Can you get Worker’s Compensation and Social Security?

Written by Adian Martin on . Posted in Posts: Social Security Disability, Posts: Workers' Compensation

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.        

Workers Compensation is Important for you!

Written by Adian Martin on . Posted in Posts: Workers' Compensation

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.
Not sure? Talk to a member of our staff free of charge today. Why You Should Partner With Our Legal Team Our law firm has over 50 years helping Oregon residents just like you get their benefits, or a fair  settlement.  We can help with the most complex or difficult cases.    In addition to our Portland office, we have offices in Pendleton.  So wherever you live, in Portland area, Hermiston, Pendleton or anywhere else in Oregon, our team is dedicated to seeking the best resolution for your claim. Contact us today for a free consultation where we’ll evaluate your case and recommend your best course of action.

Can You Be Fired if You’re Out on Workers’ Compensation?

Written by BooAdmin on . Posted in Posts: Workers' Compensation

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" Employees

In 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 Contractors

In 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 Recovery

In 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.

Common Workplace Threats to Nurses

Written by BooAdmin on . Posted in Posts: Workers' Compensation

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.

Infections

By 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 Falls

Nurses 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 Injuries

Back, 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 Drugs

When 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 Sticks

Every 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 Chemicals

As 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.

Radiation

Radiation 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 Patients

Through 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
Your career as a nurse can be both fulfilling and dangerous. As you go to work each day, keep an eye out for these common hazards and work with your employer to develop a safer environment for everyone. If you are injured on the job, contact a workers compensation attorney for help with your case.

What You Should Know About Common Occupational Diseases

Written by Adian Martin on . Posted in Posts: Workers' Compensation

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.
  1. Hearing Loss
Many employees across industries experience some form of hearing loss. Hearing loss usually results from constant exposure to loud noises, including:
  • Printers, copy machines, etc.
  • Industrial or construction equipment
  • Large washing machines or sewing machines
  • Music
  • Shouting
Hearing loss can also result from compressed air or blows to the head. If you've experienced hearing loss, evaluate how it occurred to see if you deserve compensation.
  1. Musculoskeletal Disorders
Workers across industries also tend to develop musculoskeletal problems because they repeat the same tasks over and over. This can result in a number of 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.
You could also develop any number of other musculoskeletal disorders depending on which body parts you use at work. Consult with your doctor if you think you have a musculoskeletal disorder.
  1. Skin Disorders
Skin disorders usually manifest as allergic reactions. You'll see redness or other signs of irritation appear after exposure to a chemical agent of some kind. If these conditions persist, your skin could suffer permanent damage. You'll also feel miserable at work. In severe cases, your workplace could also cause disorders like vitiligo. When you have this condition, you lose pigment in your skin, hair, mucus membranes, or other areas. If you can prove that your work conditions caused this disorder, you have the right to compensation.
  1. Asthma and Other Respiratory Problems
Chemicals can also cause adverse reactions in your lungs. If you constantly inhale dust, not only will you feel ill, but the dust may also destroy your lungs. Metal dust, cotton dust, and mineral dust can cause bronchopulmonary diseases or pneumoconiosis. These conditions will affect your quality of life-after all, if you can't breathe, you can't do any of the other activities you love either. Sometimes airborne contaminants can also cause asthma, which will affect you for the rest of your life. You don't deserve to suffer after all your hard work, so if you develop this condition, consult with your doctor to see if your workplace caused it.
  1. Diseases Caused by Radiation
Does your line of work deal with X-rays or other radiation sources? You may slowly develop complications from constant exposure. These complications include cancer, radiation poisoning, and more.
  1. Cancer
Cancer can come from more than just radiation. You could also develop it because of the following:
  • Asbestos
  • Coal tar, pitch, and soot
  • Arsenic
  • Wood dust
  • Cadmium, beryllium, nickel, benzene, benzidine, benzene, or erionite exposure
  • Hepatitis B or C viruses
Cancer can occur for other reasons as well. If you have developed cancer, work with your doctor to try and find the cause.
  1. Post-Traumatic Stress Disorder
"Occupational diseases" can refer to mental conditions as well. If you deal with traumatic events at your workplace (even if you only deal with them once), and you develop this disorder, you have the right to workers' compensation. What to Do If You Get These Diseases If you have any of the occupational diseases listed above, you may have the right to your employer's help when paying for losses or treatment. Simply take the following steps:
  • 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.
Once you and your lawyer have filed the claim, you just have to wait for approval, and then you'll get the help you need. You work hard at your job, and you don't deserve to develop an occupational disease because of it. You deserve fast relief. If you have one of these diseases, contact your lawyer to begin the filing process as soon as possible.

Workers’ Comp and Retirement: How Disability Payments May Affect Your Other Benefits

Written by Adian Martin on . Posted in Posts: Workers' Compensation

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
However, you must apply for retirement benefits, even if you are receiving workers' comp, to protect your future rights to annuity. In the case of your death, your loved ones may no longer qualify for workers' compensation and need survivor annuity benefits. When you apply for retirement, list your workers' compensation on your application. If you are eligible for civil service annuity, you can select the benefits that work best for you and your family. The Office of Workers' Compensation Programs (OWCP) can help you make this decision. You can also accept annuity payments later on if your workers' comp benefits stop or if you are waiting for those compensation benefits to be approved. However, you may have to reimburse the U.S. Office of Personnel Management (OPM) if you begin receiving workers' comp after you accept civil service annuity. This rule does have an exception. Y ou can obtain both payments if you have scheduled benefits. The government may grant you scheduled award payment if particular internal/external organs or bodily functions were impaired as part of your injury. Contact the OPM if you are unsure of the benefits you should receive. To learn more about workers' comp as it relates to the CSRS or the FERS, read the official documentation (http://www.opm.gov/retirement-services/publications-forms/csrsfers-handbook/c102.pdf?nocache=1). Talk to Your Employer and/or a Disability Attorney As you can tell from the information above, there is a complicated relationship between workers' compensation and other benefits you may receive after retirement. Don't take the risk of missing out on important funds. Seek help before you decide how to proceed. Talk to your employer about how the company obtains workers' compensation insurance. Whether the employer goes through a state-run program or a private company may affect the restrictions. Finally, contact a disability or workers' compensation attorney-long before your retirement, if you can. He or she will understand the finer points of the law so you don't have to question. Plus, a lawyer will consider all of your potential sources, even private pensions and savings accounts, to make sure you receive the payments you need to rest comfortably.

9 Common Defenses Against Workers’ Compensation Claims

Written by Adian Martin on . Posted in Posts: Workers' Compensation

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.
  1. Self-Inflicted Injuries
In rare circumstances, employers may claim that their injured employees intended to become injured so they could pad their pockets with the compensation money. You may see this kind of defense with claims where the employee has a somewhat low income-but it can occur with any kind of workers' compensation claim. The employer wants to pin fault on you to void the case.    2. Negligence or Failure to Follow Rules More commonly, an employer will say that an employee's injuries occurred because of failure to pay attention. The employee did not adhere to safety rules, or simply operated heavy equipment while distracted. As a result, the employer did not cause the problem and should not have liability for it. You will have to prove that you did not behave in a negligent way before sustaining injuries.    3. Horseplay "Horseplay" refers to another way your employer may try to dodge your claim. Essentially, if you acted rowdy or clowned around before the injury occurred, your company may point the finger at you instead of giving you the compensation you require. Therefore, you will either have to attest that you kept your actions professional, or you will have to verify that you should have been safe no matter how you acted.
  1. Intentional Misconduct
Intentional misconduct goes beyond horseplay and indicates that you purposefully violated safety rules in the name of fun or rebellion. You didn't intend to sustain injuries, but you did intend to do something unsafe. You will need your lawyer's help to refute this claim as well so no obstacles stand between you and your compensation.    5. Intoxication When a person becomes intoxicated or uses illegal drugs, his or her inhibitions suffer, so he or she may try to do unsafe things. Alcohol and drugs also undermine one's motor skills and depth perception. Employers sometimes try to say that you became injured because you worked under the influence. Luckily, your lawyer can arrange blood tests and other proofs that help you get around this defense.   6. Medical Causation As mentioned above, you have to prove medical causation when you file a workers' compensation claim. If you have a preexisting condition, or if your physiology has any characteristics that could have caused the injury instead, the company you work for could attempt to use that condition to void your claim. Depending on your circumstances, you and your lawyer may have the ability to prove that you should not have sustained the injury despite any preexisting conditions.
  1. Failure to Notify Employer
When you become injured on the job, you have the responsibility to tell your employer about the incident no more than 120 days afterward. If you wait longer than that, the court may deny your claim. However, if a coma or other severe debilitation kept you from reporting the accident, you can prove that you lacked the ability to tell your employer on time.    8. Failure to Follow the Statute of Limitations Depending on the state you live in, you may have to deal with a statute of limitations on your workplace injury. The statute of limitations may give you up to three years to file your claim. It may give you more, or it may give you fewer. In any case, make sure you file your claim as soon as possible so your employer cannot use this defense against you.    9. No Connection to Employment Perhaps you became injured at a company party. Or perhaps you sustained injuries as you carried your heavy briefcase across the ice in the morning. With either of these situations, you will have to prove that your injury occurred because of something your employer did. Otherwise, he or she may posit that your injury happened due to outside factors, not something work related.   Workers' compensation claims may seem complicated and intimidating, especially if you try to navigate them on your own. Study our posts on the subject to become more informed, and do not forget to hire a lawyer. Your lawyer can see which of the above defenses your company may gravitate to, and he or she can help you prepare for and then overturn that defense.

Common Accidents that should not be Denied Workers’ Compensation

Written by Adian Martin on . Posted in Posts: Workers' Compensation

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.

Overexertion

Your body can only do so much.  Overexertion results from when your muscles or joints are put to use beyond their limits.  This can be from lifting heaving objects, moving in tight positions, or repeating awkward movements. Often, these types of injuries are first called a “strain.”   This is often before your doctor knows all the information; before you had x-rays or an MRI.  Workers compensation may accept this type of claim and call it a “strain.”  Then, when you find out it is worse, workers comp will deny your benefits, saying you have a pre-existing condition.     It is true, that x-rays and MRIs can help your doctor, but they often also show some type of arthritis, which is wear and tear.  We all have some wear and tear.  So, the x-ray and MRI findings are use against you by workers comp.  Then, it becomes a fight to prove you have a serious injury and not merely a painful pre-existing condition.

Trips, Slips, and Falls

Most trips, slips, and falls are avoidable with the use of proper safety procedures and equipment.  However, accidents may still happen.  A construction worker may trip over exposed wires or loose tools. A waiter may slip on a wet floor. A roofer may fall from an elevated platform.  An orchard worker may fall for a ladder.   You may be denied Workers’ compensation for these obvious injuries.  Your employer may simply not believe you, or someone may say you were not hurt at work.  Often you will need a witness to the injury.  If no one saw it happen, you may need a witness to say they saw you at work before the injury and you were okay.   Another witness may have seen you after the injury.   

Motor Vehicle Accidents

Not all workers spend their day behind a desk. Many of today's workers find themselves on the open road. Truck drivers and emergency service providers, such as police officers, firefighters, and paramedics, spend most of their day traveling from one location to another. Dangerous weather conditions, heavy traffic, and fatigued and distracted drivers can all lead to injuries on the highway. Sometimes, claims like these are denied, because the workers comp says you were off the clock, or not doing work at the time you were injured.  The law can be somewhat complicated about what is covered and what is not.    

Workplace Violence

Employees spend many hours with their coworkers, so for many people coworkers often feel like a second family. It is difficult to imagine a member of your second family harming you. But, from time to time, problems do arise. Passions ignite, tempers flare, and people get hurt. This can come as a result of violence between coworkers, disgruntled former employees, or dissatisfied customers. The violence may come as physical or emotional abuse. Even when you are involved in a fight, workers comp may have to provide benefits.

Other Common Injuries Covered by Workers' Compensation

While the incidents mentioned above are some of the most common accidents covered by workers' compensation insurance, they do not represent a comprehensive list. Other injuries and illnesses suffered while on the job, and covered by workers' comp include: Occupational illnesses including heart attacks, hernias, and mesothelioma Repetitive motion injuries If you've suffered an injury or illness on the job, it's important to know what rights you have as an employee and what your employer's responsibilities are. If you have questions about workers' compensation insurance or need help filing a claim, contact a lawyer who specializes in this area. With their expertise, you will ensure your financial and medical needs get met.

Injured Off the Clock: Can You Still Get Worker’s Comp?

Written by Adian Martin on . Posted in Posts: Workers' Compensation

Almost every morning, you get up, you drive to work, and you clock in. Almost every evening you clock out, you drive home, and you go to bed. Then you repeat the process the next day, and the next, and the next . . .

On most days, this seamless process stays fairly uneventful. But what about those unexpected days? Those days where one small action changes your life? Perhaps you decide to buy pizza for your boss to celebrate their birthday, but then you get hit by a car outside of the restaurant. Maybe you stop by the company basketball court during your lunch break to socialize with your coworkers, but a stray ball breaks your nose.

Are you still covered for worker's compensation?

Understanding Employer Liability

Worker's compensation covers work-related injuries or illnesses. When you're on the clock, you can receive compensation, which includes payment for 100% of your medical treatment, lost work pay, and if needed a permanent disability award and vocational assistance.

However, "work-related" can be a tricky rule at best. Most states, including Oregon, have a "going and coming" rule or a "portal to portal" rule. Under this law, worker's compensation coverage doesn't begin until the employee arrives at the workplace, and it ends when he or she leaves the office at the end of the day.

Consequently, lunch breaks and daily commutes may, or may not, qualify for compensation, even if you're on your way to the workplace. So if you twist your ankle outside the deli during your lunch break or if you carpooled with your coworkers and were involved in an accident, your claim may be denied, and you likely will need the help of an attorney to figure out if you are covered.

Exceptions Do Apply

While worker's compensation doesn't usually cover injuries when you're off-the-clock, a few exceptions to this rule do exist. Depending on your situation, you might be able to receive compensation, even if you weren't at the office.  Here are examples of some of the exceptions:

Sidewalks and Parking Lots

In many cases, your worker's compensation starts when you step foot on your employer's premises, not necessarily when you punch in on your time clock. These premises include sidewalks, parking lots, and grassy areas controlled by your employer.  In a sense, these areas are an extension of the workplace.

So, if you slip and fall on an icy sidewalk your company neglected to maintain, you qualify for worker's compensation. It doesn't matter whether you clocked out just a few minutes before the incident.

Employer Benefits

If your employer requires you to perform a duty that directly benefits him or her, then you're still covered with worker's compensation.

For example, your boss wants you to attend a dinner with a new client. You stop by the restaurant, have a nice meal, and talk shop for an hour or two. But on your way home, a car runs a red light and crashes into your vehicle. Because you were doing a task that specifically benefited your employer, you would still qualify for worker's compensation.

However, this exception doesn't apply to all circumstances. Let's say you had a drink or two at the dinner, and you drove while intoxicated. Worker's compensation does not cover crime-related activity, which includes a DUI conviction. Even though you were doing a favor for your boss, you wouldn't receive compensation because of your misconduct.

Running Errands

You likely have a normal routine for your workday. Perhaps you clock in, check your email, file some documents, and attend a few meetings. Maybe you clock out at 1 p.m. for your lunch break, head to your nearest sandwich shop to pick up your favorite combo, and then head back to work at 2 p.m.

However, your boss asks you to drop off the mail during your lunch break, and pick up another sandwich and a coffee for him or her while you're at it. As you drive back to the office, you spill your boss' coffee all over your lap. The coffee was unusually hot, so you suffered severe burns.

Although you normally wouldn't receive compensation for injuries on your lunch break, your boss' extra mission would qualify you for compensation.

After-Hour Duties

Your office may stay open during certain times of the day. Perhaps your typical shift starts at 8 a.m. and ends at 5 p.m. You clock in and clock out at these same times every day.

However, what if your work duties don't end when you clock out for the day?

Is Obesity an Occupational Disease Covered by Workers’ Compensation in Portland, OR?

Written by Adian Martin on . Posted in Posts: Workers' Compensation

Obesity continues to rapidly increase in the United States.  Statistics estimate that more than two-thirds of adults are overweight or obese, and more than 6 percent of adults have extreme obesity. This represents a serious public health concern, because obesity is linked to many other diseases such as diabetes, cancer, coronary artery disease, and stroke.

Your Job May Be Killing You
According to a survey conducted by CareerBuilder, nearly half of desk-job employees gained weight in their current position, compared to 30 percent of workers in non-desk jobs.

Statistics also show that workers with obesity have an increased risk of injury. Such workers have twice as many workers compensation claims, and these injuries tend to be more severe.  Our extra weight can generate more force during an accident, resulting in greater damage to vulnerable joints like wrists, ankles, and knees.

Can You Receive Workers Compensation for Obesity?
Everyone knows that workers’ compensation covers work-related injuries.  Injuries are sudden harmful events.  But, workers’ compensation also covers occupational diseases.  These are gradual medical conditions caused by work.  Examples of occupational diseases include hearing loss, carpal tunnel syndrome, and arthritis. Every disease can be covered, but only if doctors can prove that your work is the biggest cause of the disease.  While obesity is not excluded from being covered, it is not likely that your work can be proved to be the biggest cause.

Can Treatment of Obesity be covered by Workers’ Compensation?
Yes!  This is true even if work did not cause your obesity.  Here’s why:

A Closer Look at the Sprague Case

In 1976, Edward G. Sprague injured his knee at work. He filed a claim for his knee which was accepted by SAIF.  He had surgery and his knee recovered.  Years went by and Mr.  Sprague gained a lot of weight, reaching close to 320 pounds. This weight made his knee worse, and in 1999 he injured his knee again at work.

In addition to a knee replacement, his doctor suggested that he have a weight loss surgery- gastric bypass- to ensure full recovery.

Sprague filed a workers’ compensation claim to cover the costs, but the claim was denied, because the knee arthritis seemed to be the result of the 1976 injury. Sprague then took to the case to SAIF, but they, too, denied this claim.  SAIF said that Sprague's obesity was the cause of the knee arthritis condition.

Sprague took his case to the appeals court.  The Oregon Court of Appeals ruled that SAIF must cover the costs of the arthritis because it happened due to the initial injury. The Court also ruled that SAIF had to cover the cost of the weight-loss surgery because it was a necessary treatment for the knee to recover.

Therefore, it is Easier to get Treatment Covered by Workers’ Compensation; then it is to get other Benefits

Because of the Sprague Court ruling, employees can receive workers’ compensation to cover the cost of weight loss surgery.  More, importantly, you can get medical treatment for other condition under similar circumstances.  For example, if you injure your spine at work and need spine surgery, but must have heart surgery to make you fit enough for the spine surgery, workers’ compensation must cover the heart surgery.  

Not Sure If You Have a Case?
Unfortunately, workers compensation laws tend to be complicated. If you're not sure if your case qualifies for compensation, talk to a lawyer. Your lawyer can work with your doctor to determine what should be covered by workers’ compensation.