If you are reading this article it is because you have work-related hearing loss and are wondering about filing a workers' compensation claim in Oregon. You also probably have a lot of questions and no one who can answer them. Or, if you are like me, your spouse is so tired of hearing about workers' compensation, they fall asleep every time you bring it up...
Well, I am here to help! Here is a list of the most frequently asked questions about hearing loss workers' compensation claims in Oregon:
1. I am retired - so how do I file a claim?
If you are retired, you can't just waltz into an HR office to file a workers' compensation claim. Sometimes, your company may even be out of business or merged by the time you realize you have hearing loss and that it is probably related to loud noise at work. The answer is that you file through your doctor's office. Legally, you have a workers' compensation claim when a doctor determines you have some injury (hearing loss) that can be related to exposure (noise) at work. You then complete an 827 Form at the doctor office. The doctor office is required to send the form in to the insurance company and to the Workers' Compensation Division.
If your doctor does not want to file the claim or does not know how, you can do it yourself. If you get into this situation, I recommend you contact a lawyer or the Oregon workers' compensation ombudsman to help you determine the correct insurer to send the form to.
2. How long do I have to file a claim? Is there a statute of limitations?
Yes, there is a statute of limitations (a deadline) for filing a hearing loss claim under Oregon workers' compensation law. You have one year from the first date a doctor (an M.D./ENT, not an audiologist) tells you your hearing loss is work related. For example, if you went to an ENT doctor last month and they told you your hearing loss was related to noise at work, you have 11 more months to file a claim. However, if you had a hearing test ten years ago at work and the audiologist or technician told you your hearing loss was related to noise at work, your deadline has not begun ticking away. The deadline is only triggered by a medical doctor's opinion or chart note.
3. What benefits will I get?
You will be entitled to hearing aids for life at $7,000 per pair every 5 years. Your other medical costs, (doctor visits, hearing tests, etc) will also be covered. You will also be entitled to a permanent impairment award for your permanent hearing loss. This is calculated based on your age, sex, and how great your hearing loss is. It is a lump sum dollar amount awarded under the law to compensate for your permanent hearing impairment.
Permanent impairment is something that is often calculated incorrectly and if you have questions about a permanent impairment award (which is included with your Notice of Closure), I recommend you ask an attorney to review it. (I am happy to review permanent impairment awards for free - just give me a call!)
4. Will my claim be accepted or denied?
Probably denied. Many hearing loss claims are initially denied because they can be difficult to prove. The older you are and the longer you have been retired, the more likely your claim is to be denied.
5. My claim is denied, what should I do?
Call a lawyer. You will need a workers' compensation lawyer to help you appeal the denial and fight the insurance company. The good news is that it will cost you nothing to have a workers' compensation attorney. Oregon law requires the insurance company to pay your lawyer's fee if the lawyer helps you overturn a denial. The fee does not come out of your benefits.
6. The insurer told me another insurer is responsible - what do they mean?
A responsibility denial means the insurance company thinks a different insurance company is responsible for your workers' compensation claim. Often, companies have different workers' compensation insurance carriers over the years, or you may have worked for different employers throughout your career. Either way, an insurance company can try to move the claim to another insurance. If you receive a responsibility denial, you will need a workers' compensation lawyer to help to fight it and file claims against the other potentially responsible insurers.
If you have any more questions, feel free to call me at (503) 975-5535 or comment on this post. Consultations are always free!
March 31, 2015
March 4, 2015
Check out this article about how workers' compensation systems across the country have been dismantled, reduced, gutted, etc...