November 11, 2011

How to Appeal a Workers' Compensation Denial

So, you were injured at work and you have now received a denial in the mail and are wondering what to do.  The denial will be in the form of a letter and will look something like this:

Dear Ms. Smith, 
After investigating your claim for an injury to your low back occurring on January 1, 2011, we are denying your claim for workers' compensation benefits....

Below this will be language in bold caps explaining how to appeal the denial.  However, that language can be a little confusing.  The most important thing to remember is that you have 60 days from the mailing date of the denial to appeal.  You can technically appeal it on your own, but it is much smarter to retain a workers' compensation attorney.  Oregon law requires that workers' comp attorneys work on contingency, which means they are not paid unless they obtain additional workers' compensation benefits for you.  The attorney fee will not come out of your benefits when the attorney helps you overturn a denial.  Because it will cost you nothing to have an attorney help you with your workers' compensation denial, it is very likely worth it to retain one.

If you would like to talk to an attorney, or have any questions about appealing your workers' compensation claim denial call the Alana C. DiCicco law firm at 503-975-5535 or post a response to this blog.  All consultations with workers' comp attorneys are free.  More information can also be found at www.oregonworkinjury.com

Why Was My Workers' Comp Claim Denied?

There are lots of reasons that insurance companies deny workers' compensation claims, but usually it is about money.  For example, most stress claims are denied as a matter of course.  They are difficult claims for the worker to prove and insurance companies save money by denying most stress claims.  The idea is that only a certain number of the claim denials will be appealed and only a certain number of the appealed denials will be overturned by the Workers' Compensation Board.

However, sometimes claims are denied for other reasons.  Maybe there were no witnesses to the injury, or the employer has some reason to believe the injury occurred outside of work.  Often, a workers' compensation claim will be denied if the insurance company suspects you have a preexisting condition that is the major cause of your new injury or occupational disease.

The most important thing to remember is that it is always worth it to retain a workers' compensation attorney and appeal your denial.  This is true even if you are not sure about your chances of having the workers' compensation claim denial overturned.  A workers' compensation attorney can help you gather evidence to support your case or negotiate a financial settlement if you do not want to have a hearing before the Workers' Compensation Board.

If you have a denied workers' compensation claim and have questions, or want to appeal it, you can post a question to this blog or call my law firm at 503-975-5535.  Consultations by phone or in the office are always free.

Additional information about denied workers' compensation claims can be found at www.oregonworkinjury.com

June 1, 2011

Why Are Workers' Compensation Claims Denied?

Insurance companies deny workers' compensation claims for a variety of reasons.  In my experience as a workers' compensation attorney, these fall into several categories.

Some claims are denied because the employer has a reason to believe (often incorrectly) that the injury did not occur at work.  A good example of this might be that your boss knew you were moving furniture over the weekend and you report a back injury claim on Monday.  They may believe you are lying about the back injury occurring at work.  Although these types of denials are common, they are usually fairly easy to overcome.  Workers' compensation judges will listen to your story and will believe your version of events unless there is a strong reason not to.

Another common reason for denying workers' compensation claims is when the insurer determines that work is not the main cause of your injury.  Sometimes this is based upon the doctors' chart notes and sometimes it is really just a gut call by the insurance adjuster.  The basis for these types of denials is not that you did not have a work injury, but that the major cause of the work injury is something aside from your work activities.  A common example is when a worker lifts something heavy at work and injures his or her back.  The doctor takes an MRI and finds a disc herniation, but also arthritis in the worker's back.  If the insurance company can prove that the work injury "combined" with the arthritis in the worker's back, AND that the major contributing cause of the disc herniation and need for treatment was the arthritis, their denial will be upheld.  However, keep in mind that these denials are overturned all the time.  Also, even if you cannot get the denial overturned, a workers' compensation attorney may be able to help you negotiate a settlement.

Finally, some denials are simply because the insurance company does not believe you have enough evidence to prove that you were injured at work.  These are usually the easiest type of denial to overcome.  In fact, the insurance companies will sometimes even withdraw the denial prior to a hearing if your workers' compensation attorney is able to provide enough evidence of your injury.

The most important thing to remember if you have a denied workers' compensation claim, is that denials are overturned all the time.  Even if you settle your case prior to going to a workers' compensation hearing, it is worth it to have your attorney appeal the denial.

If you have any other questions about appealing workers' compensation claim denials, visit us at www.oregonworkinjury.com and set up a free consultation.

February 28, 2011

Deadly Work Injuries Throughout American History








Here is a scary bit of history:
The new Pemberton Mill
Public Domain

The new Pemberton Mill
January 10, 1860
Lawrence, Massachusetts
The Pemberton Mill, a large cotton goods factory, collapses without warning, killing an estimated 145 workers and injuring another 166. It is one of the worst industrial accidents in the state's history.

May 2, 1878
Minneapolis, Minnesota
Flour dust inside the Washburn Mill ignites, causing an explosion that levels the seven-and-a-half story building and blows the roof several hundred feet into the air. Eighteen workers die.

May 1, 1900
Scofield, Utah
Two hundred men in a Pleasant Valley Coal Company mine lose their lives when 24 kegs of black powder accidentally explode.

March 20, 1902
Brockton, Massachusetts
Following a boiler explosion, the four-story wooden R.B. Grover Company's shoe factory collapses and bursts into flames, burning workers trapped in the wreckage. Fifty-eight people die, and 150 are injured.

May 19, 1902
Coal Creek, Tennessee
An explosion at Fraterville Coal Mine takes the lives of at least 184 men and boys. The cause was most likely a build up of methane gas.

December 6, 1907
Monongah, West Virginia
In the worst mining disaster in American history, an underground explosion kills 362 out of the 380 men and boys working that day.

January 20, 1909
Lake Michigan, Chicago, Illinois
Approximately 60 workers constructing a water intake tunnel a mile offshore die after a powder magazine explodes. Made entirely of wood, their living quarters quickly catch fire, and the flames spread throughout the construction site trapping the men between the fire and the ice-filled water.

May 5, 1910
Palos, Alabama
A coalmine explosion traps 145 men, more than 80 of whom die.

Triangle Fire
New York Times

Victims of the Fire
March 25, 1911
New York, New York
Workers at the Triangle Shirtwaist Factory become trapped after a tossed match ignites an enormous fire. Exits are blocked, and several people jump out of the ninth and tenth-floor windows in attempt to escape. The 146 victims were mostly women and girls.

October 22, 1913
Dawson, New Mexico
The Stag Canon coal mine collapses after a controlled underground detonation sets off large explosions of dust. Out of the 284 men in the mine, 261 die along with two rescue workers.

June 8, 1917
Granite Mountain, Montana At a North Butte Mining Company copper mine, a lamp flame sets fire to uncovered insulation. A mine shaft erupts in flames killing 164 men.

January 15, 1919
Boston, Massachusetts
Also known as the Great Molasses Flood, 21 people die and 150 are injured when a storage tank bursts at Purity Distilling Company and a giant wave of molasses speeds through the streets of Boston's North End neighborhood at 35 miles per hour.

March 8, 1924
Castle Gate, Utah
A miner ignites a pocket of methane gas while lighting his safety lamp, causing an underground explosion that kills 172 men.

Hoover Dam
WGBH

Hoover Dam
1930s
Boulder City, Nevada
Over the five-year construction period of the Hoover Dam, there are at least 96 construction-related deaths, though accurate records were not kept. Many are caused by carbon monoxide poisoning in the diversion tunnels.

May 7, 1935
Wilkes-Barre, Pennsylvania
Seven miners riding up an elevator are killed when a large boulder crashes down the shaft.

July 17, 1944
Port Chicago, California
At a Naval Magazine 35 miles from San Francisco, 4,600 tons of incendiary bombs explode during ammunition loading, killing 320 cargo handlers, crewmen, and sailors.

October 20, 1944
Cleveland, Ohio
An above-ground storage tank holding liquefied natural gas -- one of many in the East Ohio Gas Company's tank farm -- leaks vapor from a small seam. Winds from nearby Lake Erie push the vapor into a residential area where it drops into the sewers. When the vapor ignites, the explosion sends manholes flying into the sky lifted by jets of fire. The ignited gas sets residential homes aflame, along with the people inside. One hundred thirty people die and hundreds more are left homeless.

March 25, 1947
Centralia, Illinois
A coal mine explodes, killing 111 miners. A Federal inspection a week prior to the disaster showed "no imminent danger."

SS Grandcamp
Public Domain

The SS Grandcamp
April 16 and 17, 1947
Texas City, Texas
The S.S. Grandcamp explodes while in port, killing 581 people. It had been holding roughly 2,300 tons of ammonium nitrate when someone noticed a fire on board.

August 9, 1965
>Searcy, Arkansas
In the Titan II underground missile silo, a rupture in the electrical system causes an explosion, trapping 53 men inside. None survive.

May 6, 1968
Nicholas County, West Virginia
An in-rush of water from an unintentional "holing through" of a room into an abandoned mine traps 25 men inside the Saxsewell No. 8 mine. Four of the men die from drowning or fatal injuries.

November 20, 1968
Farmington, West Virginia
Seventy-eight miners die in a mine explosion when dangerous accumulations of loose coal and coal dust spark an explosion that spreads throughout the entire mine.

Buffalo Creek
Public Domain

Buffalo Creek
February 26, 1972
Logan County, West Virginia
In Buffalo Creek, one of the Pittston Coal Company's coal slurry impoundment dams bursts, unleashing 175 million gallons of black wastewater, killing 125 people, and leaving 4,000 homeless. Just four days earlier, a federal mine inspector had declared the dam "satisfactory".

April 27, 1978
Willow Island, West Virginia
A partially constructed cooling tower at a coal power plant collapses and sends 51 men falling to their deaths.

July 23, 1985
Romeoville, Illinois
At the Union Oil Company Refinery, a worker notices vapors escaping from a tiny crack in a high-pressure, 100-foot tower filled with gas. He works quickly to shut off the pressure valve, but a spark from an unknown source ignites the fumes. The subsequent explosion launches the 34-ton tank more than 3,400 feet in the air and engulfs much of the refinery in flames. Seventeen workers are killed in the fire.

April 23, 1987
Bridgeport, Connecticut
A partially constructed 16-story apartment building at L'Ambiance Plaza collapses due to structural deficiencies, killing 28 construction workers.

May 5, 1988
Norco, Louisiana
An oil refinery accident kills seven workers and leaves 42 injured. A malfunction in the catalytic cracking unit, used to break down crude oil into gasoline, is cited as the cause of the explosion.

June 28, 1988
Auburn, Indiana
At a local metal-plating plant, the improper mixing of chemicals suffocates and kills five workers.

July 6, 1988
North Sea
An American oil rig, the Piper Alpha, explodes and kills 167 men.

October 23, 1989
Pasadena, Texas
A series of explosions near the Houston Ship Channel kills 23 people and injures 314. The blast occurs during a routine maintenance check on the Phillips chemical plant's polyethylene reactor, when a large quantity of flammable gases ignites.

Imperial Foods plant
Jack Yates

Imperial Foods plant
September 3, 1991
Hamlet, North Carolina
At an Imperial Foods chicken processing plant, 25 workers die in an industrial fire after being trapped inside by the locked fire doors. The fire was caused by a faulty modification in a hydraulic line. In its 11 years of operation, the factory had never received a safety inspection.

March 23, 2005
Texas City, Texas
Poor working conditions and broken safety devices lead to a gas explosion at a British Petroleum oil refinery. Fifteen people die in the blast and over 170 are injured.

May 20, 2006
Holmes Mill, Kentucky
A methane explosion at the Darby mine kills five workers.

February 7, 2008
Port Wentworth, Georgia
A dust explosion at the Imperial Sugar refinery kills 13 people and injures more than 30 others.

February 7, 2010
Middletown, Connecticut
At an under-construction power plant, six people die and at least 12 are injured in a gas explosion. Workers are clearing gas from the pipelines when the explosion occurs.

April 5, 2010
Montcoal, West Virginia
At the Upper Big Branch mine, 29 people die in an underground explosion after a methane gas leak reduces oxygen levels to deadly levels and eventually ignites. The mine had a history of safety violations.

Deepwater Holizon oil rig in flames
U.S. Coast Guard

Deepwater Holizon oil rig in flames
April 20, 2010
Gulf of Mexico
Methane gas shoots up a Deepwater Horizon oil well, igniting from a spark in the rig's engines. The explosion kills 11 workers, and the incident results in the worst oil spill in U.S. history.

February 23, 2011

What Qualifies as a Workers' Compensation Injury in Oregon?

How do you know if your injury would be classified as a "work injury" under Oregon workers' compensation laws?  This is a tricky question and can be difficult for even attorneys and judges familiar with workers' compensation to answer.  However, there are several basic concepts that are a good starting place.  In Oregon, a work injury is described under the law as "arising out of and in the course of employment."

An Oregon work injury "arises out of" employment when it was the employment itself that caused the injury.  This portion of the legal requirement is met if your injury was the result of pretty much anything relating to your employment.  This could mean all sorts of things from driving your car on a work errand to running and tripping in your office because you were late for a meeting.

An injury is "in the course of employment" when it happens while performing job-related duties.  This means that you have a work injury if it was sustained while actually doing work.  For example, if you were injured while lifting a box of office supplies at work, you have a work injury.  But if you were injured while doing a handstand in the hallway, you probably do not have a work injury.  (Unless your boss asked you to do the handstand, of course!) 

With all this in mind, it is a good rule of thumb that if you were injured while on your employer's property or premises, it counts as a work injury under Oregon's workers' compensation laws.

If you are not sure if you have a work injury, check out additional information on my website www.oregonworkinjury.com or give me a call at (503) 975-5535.

Who Am I?

Hello and welcome to the Oregon Work Injury Blog.  My name is Alana DiCicco and I am a workers' compensation attorney.  I practice in the Portland metro area with offices in both Beaverton and Clackamas.  I specialize in helping injured workers navigate Oregon's workers' compensation laws and obtain the benefits they are entitled to.

Each post is designed to answer common questions injured workers have about Oregon's workers' compensation laws.  It is my hope that these posts will prove helpful to you.  But, if you have any more questions, or you think you need a workers' compensation attorney, feel free to give me a call.  I will set up a free consultation to discuss your case.  My office number if (503) 975-5535.

You can also find additional information at my law firm's website: www.oregonworkinjury.com.