Frequently Asked Questions about Workers’ Compensation Claim*
- What happens if my workers’ compensation claim is denied?
- How do I get my lost wages?
- What is a “written time loss authorization”?
- What should I do if my medical bills are not being paid?
- Can I return to work while my claim is pending?
- Are there any physical activities I cannot do while my claim is pending?
- What happens if I change jobs while my claim is pending?
- What happens if my employer changes workers’ compensation insurers while my claim is pending?
- Information for Alvey Law Group Clients
Unfortunately, once the insurer denies your claim, you will receive no benefits until and unless your attorney can get that denial overturned.
Even if your claim has been denied, you should continue to obtain any medical treatment necessary for your injuries.
If you have private health insurance, consider submitting any outstanding medical bills submitted to your health insurer. Most insurance companies will ask you sign a Trust Agreement, which states that they will be repaid by the workers’ compensation carrier for any benefits if you are successful in overturning the denial.
Contact your lawyer’s office: they can make arrangements with your health insurer to get your benefits started.
If your doctor has not cleared you to return to work, or if you should be working modified or light duty, keep getting your written time loss authorizations for each pay period, and send them to the workers’ compensation insurer.
If your workers’ compensation attorney is successful in overturning the denial, the insurer will retroactively pay any time loss benefits you are owed.
If your doctor says that you temporarily cannot work as a result of your on-the-job injury, or that you can only work modified or light duty, you are entitled to recover your wages.
To do this, you need a written time loss authorization from your doctor. Submit that authorization to the insurance company.
You must continue to obtain written time loss authorizations for all pay periods where you cannot work or can only work with restrictions in order to receive wage loss benefits.
Without a written time loss authorization from your treating physician, the insurance company may not be obligated to pay your time loss benefits. Please be sure to keep copies of your time loss authorizations as many doctors do not keep copies in your chart.
If you cannot perform your regular job duties because of a work injury, you need to see your doctor. The doctor can provide the time loss authorization, which is simply a document that states that you cannot work, or can only work with restrictions.
The insurance company will need a written time loss authorization to process and pay your lost wages. Without that authorization, the insurance company may not be obligated to pay your time loss benefits.
Make copies of all unpaid medical bills and collection notices, and send these to your workers’ compensation attorney.
Your attorney’s office can contact the medical provider or collection agency, and request that collection action be stopped until the outcome of your workers’ compensation claim is determined.
Under Oregon law, medical providers cannot take collection action against you for medical bills incurred as part of a workers’ compensation claim that is pending litigation.
Your primary concern must be your own long-term health. Follow the care recommendations of your treating physician. Your doctor can help determine the physical limitations you should be following during your treatment.
It is imperative that you talk to your treating physician about your physical activities and limitations.
You should know that photographs and comments posted to any social media (Facebook, Twitter, etc.) can be considered relevant to your injury claim. While your claim is pending, you should not be undertaking any activity that you do not want to explain to a judge in court.
Your workers’ compensation claim will not change. Your former employer’s workers’ compensation carrier is still responsible for handling your claim. You will not be penalized for changing jobs.
Your workers’ compensation claim will still be assigned to the employer’s insurer at of the date of the injury.
You are encouraged to call the office at any time with questions or concerns about your case.
You should know that attorneys are often out of the office at hearings, trials, depositions and meetings with physicians. They also spend a great deal of time on the phone with clients, claims adjusters and defense attorneys.
If you reach your attorney’s voicemail, please leave a detailed message about your question or concern. You can contact your lawyer by email at any time.
Alvey Law Group paralegals are very experienced, and work closely with the attorneys. The staff may be able to assist you immediately at 503-229-0895.
* This is general information about Oregon Workers’ Compensation Claims: it may not apply to your situation, and should not be construed as legal advice.