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The information below is from the Oregon State Bar's Tel-law service, a collection of recorded legal information messages prepared by the lawyers of Oregon. In addition to being online, the Tel-law service is accessible by telephone at 503-620-3000 or toll-free in Oregon only, 1-800-452-4776. A touch tone phone allows direct access 24 hours a day, 7 days a week. To receive a free Tel-law brochure listing the subjects available call the Oregon State Bar Order Desk, 503-620-0222, ext. 413.
This is Tel-Law topic number 702, Workers' Compensation brought to you as a public service by the lawyers of the State of Oregon. The material presented is general legal information intended to alert you to possible legal problems and solutions. This topic outlines workers' compensation benefits and how to file a claim. What to do if your claim is denied or accepted is also covered with an explanation of benefits and costs.
Nearly every worker in the state of Oregon is covered by workers' compensation insurance. This insurance pays for medical expenses and provides compensation when you lose time from work or suffer a permanent disability from an accident or disease arising out of your employment. If you work for the federal government or are engaged in maritime employment, you will not receive state workers' compensation benefits. Other remedies are available to you.
If you have sustained a work related injury or disability, you must give your employer written notice of your claim stating when, where, and how your injury occurred. Your employer will send the notice to its workers' compensation insurance company. Usually, your employer will have a special form that you can use. You should file your claim as soon as possible because if you delay too long you may be denied workers' compensation benefits.
There are specified deadlines established by law for filing your claim. Some deadlines are as short as 30 days from the date of your injury. Your employer cannot refuse you the right to file a claim, and the law prohibits your employer from firing or disciplining you for filing a claim.
You may be entitled to select a physician of your choice within Oregon, or you may have to choose from a list of doctors provided by the insurer. If you are dissatisfied with this physician, you may seek another Oregon physician. One hundred percent of your medical expenses related to your injury will be paid by your workers' compensation insurance. Your workers' compensation carrier must either accept or deny your claim within 90 days from the day your employer had notice of your claim.
Additionally, if you lose more than three days in a row from work or are hospitalized, you are entitled to receive money to compensate you for your lost wages within 14 days of the day your employer had notice of your claim. The amount of money you will receive will generally depend on your average weekly wage. It probably will be close to two-thirds of your gross salary tax-free up to a maximum amount set by the legislature. Your wage reimbursement checks will continue to be paid to you every two weeks, until your doctor releases you to return to work. If you return to regular work without a doctor's release, if your claim is denied, or if you receive an order from the workers' compensation department or your insurer closing your claim, your checks for time loss also will stop.
If your claim is denied, you may contest this denial by requesting a hearing. You must request a hearing within 60 days or you risk losing all of your rights under the Workers' Compensation Act. If you ask an attorney to help you contest the denial, you will not have to pay for the attorney's professional services, although you will be responsible for out-of-pocket costs. The attorney cannot charge a fee that is not approved by the Workers' Compensation Board or the court, as the case may be. If you win your case on the insurance company's denial, the insurance carrier will have to pay your attorney. If you lose and the denial is upheld, you will not owe the attorney for professional fees.
If your claim is accepted, it will remain open until you are medically stationary. When you are medically stationary, your claim will then be closed. If you have suffered any permanent disability, you will be entitled to receive additional compensation called permanent partial disability, or PPD. PPD is measured in degrees to a maximum of 320 degrees depending on the type of injury. Depending on the date of your injury, and the part of your body which is injured, each degree is equal to a minimum of $137.80 or a maximum of $662.50. If you are dissatisfied with the amount of your PPD award, you may appeal that order within 60 days from the date your claim is closed by requesting reconsideration. If you ask an attorney to help you obtain increased compensation, the attorney will charge you 10% to 25% of any increase you actually receive, subject to limits set by the board or court. If you do not receive any increased compensation, you will owe your attorney nothing except for out-of-pocket costs he or she has paid on your behalf.
After your claim is closed, you are entitled to medical care but some medical services may not be covered. If your condition becomes worse within five years after your claim is first closed and this results in increased disability, you are entitled to have your claim reopened for additional compensation including time loss if you miss work. Any request to reopen your claim should be in writing and directed to the insurance carrier and should be supported by a report from your doctor. After five years, your rights are much more limited.
While your rights under the Workers' Compensation Act are generally your only remedy against your employer for a work related injury, you may have additional remedies against other persons who are responsible for your injury. The Workers' Compensation Ombudsman's services are available free of charge to injured workers. The Workers' Compensation Ombudsman answers questions and provides information to help injured workers protect their rights. The Workers' Compensation Ombudsman also acts as an advocate for injured workers, investigating complaints and attempting to resolve them. For Salem-area and out-of-state callers, the number is (503) 378-3351, and the in-Oregon toll-free number is (800) 452-0288. When calling, ask for the Workers' Compensation Ombudsman.
Although Tel-Law information is periodically reviewed, it is important for you to realize that changes may occur in this area of law.
This information is not intended to be legal advice regarding your particular problem, and is not intended to replace the work of an attorney. If you do not have an attorney, the Oregon State Bar Lawyer Referral Service can assist you. The number to call is 684-3763 or toll-free in Oregon, 1-800-452-7636. This service will help you contact a lawyer who can advise you.
Webmaster note: This information is accurate as of 3/2000. It could, at any time, become innacurate. Call the telephone numbers listed above or the Workers' Compensation Ombudsman at (800) 452-0288 for the latest information.