Workers’ Compensation Claims Process
Facing a Mysterious Legal Process Doesn’t Have to Be Hard
As an employee, you work hard to perform your daily tasks responsibly and efficiently to meet deadlines. Your job is important, and you know how it is done.
But what happens when you get injured on the job?
Can you file a workers’ compensation claim? What is the process like? How many steps are involved? Do you need an attorney?
After more than 20 years of helping injured workers navigate through the complicated workers’ compensation system, the highly experienced and knowledgeable attorneys at Ransom Gilbertson Martin & Ratliff (RGMR) are here to help you every step of the way!
What is a Workers’ Compensation Claim?
A workers’ compensation claim is filed to protect an employee’s financial interests in the event that they suffer an injury while on the job. Any employee in Oregon that’s been hurt is eligible to apply. The claims process can be difficult to understand so we broke down the process into clear steps in our workers’ comp claims process guide.
What Injuries Qualify?
The following types of injuries almost always qualify:
- Injuries that need medical treatment
- Injuries that result in time away from work
- Injuries that require rehabilitation or vocational retraining
- Injuries that cause disability
If you’ve experienced financial, physical, or emotional pain because of an injury like these, you’re not alone. We’re here to help.
What is the Workers’ Compensation Process From Start To Finish
Step 1: File a Workers’ Comp Claim
Your claim starts with an injury or disease that requires medical treatment of time away from work. A claim is filed when your employer has notice of an on-the-job accident resulting in an injury. Notices must be given and it does not have to be in writing. However, it is best to complete the paperwork for your employer as soon as possible. Once you give notice of a claim, your employer should provide you with the 801 “Report of Job Injury or Illness” form. If your employer does not provide you with the proper form, you can download a copy of it from the state’s website. Need help filing a claim? Our attorneys can help you!
Step 3: Claim Gets Investigated
The vast majority of workers’ comp claims are legitimate; however, insurance companies like SAIF still investigate your claim and have 60 days to accept or deny your claim. While they investigate, you can get paid for missing work if you have in writing your doctor’s permission to be away from your regular work. The claim investigation may include taking a statement from you, and you are required to cooperate.
Often, SAIF and other insurance companies will also choose a physician to conduct an independent medical exam to confirm your claim. Keep in mind that companies will sometimes choose doctors that have a bias against your particular injury or illness to avoid giving you benefits. For example, some IME doctors actually believe all back injuries, except for strains and fractures, are caused by the aging process and/or degenerative disc disease.
Additionally, some may deny your claim stating that your injury was due to a preexisting condition. Know what to expect and how to prepare for your independent medical exam in our complete guide. Our job is to fight for your interests and prevent companies from short-changing you or wrongfully denying your claim.
Step 2: See a Doctor
The second step is to see a doctor. This must be a medical doctor (MD), osteopathic doctor (DO), or podiatric physician. A chiropractor can only serve as an attending physician for 60 days. In many cases, you can choose your own doctor. However, the insurance company may require you to choose a doctor from a managed care organization (MCO) panel. If you don’t like the doctor you have, you can change doctors at least 3 times.
Step 4: Claim is Approved or Denied
Once you’ve notified your employer and attended your medical exams, the insurance company will either accept your claim and award you benefits or deny your claim, leaving you with no compensation.
If your claim is denied, you and your attorney will need to appeal the denial to the Workers’ Compensation Board, and it must be filed within 60 days.
The Board will consider the following when reviewing your case:
- The circumstances of your injury
- Your story and any witness testimonies
- Medical opinions and records from all doctors, including your attending physician.
You will receive a written notice of the decision.
Step 5: Receive Workers’ Comp Benefits If Claim Is Approved
If you win at a hearing, or if your claim has already been accepted, you can get workers’ compensation benefits. These benefits include medical treatment, wage replacement benefits called temporary disability, permanent partial disability, vocational retraining benefits, and more.
How We Can Help
If you have suffered a work-related injury, you have the right to seek compensation. At Ransom, Gilbertson, Martin & Ratliff, LLP, we don’t charge legal fees and only get paid if you win your case. That means that every consultation you have with us is free, including your first one.
Our attorneys are here to listen to you, help you understand your rights, and fight for the benefits you deserve. We strongly believe you should get fair compensation, and we never back away from a challenging case.