Common Mistakes That May Ruin Your Workers’ Compensation Claim

Most employers are required by law in Oregon to provide workers’ compensation coverage for their employees. When an accident or conditions at work cause an injury or illness, workers’ compensation provides access to medical care and reimbursement of lost wages. It is a no-fault system, which means that you may recover benefits even if you were at fault. 

Your right to benefits can be affected by failing to follow specific rules and procedures that exist throughout the workers’ compensation process. To help protect your right to recover benefits, here are some of the most common mistakes to avoid. 

Failing to notify your employer of the injury or illness 

You must notify your employer as soon as possible about an injury or illness that occurred at work to preserve your right to file a claim for benefits. Steps to take after an employment-related injury or illness should include: 

·         Report it to your supervisor or manager as soon after the incident as possible.

·         Complete a written report of the injury or illness using an official form available from your employer. Your employer will complete the form, send a copy to the workers’ compensation insurance company, and give you a copy of it.

·         Ask your employer for the name and contact information of the insurance carrier. The workers’ compensation insurer becomes your primary source for information about the status of the claim. 

An injury or illness may not immediately appear to be serious or require medical treatment, but symptoms may worsen over time. For example, symptoms from a blow to the head may take hours to develop and reveal an injury to the brain. It is safer to report incidents when they happen rather than waiting for serious symptoms of an injury to develop. 

The law protects your right to file a claim for benefits. It is unlawful for an employer to refuse to allow you to file a claim or retaliate against you for filing one. Retaliation may include termination, demotion or other discriminatory action. 

Delaying medical treatment 

If an accident occurs at work and you suffer an injury, let a doctor evaluate your condition and determine whether you need medical treatment. The workers’ compensation system in Oregon allows you to go to any health care provider of your choice as opposed to some states that let employers or compensation insurance companies determine your medical providers.

Not following rules about changing doctors 

The doctor you initially consult about your work-related health issue becomes your attending physician. If you decide to change doctors, you may only do so two times without the approval of the workers’ compensation insurance company. The following do not count as changes: 

·         Treatment provided by a doctor in an emergency.

·         An on-call physician covering for your attending doctor.

·         Referral to a specialist with your attending doctor retaining responsibility with your care.

·         Change in health care provider caused by circumstances beyond your control. 

If the workers’ compensation carrier refuses to agree to a change of attending physicians, you may request approval from the Oregon Workers’ Compensation Division. Changing physicians without approval may result in the insurer refusing payment for the services rendered by the new doctor. 

Missing the deadline to appeal a denial of your claim 

The workers’ compensation insurance company has 60 days from receiving notice of your claim to either accept it and pay benefits or deny it. You have only 60 days to appeal a denial of benefits to the state workers’ compensation board. 

Missing work without authorization from your attending physician 

Workers’ compensation benefits include reimbursement for time lost from work due to the injury or illness. Your attending physician must first authorize it as being medically necessary because of the medical issues forming the basis for the workers’ compensation claim.

You will not be compensated for taking time off that has not been medically authorized. You also put yourself at risk of being fired by your employer. 

Refusing to return to work when authorized by your doctor 

If your attending physician clears you to return to work or to return to light or modified duty, you cannot refuse and continue to collect compensation benefits. An offer of light-duty work by your employer at a reduced rate of pay may only be refused if your doctor determines that your current medical condition prevents you from doing so. 

Accepting light-duty work at lower wages than you earned prior to the injury or illness results in a recalculation of your compensation benefits. The workers’ compensation insurance company adjusts your benefit for time lost from work by the amount you receive for the light-duty assignment. 

Failing to retain the services of a workers’ compensation lawyer 

Consulting an experienced workers’ compensation lawyer about an injury or medical condition related to your job lets you avoid the common mistakes that can affect your right to benefits. Learn more by contacting a Bend compensation lawyer today.

Featured image by Andrey_Popov/

Leave a Reply

Your email address will not be published.