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Types of Covered Medical Care Under Workers Compensation in Oregon

medical care under workers compensation in OregonThe first hurdle you will face with worker’s compensation claims is the work-related requirement. You must prove that the injury or illness was connected to your job. Benefits for medical care under worker’s compensation in Oregon only apply with proof of on-the-job injury.

Covered injuries can include:

Occupational Illness

Illnesses and diseases employees develop on the job are generally covered. Black lung from coal mining, asbestos exposure, and COVID-19 are all potential claims.

COVID-19

If you contracted COVID-19 or were exposed at work, you might be eligible for benefits. You would have to prove that your job presented a special risk beyond that of the general public.

Repetitive Motion & Overuse Injuries

Repeatedly performing the same physical tasks can result in strains and injuries. Worker’s compensation benefits typically cover them, but you will need to provide evidence.

Pre-Existing Conditions

Pre-existing conditions don’t automatically mean your injury is not covered. If your work aggravates the condition, you may be eligible for worker’s compensation.

Hearing Loss

Several jobs can damage hearing and benefits often cover deafness attributed to work.

Stress-Related Injuries

Long-term stress and its connection to physical illness are becoming more recognized. However, it is still challenging to prove the correlation to receive worker’s compensation benefits.

Stress Resulting from Work-Related Physical Injuries

The toll a physical injury takes can affect an individual’s mental and emotional state. Benefits may include “compensable consequence,” meaning the injured employee is eligible for treatment and other benefits.

Oregon Employer Liability For Work-Related Injuries

employer liability in oregonWhen it comes to worker’s compensation, employer negligence is often a primary consideration. Should an employer take no action or apply the incorrect action to ensure employee safety, they could be held liable if an accident occurs.

Employer liability in Oregon must first be proven based on four elements:

That the employer owed them a duty of care
That there was a breach of duty
That the claimant suffered an injury because of the breach
The injury to the plaintiff was a reasonably foreseeable consequence of the breach

Liability isn’t always clear, but some examples might include:

Negligent Hiring

Employee screenings should rule out individuals not qualified for the position. If someone doesn’t possess the appropriate credentials, they could threaten the safety of others.

Negligent Retention

An employer may be responsible if an individual’s training is inadequate or absent and their actions result in injury.

Negligent Supervision

Employers who turn a blind eye to dangerous or inappropriate actions by an employee could be liable for supervisory negligence.

Should the claim be found in favor of the employee, their expenses and medical care under worker’s compensation may be covered. Since costs can quickly add up, these are important considerations. Speaking to a worker’s compensation attorney will clarify your position and help protect your employee rights.

What Happens When Your Work Injury Goes Unreported

man in group therapyIf you delayed filing your claim past the 90-day allowance in Oregon, there is still hope. You can file a late claim by asking for a one-year extension, but you will have to supply a valid reason for the delay. The responsibility now falls on you to provide a reasonable explanation as to why you were unable to file the claim.

In cases like this, it’s best to choose a knowledgeable lawyer to assist with your claim because of the challenge in establishing “good cause” for delayed filing of workers’ compensation in Portland, OR. While Oregon has a “reasonable worker” standard that considers the true nature of the work accident, pursuing your case is best left to a legal representative experienced in navigating the system.

The “Reasonable Worker” Standard

Oregon’s “reasonable worker” standard takes into consideration:

 

  • The nature of the work accident
  • The worker’s understanding of the accident’s relationship with associated symptoms
  • Medical evidence
  • Alternative symptom explanations
  • Self-treatment
  • How the symptoms restricted the employee’s work and life activities
  • Education and occupational background of the worker
  • The reliance on legal or medical advice

These factors are weighed and will determine the establishment of “good cause.”

A delay in filing a claim is not insurmountable but does present a challenge. Your workers’ compensation lawyer is an excellent resource for determining the likelihood that your case will be heard.

 

When PTSD is Covered by Workers’ Compensation in Oregon

man in group therapyPTSD occurrence is higher in some occupations than in others, although it can happen on almost any job site. Firefighters, law enforcement officers, paramedics, and hospital workers often face situations that are especially traumatic or stressful. These individuals are particularly susceptible to developing symptoms of PTSD.

Some workers’ compensation benefits in Oregon will cover the effects of PTSD depending on the circumstances. To be considered for coverage, a worker must be evaluated and diagnosed by a psychologist or psychiatrist. Workers’ compensation may cover PTSD as a purely mental injury, such as witnessing a shocking workplace event or a physical injury at work that results in PTSD.

Symptoms of Workplace PTSD

  • Flashbacks
  • Anxiety
  • Depression
  • Anger & Irritability
  • Easily Startled or Jumpy
  • Emotional Detachment
  • Violent or Self-Destructive Behavior
  • Memory or Concentration Problems
  • Obsessive-Compulsive Behavior
  • Nightmares

What May Be Covered

Worker’s compensation benefits vary according to the individual circumstances, but most often, they include:

Cost of treatment covering mental health therapy and medications

Temporary disability benefits covering time off work from to process and recover from the event

Permanent disability benefits covering an individual who cannot return to work due to the severity of the traumatic event

It is essential to speak to a workers’ compensation lawyer if you believe PTSD affects your ability to do your job effectively.

What to Expect at a Workers’ Compensation Hearing

court hearingFor many people, the most intimidating part of filing a worker’s comp claim is the hearing. It’s a crucial time that can have major impacts on your future – which is why being prepared is essential. Step one is finding a worker’s compensation attorney you in Oregon you can trust. After that, though, it’s worth getting a general idea of what to expect from your day in court. Here are a few things to consider:

The Worker – Depending on your situation and your attorney’s strategy, you may need to testify during your hearing. This is your big moment, and there are two keys to success. First, present a clear and rehearsed telling of your experience. Second, communicate the impact of the injury and the difference it’s made in your life.

The Evidence – Your worker’s compensation attorney has the job of gathering and presenting compelling evidence in support of your claim. This could be verification of your injuries, the accuracy of your testimony, or other relevant details that could impact the court’s decision.

The Resolution – After the presentations and examinations, the court will issue an opinion and order to resolve the claim. If you get the compensation you need, great! If not, that isn’t the end. Your attorney may be able to help you file an appeal.

 

Was Your Workers’ Comp Claim Denied? This Might Be Why.

business womanWorker’s comp exists to protect everyday employees. No matter the work you do or the situation behind your injury, you should feel confident getting the money you need to recover well. Unfortunately, not every claim is easy to navigate. If you’re struggling with worker’s compensation in Portland, OR, take a look at these that might impact your claim:

Employment Issues – One of the most common reasons for denials is a failure to prove that a particular injury happened while “at work.” What qualifies for your case might be different depending on your field and how you generally spend your time on the clock. For many claimants, however, the real struggle is documenting the time and place of the injury so that it’s possible to present evidence during the hearing. Be sure to gather any documentation that shows you were working at the time of your injury.

Disqualifying Conduct – Some factors about the claimant can lead to a denial. Working while impaired, failing to seek medical treatment, or seeking the wrong type of treatment can all leave you with less recourse. Fortunately, a skilled lawyer can often contest accusations of misconduct.

Technical Problems – Paperwork can be confusing, and it’s all too easy to let a form or formality get in the way of your worker’s compensation claim. Make sure you work with a trusted professional who knows the ins and outs of the system.

physical therapy

Vocational Rehab Vs. Physical Therapy – What’s the Difference?

When you’re recovering from an injury, your doctor may recommend physical therapy as a way to rehabilitate your body. Physical therapy can include specific exercises to target affected muscles, massages, and other medical treatments. Of course, individuals who have suffered a disability that has diminished their capacity to work will need more than just physical therapy. That’s where vocational rehabilitation comes in.

Mark Thesing Inc. is available to discuss vocational rehabilitation in Oregon with injured clients. If your injury has left you unable to perform the job you once did, this option may be available to you. Vocational rehab is a workers’ compensation benefit. It covers your tuition and time lost while you train for a new role that you are still able to perform.

Injured individuals who have chosen a lump sum settlement will not be eligible for vocational rehabilitation. If your claim has been denied, you don’t know the right option for you, or you need assistance filing your claim, you need to speak to a workers’ comp attorney right away. Your attorney will guide you through the process to help you receive the fair compensation that you deserve.

 

wheelchair

What to Do If a Work Injury Leaves You Permanently Disabled

If you have suffered permanent disability in Oregon due to a work-related injury, you may be entitled to workers’ compensation benefits. To apply for these benefits, you’ll first need to reach the point of “maximal medical improvement,” or MMI, which is when your doctor determines that continued therapy will not further restore your abilities. After this, your doctor will evaluate your injury and assign you a disability rating.

Your disability rating will be used to determine your eligibility for benefits. These benefits are difficult to calculate and come in several levels. If you have sustained a catastrophic injury, you may be given a whole permanent impairment rating. Lower injury ratings may entitle you to permanent total disability benefits or permanent partial disability benefits.

Permanent disabilities are classified as either scheduled or unscheduled. Scheduled disabilities have clear benefit guidelines and payouts. Unscheduled disabilities are more difficult to define and tend to be calculated on a case-by-case basis.

Experienced a permanent disability is a stressful and emotional time. If you have been denied workers’ comp benefits, or you require assistance filing your claim, Mark Thesing Inc. is here for you. Our law firm proudly represents injured individuals who are seeking the compensation they deserve.

woman thinking

What Happens to Your Worker’s Compensation if You Lose Your Job?

Many injured workers on workerscompensation do not plan for getting fired or laid off from their jobs. An employer may have fired them in retaliation for seeking workerscompensation benefits (which is against the law), or they may have been fired for reasons unrelated to their workerscompensation claim. Layoffs are often due to unforeseen economic downturns or budget cuts.

People in this situation may be concerned about the future of their workerscompensation benefits and should seek advice from a workerscompensation attorney in Oregon.

A workerscompensation attorney would advise that typically if someone was already receiving benefits when they were fired or laid off, they should continue to receive them if they were injured while working and approved for benefits while still in the job.  However, if the person was fired for cause, such as a disciplinary issue, he or she may lose the benefits. A person may also lose benefits if their doctor determined they were fully recovered before being fired. This is because, even if the person was not fired, the benefits would likely have stopped anyway.

A workerscompensation attorney would also confirm that even if a layoff coincides with the employer going out of business or filing for bankruptcy, this event should not affect someone’s benefits, as they are paid by the former employers workerscompensation insurance. That said, if the insurance company begins having financial troubles, it is possible a person may stop receiving benefits as a result.

woman working in an office

How to Prevent Ergonomic Workplace Injuries

Most occupations require workers to perform repetitive tasks. Whether it’s typing on a keyboard or operating large machinery, many jobs can be physically limiting. Repeating your actions or holding yourself in a particular position for hours at a time has been known to take a toll on physical health. These types of work-related injuries in Oregon are more common than most people think.

What Ergonomics Are

Adjusting the work environment and conditions to reduce the physical stress and strain on an employee is considered applying ergonomics. Typically, jobs requiring individuals to remain in static positions or using repeated motions have the greatest risk factor for ergonomic work-related injuries. Assessing the environment and adjusting workspaces can often make a significant difference to the employee’s everyday experience.

Changing the Way We Work

Most companies today provide an ergonomic assessment for their employees. From something as simple as an anti-fatigue mat to changing a desk’s configuration, ergonomics can increase worker morale and preclude worker’s compensation claims and absences.

If you feel you’re working in an environment that could benefit from an ergonomic assessment, talk to your employer. Chances are they’d prefer to provide an accommodating solution than risk downtime and reduced productivity due to work-related injuries.