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)

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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