Educating people on workers comp – how to make sure your claim gets accepted
It happens all the time. You injure yourself at work, but shake it off, man up and keep working, because you want to be a good employee, a team player. You go home and hope it will get better and it usually does. If you don’t get better, you have a legitimate Oregon workers comp claim. This might be the worst thing you can do in terms of getting the benefits you’re entitled to. What should you do when you’re hurt at work?
Workers Comp Simplified
It seems extreme, but the best thing to do is to sit down right where you are and have an ambulance haul you off to the hospital. Think about it this way. (The insurance carrier does.) If you had an accident at work that caused an injury on Friday, and you went home and do some activities over the weekend, the insurance company will always try to blame it on whatever happened over the weekend. If you had a pre-existing condition, the insurance company will always argue that the injury was a result of the pre-existing condition. The insurance company will also point to rules by the employer that require immediate notification of injury, and impugn your credibility.
You should get medical intention immediately, at least documenting the injury! Don’t try and shake it off and hope it’ll get better. Don’t give the insurance company a chance to say “well, if he really would have hurt himself, he would have gone to the doctors’ office right away. It must have happened somewhere else…” [They’ll get some hooker insurance doctor to say that.] And don’t forget, the insurance company’s business plan is to collect premiums and minimize claims to increase profits. They are motivated to take in money and not pay out. Don’t think otherwise.
The next thing you need to do is file a form 801 (link) with your employer. You can get the form from your employer or download on here. (Link) Most medical offices that deal with workers comp claims also have a form 827 (that can also be downloaded online – link), and your doctor can also send that in.
There is also a resource called an employer index where you can find out who the Employer’s workers comp insurance carrier is. (Link) Medical offices familiar with workers comp claims have that index and can send that form directly to the insurance carrier rather than going through the employer. If you have any reason to think you’re employer will be angry about the claim, you might choose this option.
You have as little as 60 days to file and then the insurance company will deny or accept the claim, generally within another 60 days.
What do I do while waiting for my claim to be accepted?
Do what your doctor says. If he says go to work, go to work. If he says stay home, stay home. But if you disagree with your doctor, you need to be very clear and tell the doctor to reconsider because you’re not going to get paid time loss benefits unless your doctor authorizes it.
Is there any reason to hire an attorney before you get a denial?
Obviously there are some cases that are likely to be denied and we do assist people in some cases on claims that are likely to be denied and help them give their statement to the insurance company. But, in general, if you are honest about your claim and it gets denied, then you should get a lawyer involved to help ensure you get the benefits you deserve.