Posted by Tom L on March 24, 1999 at 14:50:14:
On March 17,1999, The Oregon Court of Appeals issued a decision in the case of Fred Meyer Inc. v Bundy that may affect your right to time loss benefits in your worker's comp claim. The decision says that a claiment now cannot recover time loss benefits at any time unless the claiments doctor has authorized payment of those benefits.
This issue arose with a 1995 amendement to the Workers Compensation Act, That amendment states "Temporary disability compensation is not due and payable pursant to ORS 656.268 after the workers attending physician ceases to authorize temporary disability or for any period of time not authorized by the attending physician. No authorization of temporary disability compensation by the attending physician under ORS 656.268 shall be effective to retroactively authorize the payment of temporary disability more that 14 days prior to its issuance.
Before March 17, 1999, claiments who did not get a time loss authorization while their claims remained open or in denial status had a safety valve;
They could claim unpaid time loss at closure of the claim. This statute requires one's attending physician to continuously authorize payment of time loss "Temporary Disability" for that time loss to be payable by an insurer or self-insured employer.
The Court of Appeal has thrown out that safety valve. Under "Bundy" a claiment now cannot recover time loss either while the claim is open or in denied status or at the time of closure "Unless the attending physician has authorized time loss at the time the claiment was restricted from work".
This means that any time loss authorization now will be good for two weeks back from the date the authorization is issued. The bundy decision makes it vital for the injured worker to get time loss authorization whenever you are off work. Under Oregon Law, an attending physician is supposed to issue a time loss authorization whenever the doctor restricts a claimant from doing work the claimant was doing at the time of injury of occupational disease. I was told that the attorneys in the "Bundy" case intend to seek review by the Supreme Court, It is possible that the Court will overturn the desision at some point in the future.
While the injured worker waits for this ruling alot of injured workers will have to endure financial hardship. Get in touch with your Represenativies in Salem and demand a fix to the problem created by the Bundy case. If you contact your Legislator, you should bear the following "Points" in mind
Doctors frequently refuse to authorize time loss because they think doing so is equivalent to saying a claimant is totally disabled (even thought that is not what authorization means).
Doctor's "schedules" prevent claimants from getting in to see them soon enough to get time loss authorizations.
Some doctors have refused to sign authorizations without payment, under the Bundy decision, every day the doctor delay's signing the authorization, the claimant loses a day of time loss furthering the financial hardship of the injured worker!
When claims are denied, claimants frequently lack other insurance to go see their doctors, Under the Bundy decision a claimant who cannot afford to see a doctor while his or her denial remains in litigation stands to lose all right to time loss.
This fact adds an incentive for insurers ans defense council to prolong litigation as long as possible.
Insurers have refused to pay time loss when the official " attendind physician" has not been available to authorize it. There have been cases where claimants were unable to get the required authorizations because their doctors were ill, disabled, on vacation, or otherwise unavailable.
The insurers refused to pay time loss even though others doctors authorized it.
IF you are off work and have not been getting updated time loss authorizations, IMMEDIATELY DO SO. If your doctor issues a time-limited authorization make sure yoy get it renewed for as long as you are off work. Send the authorization to your insurer or your employer, Don't make it harder on yourself that it already is being a injured worker in this State.
Don't become the blood of a system that demands it.
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