My Employer Has Denied My Claim, What Do I Do?

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My Employer Has Denied My Claim, What Do I Do?

If a claim is denied, the injured worker gets a letter from the insurer telling him or her why the claim is denied and about the right to appeal the denial to the Hearings Division of the Workers` Compensation Board. If a claim is accepted, the letter from the insurer will be a notice of acceptance specifying the medical conditions that will be covered under the claim. Workers` Compensation Board oversees the claims handling process, ensuring that it is done accurately and in a timely manner. Throughout the claims process, injured workers are informed about what to do and who to contact if they disagree with a decision or some other aspect of how their claims are being handled.

Either the insurer or an injured worker may request mediation services from Workers` Compensation Board or the Workers` Compensation Board if they dispute a claim issue; either the insurer or an injured or ill worker has the right to request a hearing or an administrative review. Some issues must be appealed to Workers` Compensation Board before going to the Workers` Compensation Board. During the appeals process, the insurer will have a lawyer; injured workers may also hire lawyers, with fees paid out of or in addition to the compensation awarded.

An injured worker may also contact The Office of the Ombudsman, which was established for Injured Workers as an independent advocate for Oregon`s injured workers and reports only to the director of the Department of Consumer & Business Services. The ombudsman`s office helps injured workers dealing with the workers` compensation system.

For further information, you can contact the Workers` Compensation Division at the address or phone number below.

Workers` Compensation Division
350 Winter St. NE, Rm. 27
Salem OR 973013879

Division Reception (503) 9477810
Workers` Compensation Infoline (toll free in Oregon)
18004520288

Other Oregon Workers' Compensation FAQs

Q: How Long After An Injury Do I Have To Report It To My Employer?
A: Within 90 days a worker or workers` dependent must notify the employer of a work related injury (up to one year if the employer had knowledge of the injury or the … More
Q: How Do I Know If My Employer Is Covered By Workers' Compensation?
A: Every employer employing one or more workers in the state is subject to workers` compensation. The State of Oregon requires almost all employers to carry workers` … More
Q: What Workers' Compensation Benefits Am I Entitled To?
A: A worker temporarily or permanently disabled by an accepted workrelated injury may receive payment from the workers` compensation insurer for medical treatment, … More
Q: If I Am Injured On The Job Can I Choose The Doctor Who Treats Me?
A: Unless the insurer has enrolled you in a managed care organization, you may treat with any doctor who qualifies as an attending physician under Oregon law. Your doctor … More
Q: When Will My Benefits Begin And How Much Will They Be?
A: You will not be paid for the first three calendar days you are off work unless you remain unable to work for 14 consecutive days or are hospitalized as an inpatient … More
Q: If I Am Unable To Return To The Type Of Work I Did Before I Was Injured, What Happens?
A: Most Oregon employers are required to return you to your job or another suitable job after your doctor releases you to work. The insurer will send you written notice … More