery.
Step 3: Treatment and Time Loss
Once you have an accepted claim, you will be able to obtain treatment for your injury. All your medical costs including prescriptions should be covered by the workers' comp insurer. Your attending physician will coordinate your treatment including prescribing medication, referring you to a specialist, and giving you work restrictions.
You may also miss work during this period if you have work restrictions. If you miss work for your work injury, you will be entitled to time loss. This should be two thirds of your average weekly wage, tax-free.
Step 4: Claim Closure
Once you are done treating for your claim, you become medically stationary. Medically stationary does not mean you are completely healed. Rather, it indicates you no longer need active treatment for your injury. It is your attending physician who determines if you are medically stationary.
At this point, the attending physician also determines if you can return to the job at injury or not. If you are released to the job at injury, you may return to work. If you are not able to return to the job at injury, your attending physician determines your work disability. Work disability is your permanent work limitations such as how much you can lift, or how long you can be on your feet. You will be entitled to a cash payout for your work disability that is calculated based on the level of disability compared with your work capabilities prior to the work injury.
Finally, the attending physician determines if you have any permanent impairment (also called PPD). This relates to permanent physical impairment such as loss of range of motion or sensation loss. There is an automatic rating of permanent impairment given for some surgeries. You will be entitled to a cash payout for your permanent impairment that is calculated based on the amount of permanent physical limitations and any surgeries you had for your work injury.
Once your attending physician has made these determinations, the insurer will issue a Notice of Closure. This is a letter you will get in the mail telling you your claim is closed and detailing your permanent impairment (PPD) award and work disability award, if any. If you have questions about your Notice of Closure or you think your cash award is wrong, you should contact a workers' compensation attorney right away. You can call us with questions any time at 503-975-5535.
Step 5: Vocational Retraining
If you are not release to the job at injury, you may be entitled to vocational retraining. First, you have a vocational eligibility evaluation. The evaluator will determine what kinds of limits you have on returning to work in a job that will pay you at least 80 percent of your job at injury. If it will be easy for you to return to work, you will likely not be found eligible for vocational retraining. However, if it will be difficult for you to find work that pays about as much as the job at injury, you likely will be eligible for vocational retraining. If so, you will work with a vocational counselor to select a retraining program. Time loss will continue to be paid while you are in a retraining program.
Step 6: Aggravation
After your claim is closed, you have five years of aggravation rights. During this period you can file an aggravation claim for your workers' compensation injury. An aggravation is pathological worsening of the accepted claim. usually this means your injury or condition has worsened to the point you need another surgery, more treatment, and/or you have new work restrictions. An aggravation is generally filed via an 827 Form completed by you and your doctor. Any doctor office in Oregon will have these forms. When an aggravation claim is filed, the insurer will once again have 60 days to accept or deny the aggravation claim and the above process will begin again.
Portland Workers' Compensation Attorney
At Alana C. DiCicco Law, we're dedicated to ensuring you are represented in navigating all aspects of your workers' compensation claim - you don't have to go it alone!
Alana has practiced workers' compensation law in Oregon for more than ten years and represented over four hundred clients before the Oregon Workers' Compensation Board. She has also served on the Oregon State Bar Workers' Compensation Executive Committee. She has extensive experience in the complicated area of Oregon's workers' compensation laws.
Alana has been a licensed attorney with the Oregon State Bar since 2007.
Who Are We?
Alana has extensive experience in the field of Oregon Workers' Compensation Law. She worked for several large defense workers' compensation law firms before opening her own practice and following her dream of representing injured workers.
Her background as both a defense and claimant's attorney gives her particular insight into managing a successful workers' compensation case. She is dedicated to helping her clients obtain all the benefits they are entitled to under the law.
Alana lives in Portland, Oregon with her husband, son, and daughter. She enjoys helping her clients, painting, reading, and the outdoors.
Don't miss a deadline! It's important to speak with an attorney as soon as you have a denied claim. We are always happy to take your call and talk through your unique situation.
1500 NW Bethany Blvd., Suite 200
Beaverton, OR 97008
10121 SE Sunnyside Rd., Suite 300
Clackamas, OR 97015
205 SE Spokane St., Suite 300
Portland, OR 97202
9450 SW Gemini Dr #78393 Beaverton, OR 97008
Phone (503) 975-5535 Fax (503) 926-9103