So Who Processes These Claims: Reversing the Trend

Joe Di Bartolomeo
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Joe Di Bartolomeo is a top rated personal injury lawyer helping Oregon and Washington families

As we work with many clients who are fighting to have all of their injuries accepted by the Oregon Workers' Compensation insurance company, we notice a disturbing trend.

More and more it appears that workers' compensation carriers or pushing the job of processing a claim onto the injured worker. For example, insurance carriers are not paying the full amount of permanent partial disability due to an injured worker, but instead, are attempting to apportion or "set off" part of the permanent partial disability award to "pre-existing conditions." This is true even though the law, in our opinion, forbids this practice.

When we took this to an Administrative Law Judge recently, he rejected argument, explaining that if we wanted the pre-existing conditions to be accounted for with a permanent partial disability award, we should ask the insurance company to accept that condition three new medical condition claim. That cases on appeal.

We also noticed that many cases, insurance companies will only accept part of the injury. For example, our client may suffer a torn ligament in his knee, but the insurance company will accept only a knee strain. This is a big deal, and it is up to us to request the insurance company also include the knee ligament tear as part of the accepted conditions.

Look for some interesting Court of Appeals decisions coming up soon that will hopefully reverse the trend,  and make the insurance company to its job.

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