Do I have a workers’ compensation claim? A workers’ compensation claim is defined as an injury, incident, syndrome, or disease caused at work which requires medical services. The seriousness of the injury does not matter. What is important is that something occurs at work, which causes some sort of injury and requires medical services. Many of us do not wish to file something like a workers’ compensation claim unless the injury is serious enough. However, if you do not have private health insurance, and you do have an incident at work which requires medical treatment, you have every right to file a workers’ compensation claim in order to get those bills covered.
How do I file a claim? There are several ways to file a claim. The claim must be filed in writing. A simple note to a foreman telling them you have been injured suffices. The state of Oregon has a special form, 801 – Report of Job Injury or Illness, which is the prescribed method for filing a claim. Under workers’ compensation law, once your employer has some sort of notice or even thinks you may have a workers’ compensation claim, the employer must give you an 801 form within five days of being informed of the injury.
How long do I have to report my injury? As a general rule, you should report your injury as soon as possible to your company’s supervisor, foreman, or to whomever you have been told to report these injuries. Under the law, you may have as little as 30 days from the time of your accident to report your injury.
How long does the insurance company have to accept my claim? If your accident happened after January 1, 2002, the insurance company has 60 days to accept your claim. If your original date of injury is before January 1, 2002, and you make a claim for a new condition, the insurance company has 90 days to accept that new condition.
Can I sue my employer directly? No. If your employer has workers’ compensation insurance, even if the accident is the fault of the employer, you generally cannot sue your employer. The employer is insulated from direct lawsuit because of workers’ compensation law. 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 work in a warehouse and a delivery truck is delivering a package into the warehouse. If the driver negligently injures you when they are delivering the package, you can sue that driver’s company for your injuries. You would also have a workers’ compensation claim with your own employer to cover your medical expenses, time loss, etc.
What are my workers’ compensation benefits? Workers’ compensation benefits provide the following: payment of your medical bills and payment of your lost wages, 66 2/3% of your gross wages. This is computed by averaging your wages over a 52-week period. If you worked for the employer less than 52 weeks when your injury occurred, then your time loss is computed based on your average earnings for the period that you worked. The insurer will determine how much you made during either the 52-week period or less, they divide that number by the number of weeks you worked and multiply it by .66. That is how your average weekly wage for time loss purposes is computed. You also get your mileage paid to and from the doctors – approximately $.39 per mile. In certain situations, when workers cannot return to their regular jobs, there is vocational training available.
Can I collect money for pain and suffering? Emotional damages, loss of enjoyment of life, and other damages that are available in civil law suits are not available in workers’ compensation claims. However, there are lots of important benefits available in workers’ compensation that should be looked at and pursued.
How long does my right to get medical treatment last? Under workers’ compensation law, the right to receive medical services for a compensable injury lasts for “the life of the worker.” There are, of course, exceptions to this. However, as long as you are working, and have difficulty with an injured body part, and your doctors relate your need for treatment to the work injury, your medical bills should be paid.
The insurance company told me that carpel tunnel syndrome is not covered by WC laws, is that true? No. We have heard stories recently from our clients that the insurance companies are telling them that certain types of syndromes or diseases are not covered by the system. This is a tactic to dissuade folks from pursuing their claims. If your doctor feels your problem is work-related, then you will have a chance to win your case.
Call 503-208-9089 For Workers’ Compensation Advocacy
At Schoenfeld & Schoenfeld, P.C., we understand how intimidating Oregon’s workers’ compensation policies can be with the help of an experienced advocate on your side. Call us or email us to learn more about how our attorneys can help you get the compensation you deserve for your injuries.