February 3, 2017

Responsibility Denial in Oregon Workers' Compensation - What is a Responsibility Denial?

Responsibility Denial in Oregon Workers' Compensation - What is a Responsibility Denial?

When an Oregon workers' compensation claim is filed for an occupational disease, occasionally a responsibility denial will be issued by the insurance company.  To understand why, first recall that an occupational disease is a condition that is caused by the lifetime of work.  This is as opposed to an injury, which is caused by a single, discrete event while working for a single employer.

One of the most common occupational diseases is hearing loss.  A valid hearing loss claim is established by proving the major cause of your hearing loss is your lifetime of employment.  In other words, you do not need to prove that any single one of your employers caused the hearing loss, just that your overall employment did.  This also includes time in the military which Oregon considers employment.

Because of this, it is common that multiple employment periods contributed to the disease claim.  The claim should be filed against the last employer where it is possible there was some contribution to the disease.  For hearing loss, this would be the last employment where there was noise exposure.

Sometimes, the insurer will then issue a denial called a responsibility denial.  It will say something along the lines of: "we are issuing this responsibility denial because we are not the responsible employer or injury for your hearing loss.  We advise you to file claims against other potentially responsible employers."

This type of denial is essentially the insurance company saying: we acknowledge you have a valid claim, but we think a different employer or insurer should pay for it so you need to join them.

If you have a responsibility denial, you will need an attorney to help you appeal the denial and join the other potentially responsible employers.


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