What Workers Comp Is – And What It Isn’t

Many workers who have sustained an injury at their job have a lot of questions about Workers Compensation. The simple thought that worker’s comp will pay for all medical costs and cover time lost at work, can quickly get very complicated when an insurance company has the authority to deny or accept your claim. In this post, we’ll take a closer look at what Worker’s Compensation really is and what to expect from the process after you’ve been hurt at work. In any case, an attorney like the Law Offices of Brian Whitehead, can help you understand and navigate the system, ensure you get the benefits you deserve, and allow you to make good decisions about your legal options.

Obviously, Oregon has a system in place that helps people with work related injuries. However  worker’s compensation as a system is not always fair and it is not meant to be. What it really is, is an insurance policy with limited benefits that is required by law for most Oregon employers, to insure their employees against work related injuries.

This insurance policy will pay benefits if you’ve been hurt at work but, it doesn’t pay for everything. It doesn’t put the worker back to 100% of his pre injury status nor does it even attempt to. Think of it as an insurance policy that has a deductible. That’s the portion workers comp doesn’t cover.

A social compromise

Before approximatley 1910, an employee who was hurt at work through the negligence of an employer could sue the employer for all damages including pain and suffering. On the other hand, an employee who was even partially responsible for their own injury went uncompensated. Some people recovered all their damages, but the vast majority of injured workers received nothing, not even payment of their medical bills – and the next person in line got their job. The enactment of Workers’ Compensation laws nationwide changed this to a no fault system where all workers received compensation, but employers were protected from claims beyond that paid by workers’ compensation. It’s not fair to employees injured due to employer’s negligence, but then it is not again particularly fair to the employer if the injury is not their fault.

Workers Comp really is a social compromise, that has been enacted into law, between employers and employees, that limits the liability of the employer for their own negligence and increases the liability of the employer for injuries that are not the employers fault. In exchange the worker gave up their right to sue the employer for all their damages but more employees got to collect benefits even if the injury was the employees fault. In order to make that social compromise work, benefits were limited.

The benefits that are paid on a on a Workers Comp claim are limited to lifetime medical benefits related to the accepted claim. Additionally, it will cover 2/3 of lost wages for a period of time limited to when you are actively recovering from the injury and not medically stationary. Medically stationary means that no further material improvement in your condition is expected as the result of medical treatment for the passage of time. In other words, your condition won’t improve with more medical treatment. It also provides a cash award for permanent disability at the end of your claim and vocational training if you cannot go back to your regular job.

Workers Comp Process in Oregon

In all cases, where you have been injured on the job, the easiest and most important thing you can do to protect your legal rights is to report your injury to your employer as soon as possible.

Next you need to file a formal workers comp claim. There is a short time limit to file the claim – as little as 60 days from your notice or knowledge of the injury. There’s a form called Form 801, that you can get from your employer, fill out, and return to your employer. If you employer won’t give you a Form 801 because they don’t want you to file a workers comp claim, you can download one online.

Once you have filed the claim the insurance carrier generally has 60 days to deny or accept the claim. If the claim is denied for any reason, you have the right to appeal the decision. If you haven’t already done so, you should consult an attorney to help you decide whether or not the denial can be reversed. Attorney fees will be paid by the insurance carrier if the appeal is successful.

Help in your corner

It’s common for insurance companies to pressure injured workers into settlements that are more advantageous for the insurance carrier. A lawyer in your corner can help you value your claim, protect your rights, and maximize your settlement amount.

Call the Offices of Brian Whitehead today for your complimentary case evaluation.

fossilgraphicsWhat Workers Comp Is – And What It Isn’t