Injured on the job? You’re entitled to benefits through your state workers’ compensation system. But all too often, the system is a maze — full of dead ends where you can lose out on medical treatment or disability benefits. How can you avoid those missteps if you’re hurt at work? The Labor Press sought advice from workers’ compensation attorneys Chris Frost of Portland-based firm Thomas, Coon, Newton & Frost and Doug Palmer of the Vancouver-based firm Hamrick Palmer Johansen. The programs in Oregon and Washington have some differences, but the advice below applies to both states.
Don’t let your boss pick your doctor.
Employers often try to pick the clinic or doctor that a worker visits after an on-the-job injury, steering employees toward providers who will close claims quickly — and cheaply, for the employer. “It’s against the law for them to direct your medical care,” Frost said. “The problem is a lot of employers do it all the time.”
You’re entitled to pick your own provider. Immediate treatment can be at your regular health care provider, an urgent care clinic, or a hospital emergency room. Just make sure you tell the doctor that you’re there because of a work-related injury. Your primary care doctor is often the best choice because they know what your condition was before the injury, but many primary care providers won’t see patients for workers’ compensation claims. If you can’t use your primary care doctor, go to an urgent care clinic for an initial visit.
For continuing care, look at online reviews to find a physiatrist or occupational medicine clinic, Frost said. Palmer also recommends looking for a chiropractor.
If your employer’s workers’ compensation insurer enrolls you in a managed care organization (MCO), you will have to get care from a provider in the MCO’s network or get your provider to temporarily join the MCO. Most Washington employers get workers’ comp insurance from the Washington State Department of Labor & Industries (L&I), which has its own network.
Keep your doctor’s exam private.
Employers sometimes send their safety manager to the doctor with a worker after a significant injury. It’s fine for them to accompany you to the doctor’s office, but you don’t have to let them come into the exam room. When representatives of the employer sit in on the appointment, they sometimes push the doctor to alter the injured worker’s work restriction, which can harm the worker’s claim later on, Frost said.
Report even minor injuries.
“Most injuries aren’t where you get your finger cut off or you have a massive accident where something is majorly wrong,” Frost said. More often, a worker will feel a pop in their back or knee. They’ll tweak something, but they won’t say anything and will just hope that it goes away. The problem is three or four weeks or three months later, when the pain still hasn’t gone away and the worker decides to seek treatment, the employer will hold the fact that they didn’t make an incident report against them, Frost said. Workers don’t need to file a formal claim every time they feel a twinge in their shoulder, but they should at least make a report — in writing — to their supervisor.
When you seek medical care, make sure all parts of an injury are documented. That might require multiple appointments because short appointment time slots often only give a doctor enough time to assess one part of the injury, Palmer said. A concussion might be the most severe injury from your fall, but if your elbow pain isn’t also documented in initial appointments, you could have a hard time getting treatment covered later on.
Read (and save) the paperwork.
The system bombards you with paperwork, so it can feel overwhelming. But if you’ve filed a claim, make sure you read over anything labeled a “notice of acceptance of claim” or “notice of closure” and confirm that the listed diagnosis matches the true extent of your injury. Frost had a client who suffered a herniated disk and required surgery, but the insurer only accepted the claim for a cervical strain. Another client spent two months in a medically-induced coma for a traumatic brain injury, but the insurer accepted his claim for a head contusion. If you receive a notice that your claim has been denied or closed, contact a lawyer quickly, since you only have 60 to appeal.
Palmer recommends making copies of documentation you receive about your claim, doctor’s notes, and paystubs from recent months (which may be used to determine your time loss benefits). A photo of the document is also fine.
Don’t be afraid to ask for help.
If you run into problems getting your medical care covered, getting compensated for lost wages while recovering, or getting approved for permanent disability, you can contact the Ombuds Office for Oregon Workers or an attorney. The Oregon State Bar’s Lawyer Referral Service can help you find a lawyer, as can bar associations for some counties in Washington. Attorneys who handle workers’ compensation cases typically do not charge a fee for an initial consultation.
For a more comprehensive explanation of the workers’ compensation system, visit wcd.oregon.gov/worker in Oregon and lni.wa.gov/claims in Washington.
