April 23, 2013

Oregon Workers' Compensation Settlements - What is a Claim Disposition Agreement (CDA)?



Claim Disposition Agreement (CDA)

A CDA is a type of workers' compensation settlement that settles out an accepted workers' compensation claim. Basically, a CDA consists of a lump sum paid to the injured worked in exchange for giving up his or her future benefits under their accepted claim. The settlement thus "disposes of" the accepted claim.

Benefits Retained in a CDA

Some benefits cannot be settled out in a CDA. The most important benefit is the right to future medical care under the claim. In other words, an injured worker with an accepted claim can settle out their future right to benefits under the claim, but cannot settle out their rights to future medical care. However, it is important to note that this medical care will only be the most basic care for the accepted claim. The medical benefits retained will not include future aggravations, surgeries, or any other significant treatment.

Benefits Given Up in a CDA

When a claim is settled via a CDA, the injured worker gives up his or her rights to benefits for time loss, aggravation, vocational retraining, re-opening, and permanent impairment.

CDA and DCS

It is very common that a workers' compensation settlement will include both a claim disposition agreement and a disputed claim settlement.  In this case, the settlement is a complete settlement of the workers' compensation claim, including any accepted or denied portions, and the injured worker will not retain any rights or benefits whatsoever relating to the claim.

Attorney Fees and Costs

Under Oregon law, attorney fees for injured workers in the Oregon workers' compensation system are capped.  The amount of the attorney fee for a claim claim settlement is 25 percent of the first $50,000 and 10 percent of the remainder.  The attorney costs cannot be taken out of a CDA.  If you owe your attorney costs at the time of a settlement, you will have to pay them back directly from your portion of the proceeds.  Attorney costs will likely not be more than a few hundred dollars.

Do You Need and Attorney to Settle Your Workers' Compensation Claim?

Yes.  It is always a good idea to have an attorney help you settle your workers' compensation claim.  The attorney will help you get a better settlement and make sure you do not give up more rights than you should.

Will my Workers' Compensation Settlement be Taxed?

No, proceeds from your workers' compensation settlement will not be taxed.  Under Oregon law, it is not considered taxable income.

End Result

The final result of a CDA is that the injured worker's accepted claim still exists with entitlement to medical benefits, but no entitlement to any other benefits. In exchange, the injured worker accepts the lump sum settlement.

If you have questions about settling your workers' compensation claim, call us for a free consultation: (503) 975-5535.


April 22, 2013

Oregon Workers' Compensation Settlements - What is a Disputed Claim Settlement (DCS)?

Disputed Claim Settlement (DCS)

A DCS is a type of Oregon workers' compensation settlement that is used to settle out a denied workers' compensation claim.  Essentially, a DCS means the injured worker (and their attorney) accepts a lump sum of money in exchange for the denial remaining final.  A DCS is most commonly used when the insurer has denied a workers' compensation claim and the denial has been appealed.  This creates the "disputed claim."

Unpaid Medical Bills

If there are unpaid medical bills at the time of settlement, they must be paid out of the settlement amount.  They are usually paid at an audited rate which reflects Oregon's maximum payments allowed under workers' compensation claims.  These amounts are lower than most physicians charge so it is to the worker's benefit to wait for the bills to be audited.

The insurer will not pay the unpaid medical bills out of the settlement unless they actually have the bills in their possession.  In other words, if there are unpaid medical bills and the insurer does not have them, they will not be taken out of the settlement and the worker will be responsible for them.

If, on the other hand, the insurer does have the medical bills in their possession and they simply fail to include them in the settlement, the insurer will remain responsible for the bills.

Any medical expenses or bills incurred after the time of the settlement will be the responsibility of the injured worker.  

Attorney Fees and Costs

Under Oregon law, attorney fees for injured workers in the Oregon workers' compensation system are capped.  The amount of the attorney fee for a disputed claim settlement is 25 percent of the first $50,000 and 10 percent of the remainder.  The attorney costs (usually incurred for obtaining medical opinion reports supporting the injured worker's claim) also come out of the settlement.

Do You Need and Attorney to Settle Your Workers' Compensation Claim?

Yes.  It is always a good idea to have an attorney help you settle your workers' compensation claim.  The attorney will help you get a better settlement and make sure you do not give up more rights than you should.

Will my Workers' Compensation Settlement be Taxed?

No, proceeds from your workers' compensation settlement will not be taxed.  Under Oregon law, it is not considered taxable income.

End Result

The final result of a DCS is that the injured worker's claim remains denied and, in exchange, they accept the lump sum settlement.

April 18, 2013

Hiring an Oregon Workers' Compensation Attorney - How Much?

How much does it cost you to hire an Oregon workers' compensation attorney?  The short answer is that it is free.  In Oregon, attorneys who represent injured workers must work on contingency.  This means the attorney may not charge an hourly rate and is only paid if they win or settle the case.  Basically, a workers' compensation attorney takes on the risk with you.  They are only paid if you win.

If you have a denied claim, and your attorney helps you overturn or reverse the denial, the insurance company will have to pay their attorney fee and costs.  In this scenario, the attorney fee will not come out of your benefits.

This is also true with time loss cases.  If you have not been paid your time loss correctly and your attorney helps you get the unpaid amount, the insurer must pay the attorney their fee without taking it out of what is owed to you.

If you reach a settlement of your case, the attorney fee does come out of the total.  In Oregon, the attorney fees from a settlement of a workers' compensation case are capped at 25 percent of the first $50,000 and 10 percent of the remainder.  This is significantly lower than attorney fees on other contingency cases such as personal injury and employment law - which go up to 40 or 50 percent of the total recovery.


We offer free office and phone consultations!  Call us at 503-975-5535.

Hiring a Workers' Compensation Attorney - Why?

It is often a good idea to retain a workers' compensation attorney when you have a workers' compensation claim.  This is true even if your claim is accepted.

An attorney can help with many things.  First and foremost, a workers' compensation attorney acts as the go-between between you and the adjuster, employer, and insurer.  The attorney will also monitor your medical records, your time loss payments and the insurer's processing of your claim   The insurers often make errors in payment of time loss  and other areas of claim processing.  An attorney will help you recover the benefits you are owed and any penalties for errors in claim processing.

With accepted claims, it is common that the acceptance will not fully encompass your injury.  For example, the insurers often accept a "low back strain" when the real injury is a disc herniation or other more severe injury.  Another common scenario is an acceptance of a head contusion (i.e., bruise) when the real injury is a concussion.  By accepting a minor injury, the insurers are trying to limit their liability.  This can significantly limit the benefits you are entitled to.  It is a good idea to have an attorney review the scope of acceptance to help you avoid this situation.

Finally, if your claim is denied, you will need to hire a workers' compensation attorney to help you appeal the denial.

Questions about the costs of hiring a workers' compensation attorney?  See my next blog post...

Please note we offer free office and phone consultations!  Feel free to call us at 503-975-5535.