22 NW 23rd Place, Suite 203 Portland, Or. 97210

EXPERIENCE MATTERS

Probably! The insurance company knows the system in-and-out, but they don’t have your best interest in mind. You need someone on your side that knows as much as they do. 

The most common things that happen in a WC case where you should talk to a lawyer are the following: 

1. Your case is denied. You were injured, made a claim, and you received a denial in the mail. You have to appeal that denial within 60-daysso time is of the essence! By appealing, you’re asserting that the denial was wrong, and you want a judge to decide the matter, so you’ll want a lawyer to guide you. 

2. Your case has been accepted, but now something else is being denied. Maybe they accepted your claim for a “strain” but denied the more serious injury? Maybe there’s some treatment you need that’s been denied? There are a lot of things that can happen in a WC case, even if your claim as been “accepted.” If the insurance company says they won’t do something for you, you should think about talking to a lawyer. 

3. Your lost wages stopped coming. There are a LOT of rules about when, and how, lost wages are supposed to be paid. If you were hurt on the job and you’re not getting lost wages from the WC insurer, consult an attorney immediately

4. Your claim as been “closed”. This is a normal part of the process, and not has permanent as the papers make it seem. However, when it happens there may be good reason to appeal it, and you only have 60-days, so it’s a good time to consult an attorney. 

If you have general questions about the system and how it works, the Ombudsman for Injured Workers is a State agency created to help. They can’t give legal advice, but they are amazing people who work tirelessly to educate and help injured workers. They can be reached at 503-378-3351. 

No! There’s a lot of Important things that happen quick after a collision, the biggest of which is that you need to start medical treatment. The benefit to calling a lawyer sooner, rather than waiting, is that we can help get you to medical treatment that will actually help and not just drain your PIP/med-pay bucket. 

Also, it’s not uncommon for insurers to try to get statements, “evidence” and even dangle low-ball settlement offers. If you’ve just been hurt in an accident, you’ll want someone who’s clear-headed to advocate for you so you can focus on getting better.

Maybe, but probably not. Being injured is the key driver for the need for representation. That said, Oregon does allow “diminished value” claims, which is where there’s a difference between the value of your car before the wreck, and after it gets fixed. If you have a newish car with substantial damage, consider calling an attorney.

Absolutely! I love meeting my clients in-person. New client meetings, hearing prep, recorded statements…all benefit from being in person, despite most also being just fine over the phone. It’s really your preference as to how and when we connect. 

If you’d like to meet in person, it can easily be arranged by my scheduler (HERE). Please note that if you’re looking for representation, please start the process on the Contact page. 

My office is comfortable and easily accessible. It’s located just off I-5 on Corbett, between the South Waterfront and OHSU. There’s plenty of street parking available and no stairs to worry about. 

Regarding Covid, I am fully vaccinated and will be happy to wear a mask as well at your request.  

The WC system is the exclusive remedy for workers injured on the job. This means that if you’re hurt on the job, you have to start with the workers’ compensation system. Fundamentally, it’s an insurance coverage that your employer must carry. When a worker is hurt on the job, the insurer that their employer has a policy with will “process” the claim. If an injured worker’s claim is “accepted,” the WC insurer will provide benefits including payment of medical bills and lost wages, and potentially including compensation for permanent disability and vocational retraining if applicable. The system also provides benefits for workers (and their families or “dependents”) who lose their life on the job.

 

As a claimant, you are potentially entitled to receive each of these benefits, so long as the essential prerequisites are met. Determining whether or not you meet these requirements is not always clear. This is where we come in.

Anyone injured at work should seek medical treatment immediately.

After that, you need to give sufficient notice to your employer (i.e., human resources, your supervisor, the safety officer/director, or anyone with direct supervisory authority over you to whom you report), letting them know you suffered a work-related injury. Employees must provide this notice within 90 days of the date of injury. Please note that if you wait too long, you could be barred from pursuing the claim. Such notice can be given by telling a supervisor, preferably in writing, that you suffered a work-related injury. 

Once you report the injury your employer should give you a Form 801. If you’re at the hospital or urgent care they will probably give you a Form 827. Both forms do the same thing. They are simple, 1-page documents that “make” your claim.

Once a claim is made, the insurance company has 60 days to investigate and decide if they are going to “accept” your claim. During an investigation, they will usually take recorded statements from the claimant and any witnesses, and collect information from an independent medical examination (IME). Please note that you have the right to have an attorney present during your recorded statement, and you may bring an observer with you to your IME. This 60-day period is called “deferred status.”

During that 60-days that the insurance company has to think it over, if your doctor has taken you off work for the work injury the insurance company has to start paying you temporary disability (wage replacement).

If the insurer accepts your claim, great! Benefits will commence and (hopefully) it will be smooth sailing. If they deny your claim, you ought to be calling us. Denials must be appealed within 60 days!

Both claim acceptance and claim denial will be done in the form of a letter, so watch your mail. If you don’t get a letter and more than 60-days has passed, you can assume the claim is denied and call us about representation.

Short answer: probably not. If you are injured due to the negligence of your employer or your co-worker, you cannot sue your employer for your personal injuries. Rather, your sole and exclusive remedy for any such injuries is the workers’ compensation system. However, there are some notable exceptions to this “Exclusive Remedy” Doctrine, such as: 

Intentional injuries: if your injuries were due in substantial part due to the willful and unprovoked aggression by a co-worker or employer, then you may be able to sue that person for intentional tort.

Red-tagged equipment: if OSHA if has posted a red warning notice on a machine, device, apparatus, or equipment, and your employer requires you to use it before they make it safe, then you may be able to bring a personal injury action against your employer.

Non-complying employers: if you were injured while working for an employer that was not carrying required workers’ compensation insurance, you can not only bring a personal injury claim, you can also file a workers’ compensation claim.

Third-Party Claims: if you were injured at work by some negligent third-party who is unassociated with your employment, a viable third-party personal injury claim can be filed.

Yes. To receive appropriate medical care and temporary disability payments, you will need to establish yourself as a patient of an “attending physician,” who will work with you during your recovery. Your attending physician (AP) is the medical provider primarily in charge of directing the care and treatment of your work-related injury. If you are unable to perform your full work duties, your AP may issue off-work or light-duty work restrictions. It is your responsibility to get these restrictions to your employer in a timely manner. 

Additionally, if your claim is denied, you will likely need a doctor to provide “medical evidence” that your claim is “compensable.” Medical evidence is vital to a claim’s success and it’s vital to have a medical provider—preferably an MD or DO—“on your side.” A doctor that will treat you like a human, and not a number, and will stand up for you. The insurance company will hire a doctor to say that your injury is not from work, so you need someone on your side to stand up against that. As lawyers, there is little we can do if you don’t have medical evidence to support your claim.

Contact Aldrich & Brunot, LLC, immediately.  If the workers’ compensation insurer denies your claim, you have 60 days from the date of the issuance of the denial to request a hearing before the Workers’ Compensation Board (WCB). Do not let your denial become final by waiting more than 60 days to request a hearing. Remember, you have the right to have a lawyer represent your claim. Having legal representation to litigate the denial can prove invaluable in obtaining fair compensation. Keep in mind, the insurer will undoubtedly have legal counsel on their side as well. 

If you receive a denial and our team can help you get the hearing requested promptly.

No. We are only allowed to be paid a fee if and when and how the law says. All lawyers that represent injured workers across Oregon get paid the same way. 

Fundamentally, clients are never responsible for attorney fee. You will never get a bill from us for an attorney fee. However, clients are responsible for “costs” which is money our firm pays out administratively and to medical experts (usually, your treating medical providers).

Lawyers who choose to represent claimants in Oregon’s workers’ compensation system only get paid if they are instrumental in obtaining compensation for the injured worker. If your lawyer is not successful, you owe the lawyer nothing. Any payments for workers’ compensation legal help come in two variations: assessed fees and out-of-compensation fees.

Assessed fees: If you receive a denial of compensation (claim denial, temporary disability or medical dispute), and your attorney is successful in getting the denial set aside, the insurer will be ordered to pay your attorney directly for his or her services.

Out-of-Compensation fees: If your lawyer helps you settle your claim, your lawyer will receive a portion of your settlement. This variation looks like the standard contingency fee award in other legal settlements. Currently, this contingency fee is currently defined by Workers’ Compensation Board rule to be 25% of the first $50,000 of any settlement, and only 10% of all proceeds above $50,000.

If the insurer issues a Notice of Closure (NOC), you have 60 days from the date of its issuance to request reconsideration of the NOC by the Workers’ Compensation Division (WCD). Reconsideration is, in essence, an audit of the NOC. The WCD may rescind, modify, or affirm the insurer’s NOC. The WCD will review your file to make sure your accepted conditions were, in fact, medically stationary, you were paid temporary disability for all periods of entitlement, and your permanent disability award, if any, was accurately calculated. The WCD’s findings will be contained in a document that will be issued upon the audit, called an order on reconsideration. If you have received a NOC, please contact our office and we will be glad to help you submit reconsideration paperwork to the WCD.

 

If we obtain more benefits for you upon reconsideration from a Notice of Closure, we will receive 10% of only the increase in those benefits.

Lost wages are referred to as “temporary disability” (“TD”). Your entitlement to TD depends on a lot of factors and can be quite a complicated analysis. The first step in the analysis is that you have a work restriction from an attending physician authorized to act in that capacity under Oregon law. The second step in the analysis is that those restrictions remove you from work entirely or are so restrictive that your employer cannot accommodate those restrictions. 

Generally, if your claim is open and you have a current authorization for off-work or light-duty restrictions from your attending physician, you should be receiving TD payments every 14 days. Sometimes TD payments stop because your doctor released you to full duty, or your work restriction expires. Sometimes they stop for no good reason like negligence or mistake on the of the insurer’s claim adjuster. If you were getting TD and those payments stopped, then you should receive a letter from the insurance company with some kind of explanation.

In any event, your entitlement to TD requires careful analysis of your case. So, if your TD hasn’t timely started, , or are of the wrong amount, call us.

If you have a denied claim, then no medical treatment will be provided at all. You likely need the services of a lawyer. 

However, if your claim is accepted and the insurer is not paying for medical treatment, it is sometimes because they think your injury was just a “sprain” or a “strain” or a “contusion” despite your doctor telling you that you have a more significant condition, like a ligament tear or herniation, fracture, etc… They believe they only have to pay for whatever condition they “accept” as listed on your Notice of Acceptance. So, if they are calling your injury a “shoulder strain” but your doctor is telling you it’s a “rotator cuff tear” and wants to do surgery, then the insurance isn’t going to pay for it because you don’t need a surgery for a “strain.”

If you have an accepted claim and medical treatment is being denied. Call us.