You can file a claim for workers’ compensation benefits in Oregon, even if you were at fault in causing your injury. This is because the Oregon Workers’ Compensation system is a “no-fault” system. The statute allows benefits where an injury “arises out of” and occurs within the “course and scope of” employment. That is pretty much all you have to prove, but sometimes, it is gets a bit involved.
Of course, there are exceptions. For example, if an employee is engaged in “horseplay," that causes an injury, then the claim may be denied. This is because “goofing around” at work is not doing work. It’s goofing around. Also, if a worker suffers an injury due in major part to drug or alcohol intoxication, then the claim can be denied. These are two examples where an insurance company can deny a claim for careless behavior.
On the other side of this is the employer’s responsibility. An employer may be negligent in causing an injury to an employee. But the no fault nature of this system protects the employer too. Exceptions? You bet. An injured worker can sue an employer that intentionally harms an employee. In other cases, there may be a claim under the Employer Liability Law, which may allow for additional recovery.
Some workers' compensation claims require that you show a much stronger connection between the work activity and the need for medical care than if you were making a personal injury claim in a state court. If the employer denies this kind of claim, you may have a personal injury negligence claim against the employer. This claim may allow you to recover more than the limited benefits of an workers' compensation claim.
You may have been injured by a person other than a co-worker or employer, which allows for a "third party claim."
If you have been injured on the job and have questions about whether your claim will be denied for any of these reasons, call us at 503-325-8600. We have extensive experience working with injured workers on these issues.