If you work in Oregon and have recently sustained an on-the-job injury, you have rights! You’re entitled to benefits to help you pay your bills and seek the treatment you need to heal from your injury.
Workers’ compensation insurance exists in the state of Oregon and pays for workers’ medical treatment and lost wages in the event that an employee suffers from a work-related injury or illness. If you’ve filed a workers’ compensation claim and the insurer denies your claim, you should appeal the denial to the Oregon Workers’ Compensation Board.
This board exists for the purpose of resolving workers’ compensation disputes in the state of Oregon. In this article, we’ll give you an overview of the board, its role in the claims process, and what to expect when you appeal the denial of your claim.
How the Workers’ Comp Process Works in Oregon
Employers in the state of Oregon are required by law to carry workers’ compensation insurance or be self-insured. If you’re injured on the job or develop a chronic condition as a result of your work, you should inform your employer immediately and file a workers’ compensation claim. In most cases, your employer will have a special form you can use to file your claim, called an “801 form.” You can also file your claim through your doctor using an “827 form.”
Your employer cannot prevent you from filing a claim, and it is unlawful for them to discriminate against you or fire you for filing a claim. In general, Oregon workers who get injured on the job are entitled to go to their regular healthcare provider or another doctor of their choice.
Once you have filed a workers’ compensation claim, the insurer must either accept or deny your claim within 60 days of being notified. You should receive a letter of acceptance or denial within this time frame. If your claim is accepted, the insurer will pay for your workers’ compensation benefits. If your claim is denied, you have 60 days following the arrival of your denial letter to appeal the denial. In order to appeal a claim denial, you need to send an appeal to the Oregon Workers’ Compensation Board.
What Is the Purpose of the Workers’ Compensation Board?
Unfortunately, denied claims are common. In fact, almost 15% of initial injury claims are denied in the state of Oregon. Claims that refer to repetitive-use conditions or noise-related hearing loss are denied almost 33% of the time.
Just because your claim has been denied doesn’t mean you’re not entitled to benefits. You should fight for your rights and interests. That’s why there is a process in place to allow workers to appeal denied claims by requesting a hearing with the Oregon Workers’ Compensation Board. This board exists for the purpose of providing impartial dispute resolution under the state’s workers’ compensation law.
What Divisions Make Up The Board?
The Workers’ Compensation Board is comprised of three divisions: the Hearings Division, the Board Review Division, and the Administrative Services Division.
The Hearings Division handles the resolution of Oregon’s workers’ comp and Oregon Occupational Safety and Health Administration (OSHA) disputes. In the Hearings Division, administrative law judges conduct contested case hearings and provide alternative dispute resolution – such as through mediation services. The Hearings Division maintains four offices, located in Portland, Salem, Eugene, and Medford.
If your claim was denied, and you’ve appealed the denial, your task is to prove your case in your hearing. Hiring a knowledgeable Oregon-based workers’ comp attorney greatly increases your chance of successfully arguing and winning your case.
Board Review Division
The Board Review Division provides resolution of disputes appealed from its’ Hearings Division, in addition to conducting a variety of other dispute-resolution functions. If the decision of an administrative law judge in the Hearings Division is appealed, the Board Review Division handles this appeal.
The Workers’ Compensation Board consists of five full-time members, two of whom have a background in the concerns of employees, another two of whom have a background in the concerns of employers, and one chairperson tasked with representing the public interest.
Administrative Services Division
The Administrative Services Division provides support to both the Hearings and Board Review divisions of the Oregon Workers’ Compensation Board. Functions performed by the Administrative Services Division include docket, hearing noise production, interpreter services, litigation coding, and record retention. In addition, it also handles contracts and billing, mail processing, payroll, and other administrative tasks.
Was Your Workers’ Compensation Claim Unfairly Denied? Get Tough, Knowledgeable Representation With RGMR!
If you’ve suffered a workplace injury or illness and your claim has been denied, the last thing you need is to have to deal with complicated legal jargon and a frustrating dispute process on your own. There are too many instances of employers and insurers trying to deny injured workers the benefits they rightly and legally deserve.
At Ransom, Gilbertson, Martin, and Ratliff, LLP, we understand how difficult and frustrating this process can be. We have over 70 years of combined experience with workers’ comp cases. We’re here to offer you expert representation and help you fight for your interests, even when it feels like the system is stacked against you.
We offer free consultations and we never charge you anything unless we win your case. Contact us today to get the representation you deserve!