An older worker from Pendleton injured his back several years ago while lifting a heavy box of freight. Sadly, he herniated a disc and needed surgery, and the surgery was denied by SAIF. He contacted us and we won his case. But, SAIF appealed. While there is an appeal, a workers' compensation insurer must pay temporary disability, but they need not pay for medical treatment until their appeal is denied. Well, we won on appeal and his claim was finally accepted. He had surgery, but the disc was pinching the nerve as it exited his spine for too long, and there was permanent nerve damage and disability. SAIF was on the hook, and had to pay for this permanent disability. The amount was to be rather large. In the meantime, the injured worker had applied for social security. He asked for my help on this claim. I reviewed his case and told him we would likely win his social security benefits. (Later, we did win.) He asked what would happen to his workers' comp pay when he got his social security. I explained: Workers’ compensation may reduce your Social Security benefits. If you get workers’ compensation pay and Social Security disability benefits, the total amount can’t exceed 80 percent of your average current earnings before you became disabled, if it does your Social Security benefit would be reduced. For example, you earned $4,000/month at the time of your injury, and workers' comp pays 66% of that amount for temporary disability, $2,640. Therefore, the maximum Social Security would pay you each month would be $560. (Because %80 of our $4,000 wage would be $3,200.) In this case, your Social Security, if you were not getting workers comp, was supposed to be $2,200/month. So each month, you are losing $1,640 in Social Security benefits, because of your work comp pay. He asked: Well, is there anything that can be done? I explained: Yes. If we get SAIF to pay you in a lump sum settlement, you can get your full Social Security. The type of settlement is called a Claims Disposition Agreement (CDA), and since 1990, half of Oregon WC cases were settled a CDA. With a CDA the worker gets an immediate payment of the lump sum, but gives up rights to all other benefits, except for the right to medical expenses directly related to the injury. Most importantly, in a CDA the worker's attorney can specify a monthly amount based on life expectancy that the lump sum is supposed to compensate. In other words, your settlement may be $75,000, but since you are were expected to live 26.3 more years, 315.6 months, it amounts to $237.6/month for the rest of your life. Social Security must act as if you were getting $237.60/ month, instead of $75,000 all at once. This means you get all the work comp money in a lump sum up front, and your full Social Security monthly payment of $2,200. So, you can get both workers' comp and Social Security. Our client in Pendleton Oregon was very happy. If you have a question about workers compensation or social security please call Ransom, Gilbertson, Martin and Ratliff for a free consultation.
You work hard to achieve your career goals. You may even have moved, sacrificed other desires, and dedicated long hours to your job in order to get where you are now. So when an injury threatens your ability to work, it can affect every part of your life. At Ransom, Gilbertson, Martin & Ratliff, L.L.P., we understand how important workers compensation can be during this difficult period. Our team works hard throughout the workers’ compensation process to get workers, all over Oregon from Portland to Pendleton to the Oregon Coast, the help and support they need to move forward after a work injury. When to retain Workers’ Compensation Lawyer When you begin the claims process, you may wonder if you need to retain a workers’ comp lawyer. The answer is “Yes.” Work comp laws have become very complicated and you rights to medical treatment and disability pay may be at risk. Our team can help you at any point in the claims process. You should immediately get representation in any of the following circumstances:
- You believe you are entitled to benefits that you have not received.
- You need surgery, long-term care, vocational assistance, or costly medical services.
- You won’t be able to return to your job due to injury.
- Your compensation has been delayed, disputed, or denied.
- Your doctor believes your injury to be permanent.
Many employees worry that by filing a claim for workers' compensation, they put their livelihood at risk. They may have heard horror stories of employees who received injuries on the job, filed for benefits, and were promptly laid off. Workers' compensation laws were designed to protect employees from unlawful and unfair termination. When you learn the details of the law, you can have confidence in filing a claim and knowing your job is safe. In this blog, we'll go over the various situations workers can find themselves in and how the law applies to them.
"At-Will" EmployeesIn Oregon, courts have upheld employers' and employees' rights to "at-will" employment. That means that employers can discharge an employee at any time, without giving a required "two weeks' notice" or other period of advanced notice. Unless an employee has a contract or statute outlining a specific time period for completing a job, an employer can choose to let the employee go at will. Employers must have a legal reason for discharging an employee. For example, employers can terminate employees based on poor work performance, company restructuring, or financial problems within the company. Employees can also choose to leave an employer at will. They are not required to give a period of notice to their employers. Oregon has maintained this at will employment structure because it allows for more flexibility in the workplace. Employers can adjust their staffs as workloads increase or decrease. Employees can also leave positions of employment immediately to begin a new position or escape an unfavorable work environment, if necessary. If you find that your company has at-will status, you should recognize that filing a workers' compensation claim provides a motive for your company to terminate your employment. However, your employer cannot legally fire you in retaliation for filing a workers' compensation claim. Protect yourself from unlawful termination by keeping careful records of your claim and your interactions with your superiors. Write down a transcript of any communication you have with your company's management, especially if it relates to your workers' compensation claim. The more written documentation you have of your treatment in the company, the more evidence you have to present in the case of a lawsuit. If you are an at-will employee and you suspect your employer has terminated your employment because of a workers' compensation claim, you have grounds for a lawsuit. Contact a workers' compensation lawyer to review your case.
Independent ContractorsIn Oregon, employers can contract out work to independent contractors for a specified period of time. Independent contractors fill out different tax forms than permanent employees. They are not considered permanent employees, and often work with their own insurance providers in the case of workplace injury. Independent contractors also have different rights than at-will employees. First, your contract stipulates the terms of your employment. These terms include the time period you have contracted to work with the employer, the scope of the work to be completed, your payment rate, and specific reasons your contract can be terminated. Many contracts include a provision that allows the employer to terminate a contractor if he or she is unable to work for a given period of time. In this case, if you sustain an injury during work that prohibits you from working, you may lose contracts. This circumstance is different than termination as a result of a workers' compensation claim. In fact, independent contractors usually have no right to file a claim with the employers' insurance. If an employer terminates an independent contractor according to the terms of a provision in the contract, that type of termination is usually legal.
After Your RecoveryIn many cases, a workplace injury results in a temporary injury. After a suitable period of time (usually determined by the nature of your injury and your insurance company), you should be able to return to your original position. Keep in communication with your doctor to ensure you don't return to work before you fully heal, as you risk reinjuring yourself. But you also shouldn't return to work too late. If you exceed the amount of time determined to reach maximum medical improvement, your employer may have grounds to terminate your employment. If you can return to your former position after a period of recovery, you should have no problem resuming your duties. In some cases, however, your doctor may see the need to incorporate permanent work restrictions. These restrictions could limit the amount of physical energy you exert to perform your job. For example, a doctor could prescribe ergonomic work standards, limit the amount of time you sit or stand, or suggest a number of short breaks throughout the day. Your employer is required to exert reasonable effort to accommodate your work restrictions. See the Americans with Disabilities Act (http://www.ada.gov/2010_regs.htm) for more information on this topic. However, if you find that your employer refuses to work with you to reinstate you to your former employment status, you may have grounds for a workers' compensation lawsuit. Contact a workers' compensation lawyer for legal advice on your case.
Nothing feels worse than losing a loved one. The death of a beloved friend or family member causes immense amounts of grief and pain when it occurs naturally as a result of age or prolonged illness. But when death occurs as a result of an accident, workplace injury, or another person's negligence, it also brings about legal questions, concerns, and doubts. If there is good news to be had in a situation like this, it's that you don't have to navigate the legal system alone. To help you make sense of wrongful death claims, we've answered five of the most common questions we receive about these types of cases. 1. What Is a "Wrongful Death?" According to ORS 30.020 (http://www.oregonlaws.org/ors/30.020), a wrongful death is one "caused by the wrongful act or omission of another." In most cases, wrongful deaths are the direct result of another party's negligent, reckless, or intentional behavior. In other words, the same actions that support personal injury claims also support wrongful death claims. 2. Who Can File a Wrongful Death Claim? Because the person directly involved with a wrongful death claim would be unable to file a claim for themselves, another party must file the claim. In most Oregon wrongful death claims, immediate family members of the deceased file wrongful death claims. Immediate family members include:
- Compensate family members for costs associated, both directly and indirectly, with medical costs and funeral expenses.
- Many families also receive compensation for loss of future earnings, allowing them to support themselves in the absence of a breadwinner.
- Recoup any non-monetary damages the family incurs. These damages could include emotional damages and loss of companionship.
- Parties who incurred expenses or fees associated with the lawsuit, prosecution, or enforcement of the claim will receive reimbursement first.
- Parties responsible for paying medical, funeral, and burial expenses receive reimbursement next.
- Surviving parties with legal claim to the settlement receive the remaining damages. This is where judges consider testimonies, familial relationships, and emotional damages most.
The Social Security Administration has two main benefit areas for U.S. citizens who qualify: Social Security Income (SSI) and Social Security Disability Insurance (SSDI). The receivers of these benefits sometimes have overlapping situations, such as old age and disability. SSDI pays benefits to people considered disabled. SSI pays benefits based on financial need, which isn't always related to health costs. Age, health, and past jobs all play a role in both branches. For our purposes, we'll focus on Social Security Disability Insurance. This benefit type applies to disabled and permanently injured people who previously worked. These people must be "insured," meaning they worked long enough and paid social security taxes. Several other factors go into qualifying for SSDI, which we'll discuss below.
What It Means to Be DisabledThe term "disabled" is subjective because there are several disability benefit programs. Each benefit provider defines disability in different ways. According to the Social Security Administration, partial or short-term disability does not qualify you for benefits. Administration rules state that disabled persons meet the following criteria:
- They cannot perform work that they used to do
- They can't adjust to other work because of any medical condition(s)
- Their disability has lasted a certain amount of time and will continue to last or result in death
How to Apply for Disability BenefitsWhen it comes to applying for benefits, it's always important to apply as soon as you become disabled. Procrastinating your application can cause several problems. You could lose necessary documentation, or you could no longer qualify for benefits. No matter how intimidating you find the process, you deserve to see it through. The application process is complex for a reason; it's important to deter people who just want a free ride. Many people deserve these benefits, but getting them is often another matter. Follow the basic outline below to get an idea of where to start. Steps to Apply First, familiarize yourself with the application process.
- Visit the Social Security Disability website (http://www.ssa.gov/dibplan/#sb=3).
- Read through their various helpful publications (http://www.ssa.gov/dibplan/dapply.htm).
- Complete an online application.
- Call the toll-free number (1-800-772-1213) with any questions.
- Visit the nearest Social Security office (https://secure.ssa.gov/ICON/main.jsp).
- Original birth certificate
- Proof of citizenship
- Medical documentation: records, doctor reports, test results Recent and valid W-2 forms or self-employment tax forms
- Valid pay stubs, award letters, or settlement agreements
- Proof of any temporary or permanent benefits (including workers' compensation)
- Military discharge papers if you served before 1968
- An official adult disability report
Why Previous and Existing Benefits MatterThose applying for benefits often ask whether it's possible to have multiple benefits. There are several types of financial aid for disabled persons. Each one has its own rules, requirements, and regulations. These aid programs include:
- Workers' compensation
- Public disability benefits Civil service disability
- Temporary state disability
- Other government retirement benefits based on disability Social Security Disability Insurance
Why You Should Seek Legal HelpIn many cases, it takes more than one application to obtain Social Security Disability Insurance. Even the most careful person can have something go wrong in their application. Instead of making the same mistakes a second or third time, trust an experienced attorney to help you succeed. Consult a lawyer with knowledge of the application process and laws surrounding it. They'll provide you with useful advice and direction that will help you obtain benefits. Even better, you'll have the necessary support to achieve a well-crafted application. Get started today; schedule a consultation with a lawyer who is experienced in the realm of Social Security benefits.
As a nurse, you dedicate your days to serving patients and protecting them from harm. Hospitals and outpatient facilities place great emphasis on patient safety-and for good reason. However, as you take care of your patients, you also have to take care of yourself. Nurses have physically demanding jobs, and as such, they have a high risk of workplace injury. To protect yourself on the job, you need to know the most common on-the-job injuries for nurses and ways you and your employer can work to prevent them.
InfectionsBy definition, nurses deal with sick people. When you work in close quarters with a variety of illnesses, you can expect to end up catching a few of them. However, nurses have a right to be protected against illnesses much more serious than the common cold. Employers should train their nurses to use proper hand hygiene and wear appropriate protective clothing when dealing with dangerous illnesses. You are also never too busy to take the proper precautions when caring for patients with influenza, tuberculosis, and in recent cases, Ebola.
Slip and FallsNurses encounter slippery situations every day. When you deal with bodily fluids for a living, there are bound to be some spills. At work, you often don't see these hazards coming. In the midst of a high-pressure health crisis, you might not see that puddle before you step in it. You can reduce your risk of slipping and falling by wearing appropriate footwear and developing good observation habits. Before you run down a hall or into a room, take a quick scan of the floor. This only takes half a second and could save you a lifetime of pain.
Back InjuriesBack, leg, and spine injuries are commonplace among nurses. Even if you use proper body mechanics to lift, turn, and move patients, you still put your back on the line every day. Employers should make assistive lifting tools easily accessible to the nursing staff. You should rely on these devices as much as possible to avoid hurting yourself while helping patients. Employers should also train nurses to minimize their risk of injuries through proper lifting techniques.
Hazardous DrugsWhen you administer various drugs to patients, you sometimes end up exposed to them yourself. Many drugs are inherently poisonous and can pose threats to people who don't need to take them. For example, most chemotherapy drugs are known toxins. The American Nurse (http://www.theamericannurse.org/index.php/2012/04/02/hazardous-conditions/) also reported recently about a study that linked miscarriages among nurses to exposure from sterilizing chemicals and antineoplastic drugs. Nurses should always know the potential risks of the drugs they have to handle and should receive proper training on how to protect themselves.
Needle SticksEvery time you administer an injection, you put yourself at risk for a needle stick. Even a tiny prick can expose you to many dangerous bloodborne pathogens, including hepatitis and HIV. These incidents happen most often in surgical situations and when nurses have a heavy workload. Employers should already have practices in place to help prevent and treat needle stick injuries. However, your workplace should also have adequate staffing and reasonable patient loads to reduce the threat.
Dangerous ChemicalsAs hospitals work to prevent the spread of infection, they often turn to harsher and harsher cleaning chemicals. When cleaning staff apply these chemicals all throughout the building, nurses often face long-term exposure. Employers should work to find substitutes for hazardous cleaning chemicals. As a nurse, you should also be aware of what cleaning products your janitorial staff uses and how to avoid them if you can.
RadiationRadiation and X-rays can both help and hurt people. Although these technologies benefit patients, they can put nurses in harm's way. When you have to perform X-rays or work with machines such as lasers, you have the potential for radiation exposure. Employers must train their nursing staff on how to safely work with radioactive materials and machinery. Nurses should always have access to the proper protective gear and be able to follow safety procedures.
Violent PatientsThrough your daily work, you will likely encounter unpredictable patients with unstable tempers. Emergency nurses in particular face a constant threat of physical abuse from violent patients they are trying to treat. Even otherwise well-meaning patients can unintentionally injure nurses when they're in the throes of intense pain or stress. Although violence is often unpredictable, as a nurse, you should know how to watch out for warning signs. Employers should also implement prevention programs and train their nurses on how to respond to patient violence. Important factors that can contribute to patient violence include:
- Long wait times
- Delays receiving pain medication
- Slow transfers of mental health patients
When most people think of workers' compensation, they think of dramatic injuries and accidents. They don't often think of slowly developing conditions, like occupational diseases. Fortunately, workers' compensation covers occupational diseases as well. Your career can cause chronic conditions that don't show up right away. These conditions can affect your quality of life every bit as much as a broken arm. We want you to stay informed about these occupational diseases so that, in the event you contract them, you know you can get compensation. What Occupational Diseases to Watch For Many diseases and conditions could arise from continued exposure at your workplace. Common occupational diseases include the following.
- Hearing Loss
- Printers, copy machines, etc.
- Industrial or construction equipment
- Large washing machines or sewing machines
- Musculoskeletal Disorders
- Carpal tunnel syndrome: This affects your wrist after repetitive or forceful work or extreme wrist postures. The carpals, or bones in your wrist, could collapse without treatment.
- Radial styloid tenosynovitis: This often results for the same reasons as carpal tunnel syndrome. Radial styloid tenosynovitis can become a chronic condition.
- Olecrannon bursitis: If you experience prolonged pressure in your elbows, you could develop this disorder. You can get a similar disorder, prepatellar bursitis, in your knee.
- Meniscus lesions: These occur in your knee after you spend a lot of time kneeling or squatting.
- Skin Disorders
- Asthma and Other Respiratory Problems
- Diseases Caused by Radiation
- Coal tar, pitch, and soot
- Wood dust
- Cadmium, beryllium, nickel, benzene, benzidine, benzene, or erionite exposure
- Hepatitis B or C viruses
- Post-Traumatic Stress Disorder
- Meet with your preferred healthcare provider for an evaluation. He or she will analyze your condition to help you find its cause.
- If your workplace's conditions caused the disease, let your employer know what happened.
- Contact a trusted lawyer to begin filing a workers' compensation claim.
If you have continued working for many years despite an injury, the day of your retirement could not come soon enough. But remember, just because you stop working doesn't mean that you will stop feeling pain or restriction from your on-the-job injury. Y ou may still have medical expenses-or at least be entitled to payment for damages over time. If you are currently receiving workers' compensation, those payments may continue after your retirement. In fact, you can even file a claim after your retirement if you can prove that your disability is related to your job. But to live the life you've probably imagined after you finish working, you will need more than payments from workers' compensation. In the United States, retirees can receive funds from a number of sources, such as Social Security, but workers' compensation may affect the amount you receive. Find peace of mind now. Before your retirement, plan ahead and see how workers' compensation will fit in with your other benefits. Social Security Benefits In Oregon, the state does not offset workers' compensation for Social Security retirement benefits. What does that mean for you? If you have been receiving workers' compensation, you probably know that it affects the amount of Social Security disability benefits you can receive. The total amount of benefits cannot go over 80 percent of your average earnings before your injury or disability. For example, if you made $5,000 a month before your disability, the government will reduce your family's Social Security benefits until you receive $4,000 a month total. Y ou can receive full Social Security benefits again when you turn 65 or when workers' compensation stops. This restriction does not apply to Social Security retirement benefits. You can receive both payments simultaneously. Again, what does this mean for you? If you are in your early 60s, you may want to retire early. Full retirement age is 67 years for those who were born in 1960 or later, but you can receive retirement benefits starting at the age of 62. According to Social Security Administration, your benefit may be 25 percent lower than your payment if you waited until age 67. Speak with an attorney or find your local Social Security office (https://secure.ssa.gov/ICON/main.jsp). Either of these resources can help you determine whether you can benefit from early retirement. Civil Service Annuity If you have worked for the U.S. government, you may be looking forward to benefits from the Federal Employees Retirement System (FERS). However, the law dictates that you cannot receive workers' compensation benefits and civil service annuity payments at the same time. This rule may keep you from receiving:
- Disability retirement benefits from the FERS or its predecessor, the Civil Service Retirement System (CSRS)
- Spouse benefits
- Veteran's disability benefits
- Death benefits
As you pursue a workers' compensation claim, you will come up against a series of obstacles. These obstacles may include health limitations because of your injuries. Or these obstacles may arise because your employer finds a loophole around your claim. We've mentioned in previous posts (http://ransomgilberts.wpengine.com/denied-workers-compensation-claim-portland/) that when you file a workers' compensation claim, you have to prove that the injury happened on the job, and you have to prove medical causation, which means that no outside factors other than your work task caused the injury. Within these proofs, employers can find many ways to get around your claim. Do not let them take your compensation away from you. Familiarize yourself with their tactics so you and your lawyer can build a solid, undeniable defense.
- Self-Inflicted Injuries
- Intentional Misconduct
- Failure to Notify Employer
No matter how hard we try to avoid them, accidents happen. While most accidents are benign, causing little more than bumps and bruises, some are disabling. And when these accidents happen in the workplace, they are costly to you and your employer. Luckily, to fight these losses, we get workers' compensation insurance. This is supposed to replace our lost wages, and cover our medical expenses when we are injured on the job or have long term occupational diseases. All injured and disabled workers are supposed to have the benefit of workers' compensation insurance, even if some workers are wrongfully denied. Have you ever wondered what workplace accidents are most common? How about which claims are often denied? Below are a few of the most common work injuries.