CategoryWorkers' Compensation: Q/A - Philip Garrow LLC
What Do I Do If I am Unemployed After a Work Injury
Q: After my work injury, I was “let go” by my employer. Was that legal? If so, is there anything you can do to help me get back to work?
A: The answer to your first question is complicated. The second question is a little easier. The law in Oregon requires an employer to reinstate an injured worker if the worker is either released to return to his or her regular work or another job which is “available and suitable.” That means if you can do your normal work, you must be reinstated. If you can’t do your regular work, and the employer does not have another, physically suitable job available, they are not required to create a permanent job within your physical limitations. You do have other options if you have suffered a work injury, however. The law requires Workers’ Compensation insurers to assist injured workers in returning to the workforce. Therefore, retraining, or Vocational Rehabilitation benefits may be available to help you. Check with an experienced attorney to understand your rights. If you believe you were unfairly terminated from your job, possibly relating to a work injury, you can also contact the Bureau of Labor and Industries for advice. Or, contact a legal professional today!
Worker’s Compensation Claims and Pre-Existing Conditions
Q: I was injured on the job. I received a letter from the insurance company that said they accepted my claim. However, my doctor says I need injections in my back but the insurance company says they will not pay. They say the injections are not related to my injury. I did not have a problem until I got hurt on the job. What can I do?
A: The law says that workers’ compensation insurance companies are responsible to pay for all treatment related to a work injury. Many times an insurance company tries to limit its liability by accepting a lesser condition, such as a lumbar strain, when your doctor says you have a herniated disc, nerve, or similar problem. Consequently, workers’ compensation insurance companies sometimes deny payment for necessary medical treatment. You can appeal the insurance company’s denial with the help of the Workers’ Compensation Department. You can also seek legal assistance at no cost to you. Attorney fees are paid by the insurance company. Recent changes from the Oregon Courts require insurance companies to be responsible for any medical treatment caused by the work injury, whether or not you have “pre existing” conditions. Contact the Oregon Workers’ Compensation Department, Injured Worker’s Hotline or an attorney experienced in handling workers’ compensation cases to help you get your medical treatment.
Contact a legal professional today for assistance.
Am I Too Young to Receive Social Security Disability Insurance Benefits?
Q: I went to apply for Disability benefits and was told I was “too young.” I am 45 years old and have worked in construction most of my life. I have had two back surgeries and my doctor says I will never be able to return to construction work. I don’t have the education or training for other work. I thought Social Security Disability would cover me or anyone who cannot go back to work.
A: Anyone who has worked long enough can apply for Social Security Disability Insurance benefits. If you have applied and been denied, file an appeal and ask that the Social Security Administration (SSA) reconsider its denial. You can get assistance with your appeal if necessary. Appeals have strict deadlines, so act promptly. The Social Security disability insurance program is designed to assist anyone who, because of injury or illness, is unable to return to work. The program is based on Federal Law which requires the SSA to consider medical considerations and opinions, as well as your age, education, and work experience. SSA regulations state that an individual under age 50 who can return to some other kind of work will be found not disabled. That same individual who is over 50 may be considered disabled. It depends on the person’s ability to adapt to other kinds of less demanding work. In addition to filing an appeal, you can contact the Oregon State Employment Department or the Vocational Rehabilitation Division and see if they can provide retraining or return to work help.
Contact a legal professional to evaluate your case at no charge.
Happy Birthday Social Security
This month marks Social Security’s 80th birthday (as well as the 50th anniversary of the Medicare and Medicaid programs). Franklin D. Roosevelt signed the Social Security retirement program into law in 1935. Benefits for dependent survivors were added in 1939. In 1956, disability insurance benefits were added. The Medicare and Medicaid programs were created in 1965.
Today, nearly 65 million American men, women and children receive benefits from the various Social Security programs, including retirement, disability, children’s benefits and SSI. According to the most current data from the SSA, the average retired worker receives about $1,335 per month and the average disabled worker about $1,165 per month. Not much to live on, but life-saving for many beneficiaries.
Social Security benefits play a vital role in reducing poverty. Without Social Security, more than 22 million more Americans would be poor according to the latest Census data. Most of those are elderly but nearly 1/3 are under age 65.
Last month the Social Security Board of Trustees released its annual report on the long-term financial status of the Social Security Trust Funds. The combined assets of the Old-Age and Survivors Insurance and Disability Insurance Trust Funds are projected to become depleted in 2034, with 79 percent of benefits payable at that time. Congress needs to act, and act now, to keep these vital programs intact. Let your Congressional representatives, and candidates for public office, know how important this issue is the country, its elderly and disabled. We want Social Security to continue to celebrate its anniversaries for years to come.
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Social Security Benefits and Worker’s Compensation Benefits Q/A
Q: I am over 60, and disabled from an on-the-job injury. I was just awarded Social Security disability benefits, but those benefits are reduced by more than $1,000 per month because of my workers’ compensation benefits. Is this correct? Is there anything I can do about it?
A: Federal law requires Social Security to reduce your disability benefit if you are also receiving workers’ compensation benefits. However, if you are 62 years or older, you have another option. You can stop your disability benefit and opt to receive your early retirement benefits with no offset because of your workers’ compensation benefit. Once your workers’ compensation claim settles, you can then resume receiving your Social Security Disability Benefits with no offset. The law here is complicated. There are other factors that may influence your decision.
Worker’s Compensation Claim Insurance Question
Q: I filed a workers’ compensation claim for an injury to my hands. The insurance company wants to know every job I have had my entire life and is scheduling me to see one of their doctors. What is going on and do I have to cooperate?
A: Oregon Workers’ Compensation Claim law allows insurers up to 60 days to make a decision about accepting a claim. That means within 60 days after you filed your claim, the insurance company is required to do its investigation, which typically includes taking your statement, getting your medical records, and sometimes scheduling a medical appointment. Insurance companies can choose the doctor they send you to. Unfortunately, most of these doctors have an insurance bias and do not always agree with your doctors regarding the nature of your injury and its relationship to your work activities. By law, the injured worker has a duty to cooperate with the insurer’s investigation which usually means giving truthful and complete answers to the insurer’s questions, provided they are relevant to the claim, and obtaining an evaluation arranged by the insurer. You have the right to be represented, at no charge to you, during this process. The insurance companies are required to pay the injured worker’s attorney fees.
If you have questions, contact an attorney
What If My Insurance Company Denies my Work Injury Claim?
Q: I was in a serious accident when I fell off a ladder at work. Now my doctor wants to do back surgery to repair a ruptured disc. He says any more delay may leave me with permanent damage. The insurance company refuses to approve surgery, because their doctor says I have “pre-existing conditions.” My doctor disagrees. Is there anything I can do?
A: Yes, there is. If the insurance company denies any part of your claim or refuses to pay for treatment, you can appeal that decision, usually to a workers’ compensation judge. There is often a strict deadline to take action, so getting help quickly is in your best interests. If your doctor believes surgery is necessary, and sooner rather than later, you should be able to have your health insurance pay while you appeal the workers’ compensation denial. If you don’t have health insurance you may be able to receive help from the Oregon Health Plan or the Seniors and Disabled Services Division of the State of Oregon. Since the insurer will be represented by an attorney, you should get legal advice as well. State law requires workers’ compensation insurers to pay attorney fees for injured workers.
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Do You Qualify for Social Security Disability Insurance?
Q: I was injured on the job and received 30% disability. I can’t go back to my former job. Do I qualify for Social Security Disability Insurance?
A: Social Security Disability Insurance Benefits (SSDIB) are available to anyone who, as a result of his or her disabling injuries or medical conditions, is not able to return to work. You may qualify for SSDIB if your doctors indicate you are unable to return to your regular work and due to your medical conditions, age, education, and work experience there are no other available jobs you can perform. You can contact your local Social Security office for help filing a Social Security Disability Insurance claim, or go online at ssa.gov. Social Security will get your medical records and determine whether you qualify for benefits. If your claim is denied, you can get help from an attorney at no charge to you unless you receive your Social Security Disability benefits.
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Is It Too Late to File a Workers Compensation Claim?
Q: I got hurt on the job. My employer told me not to file a Workers’ Compensation claim and he paid my doctor bills. Now, my doctor says I need surgery and my employer won’t help. Is it too late to file a Workers’ Compensation claim?
A: No. It may not be too late. The law requires all Oregon employers to carry insurance to cover the job injuries. Some employers discourage their employees from filing claims for financial reasons, but if you were hurt on the job you can make a Worker’s Compensation claim including medical benefits. Generally, a notice of injury should be made as soon as possible, even if you don’t go to the doctor right away, but at least within 90 days of the accident. If your employer had notice of the injury, you may have up to a year to file a claim. You should contact someone experienced in handling on-the-job injury claims as soon as possible because there are some time limits that cannot be missed. The State of Oregon Workers’ Compensation Division also has people who can advise you how to file a Workers’ Compensation claim.
For assistance, contact a legal professional today!
Work Accidents: Worker’s Compensation Claims
Q: I was seriously hurt when a crane operator failed to properly secure a load, which fell and knocked me off a roof. I have multiple broken bones and probably won’t be able to return to my construction job. I am in considerable pain and my life will never be the same. Am I out of luck?
A: You are definitely not out of luck. Under these circumstances, you are protected by workers’ compensation laws. The workers’ compensation insurer is required to pay your bills and pay you lost wages while you recover from your injuries. You are likely eligible for vocational retraining to get you back to work at a new job which considers your new physical limitations. You may also eligible for Social Security benefits while you recover from your injuries, if you are off work for 12 months. And you may be protected by Employers’ Liability laws which protect workers from the negligence of third parties and other workers on the job site.