Learn What You Need to Know About Your Injury and Disability Claim.
Answering the Most Frequently Asked Questions Is Good, Answering The Questions You Should Be Asking Is Even Better
We have been answering questions about Oregon and Washington personal injury and auto injury claims, Oregon Workers' Compensation claims, and Social Security Disability claims for more than a little while. People have a lot of the same concerns, so they ask the same questions. That's good. However, our job is not just to answer the most frequently asked questions, but also the ones you should be asking. That's better.
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What if I have future medical care needs after I resolve my Oregon or Washington Injury Claim?
The Problem: Future Medical Expenses in the Oregon Auto Injury Claim
The cost of medical care has almost doubled in the last couple of decades, and it’s fair to assume the trend will continue upward. Our Oregon and Washington auto injury clients face special challenges when their injuries require future medical care. This article provides a summary of how we handle claims for future medical expenses.
First, Some Definitions
First a little background. Both Washington and Oregon split the kinds of compensation you can claim into two different categories: What is objective, and what is not.
In Oregon and Washington, medical expenses are in the objective category, because the medical bill is a specific amount. Everyone will agree on the amount of the medical bill, but they may not agree that it is part of the case. More on that below.
In Oregon, medical expenses fall into the “economic” damage category. In Washington, medical bills are a form of “special” damage. These are just two different labels for the same thing.
How You Prove Medical Expenses
First, you need to show that the medical treatment reflected in the medical bill was necessary to treat injuries related to the collision. Some medical expenses are obvious, like ambulance and emergency room bills. Others are not. If a case goes to trial, a medical expert’s testimony is needed to prove that the medical expenses are related to the auto collision injuries.
You must also prove that the medical treatment reflected in the medical bill is a reasonable charge. This is usually a formality, but some insurance companies may attack the amount of the medical expense as being unreasonable.
How Future Medical Expenses Are Different
The rules for future and past medical expense are the same but proving that something will happen in the future is always a different challenge.
To prove future medical expense, a medical expert needs to explain what care will be required, and why. But you will also need someone to talk about how much the care is going to cost over the long run. When our client is facing life long medical care needs, we work with life care planners. A life care planner is a special expert that reviews medical records, confers with medical providers, and our client, to create a life care plan. The life care plan that is created sets out a schedule of all the medical care our client will need throughout their life.
Just like any issue in a serious Oregon personal injury case, there is no guarantee that an insurance carrier or defense attorney is going to accept a life care planner’s report.
Other Claims Related to Future Medical Care
In many cases, a doctor will not be able to say that our client will probably need future medical care but can say there is an increased risk of developing future problems, or that there is a very good chance that some kind if treatment, like surgery, is in our client’s future.
Oregon law allows us to argue for non-economic damages where your injuries put you at greater risk for developing future problems that could require more medical care. Some people say that this is compensation for “fear of future disease.” In plain English, someone having to deal with the possibility that their injury is going to come back to haunt them is entitled to compensation for living with that real possibility.
When The Settlement Does Not Cover Future Medical Care
We can prove all the future medical treatment needs possible for our client, but at the end of the day, there is a limited amount of liability insurance coverage available for every claim. Sometimes, the available insurance will cover future medical expenses, but often, it does not. When faced with this situation, the challenge shifts to doing everything we can to make sure our client has access to medical care after their case is completed. That involves negotiating with health care plans or structuring the settlement so our client can get the medical care they need.
We help people with serious injury cases all the time. If you have questions, contact us. At the very least, we can help you know where you stand.
Will there be enough auto insurance to cover my Oregon auto injury claim?
The issue of whether there is sufficient insurance to cover someone's losses in an Oregon auto injury claim is becoming a more common concern. For a long time, Oregon law has required a motorist to carry a minimum of $25,000.00 in liability coverage. We refer to this as the "policy limits." This is coverage for any liability or damages caused for careless behavior.
If you were injured by a careless driver with minimal policy limits, the $25,000.00 coverage must compensate you for your lost wages, your medical expenses, and compensation for the loss of your health, often referred to as "non--economic damages", or compensation for pain, suffering, and loss of activities. We like to refer to this compensation as compensation for the loss of your health.
In many cases, my clients will suffer serious injuries that required extensive medical care, and caused significant disability. As a result, the medical expenses and lost wages alone will exceed the available insurance policy proceeds from the responsible party.
The first option we explore is an underinsured motorist claim. Uninsured motorist coverage exists on every Oregon auto insurance policy, and is designed to insure you against the uninsured motorist, or the "underinsured" motorist. Your uninsured motorist coverage is the same as the amount of liability coverage you purchased from your insurance company.
An uninsured motorist claim exists when you are injured by a driver with no insurance coverage. An underinsured motorist claim is a claim against your insurance company, but is only available to the extent that your "uninsured motorist" coverage exceeds the liability coverage of the other party. This is why we strongly recommend that you review your insurance policy to make sure you have adequate protection.
If your uninsured motorist coverage is the same as the responsible party's liability coverage, then generally, you will not have an uninsured motorist claim. In these cases, we will work with medical creditors, as well as your insurance company to negotiate any outstanding liens or medical bills to maximize your recovery. However, you may be faced with a serious injury without adequate compensation.
To learn more about whether there is enough insurance compensate you for your injury, request are free book, or give us a call at 503-325-8600.
How much is my Oregon Auto injury claim worth?
It’s A Common Question
We consult with people injured in auto collisions all the time. There are common questions. What are my rights? What should I sign, or not sign? Who are all these people calling me? These are questions we can answer, but one question we get that is not so easy is:
What is my case worth?
Oregon Injury Case Value Opinions Require Research
I can provide no opinion on the value of an Oregon auto injury claim unless I have all the information I can obtain to evaluate the claim. The first question is whether the other driver is legally responsible for causing your injuries. Many cases are straightforward. For example, a rear end collision is often the fault of the striking vehicle. However, unless you can establish that the other driver’s careless behavior caused the collision and some injury, you do not even get to a claim for damages.
The Losses You Can Recover in An Oregon Auto Injury Claim
To know the value of a claim, you need to know what you can claim.
There are two categories of “damages” or compensation you can claim if injured in an Oregon auto collision. The first is known as “economic” loss or damage. These are objectively verifiable like medical expenses or lost income. You may claim already incurred medical expenses and lost income. In serious injury claims, there may be a claim for future lost earnings or lost earning capacity and need for future medical treatment.
Although every case is different, some common themes govern our evaluation of claim value and help us advise our client how to move forward with their Oregon auto injury claim.
How Insurance Adjusters Think
Insurance carriers rely heavily on pieces of information they can use to compare one case to another. Many insurers use database programs that allow input of things like diagnostic codes, billing codes, and the damage to your car. Some of these items are known as “drivers.” Insurance adjusters evaluating an Oregon auto injury claim do not want to hear how the injury has affected you on a real-life level. This is because everyone is different, and that is not something that can be fed into a computer database.
Still, some hard facts impact the value of an Oregon auto injury claim. Here are a few examples.
How the collision occurred is key to determining not only who was legally responsible, but whether the collision could have caused injury.
Generally, the more severe the impact, the more severe the injury. However, a serious injury can occur in a “low-speed” collision, and sometimes our client is fortunate enough to escape serious injury in a high-speed collision. There is not always a strong relationship between the damage to your car or the speed of impact and the resulting injury. But insurance adjusters and defense attorneys have a lot less room to argue that someone was not injured in high-speed collision with significant damage to your car. Fair or not the collision’s severity is a factor.
Medical Evidence: The Insurance Adjuster’s Focus
Medical evidence is probably the most important factor for insurance adjusters and defense attorneys in evaluating Oregon auto injury case value. This is because medical records often contain information that adjusters can compare one case to another (see above). There are other clues in the medical records that help someone injured in an Oregon auto collision prove their claim.
Medical Evidence: Timing of Treatment
One factor is the timing of treatment. A basic assumption is that someone injured in an auto collision will seek medical care when injured. We see clients who try to “tough it out,” maybe because they are determined not to be injured or are concerned about other family members injured in a collision. Sometimes, the adrenaline is literally flowing after an auto collision, and symptoms steadily creep to the surface after thing settle down. So, there is often a reasonable explanation for avoiding treatment immediately after collision.
But if somebody waits weeks or months before seeking medical care after an auto collision, insurance adjusters and defense attorneys will be suspicious, and find a physician who is more than happy, for significant fee, to provide an opinion there is no connection between the claimed injuries and the auto collision.
Medical Evidence: Chart Notes and Tests
Medical chart notes are another source of information that helps us evaluate claim value. Most chart notes include the following outline:
- Subjective Reports
- Objective Findings
- Diagnosis and Assessment
Subjective reports are the patient’s report of symptoms to the physician. This is also called the “patient history.” This is as important as any part of a medical examination because it shows the physician the potential issues or injuries that may have occurred in the auto collision.
For example, if somebody reports of neck pain to a physician after an auto collision, the doctor may want to know if the pain is radiating into the arms or is only in the neck and upper back. Radiating pain into the arms may indicate a more serious injury like a nerve impingement or herniated disc. Other information like the onset of symptoms, aggravating factors, and the intensity of symptoms also helps a physician form a diagnosis.
Objective findings are those things that a physician can observe without a patient’s input. A fractured bone on an x-ray is an objective finding. The patient doesn’t need to be in the room when a radiologist views and x-ray to diagnose a fracture. Physicians can also perform clinical tests in the office that if positive, are objective findings. This is common with orthopedists performing an examination for damage to the knee joint like a torn meniscus or anterior cruciate ligament tear.
After obtaining a history, and performing an examination, the physician may further investigate with other testing like an MRI or x-ray. Once your doctor has all this information, the physician makes a diagnosis, and puts together a treatment plan.
We will review all this information in evaluating a case, including your response to the recommended treatment, and the treatment’s effectiveness.
Medical Evidence: Prognosis
The “prognosis” is the “forecast of the course of the injury or ailment.” What will the future be like for you?
Often, auto collision injuries cause only a temporary loss of health. The prognosis is good, and there is no ongoing impairment from the injury. However, all too often, injuries suffered in an auto collision because permanent impairment.
If a physician determines that an injury will cause a permanent change in our client’s health, our client may recover compensation not just for losing their health until the claim demand or jury trial, but for the rest of their life. Therefore, the compensation for our client’s loss of health covers a much greater chunk of time.
Injuries with permanent impairment may also require ongoing medical care, and we often work with life care planners to make sure that we have an accurate accounting of the cost of future medical care.
If an injury causes permanent disability, we often work with economists and vocational experts to determine the true loss of future income because of a life changing injury.
Real Life Evidence
This is the most overlooked but most important part of any serious injury claim because the real-life impact of an injury is what it means to our client. Insurance adjusters do not have a place to enter this data into their claims evaluation software, but jurors will want to know the day-to-day impact a serious life changing injury causes. Often, the most powerful witnesses in an injury lawsuit are our client’s friends, co-workers and relatives because they know the real-life impact and injury can cause.
If you have an Oregon injury claim, and have questions, contact us. We help injured Oregonians every day.
How do I report an on the job injury in Oregon?
The time limits for filing your workers' compensation claim in Oregon are strict. For and "injury" claim, you must file a written claim within 90 days of the date of your injury. There are a lot of arguments about what constitutes a "written" claim. Typically, your employer should provide you with an 801 claim form.
In some cases, my clients work for hostile employers. I recommend going to the Oregon Workers' Compensation Website, and searching for the insurance coverage information using the Employer Coverage Database. You can then contact the insurance company directly, and file your claim.
If you are filing an "occupational disease" claim, you have one year from the date you knew or should have known about the occupational disease. A common example of an occupational disease is occupational hearing loss. If you go to a physician for an audiogram, and here she tells you that your hearing loss is due to exposure to noise at work, you are on notice of an occupational disease, and the one-year clock to file your claim begins ticking.
What are some of the most common causes of Oregon slip and fall accidents?
Frankly, I do not care for the term "slip and fall." To some, it means a frivolous claim. Nothing could be further from the truth.
Before answering what causes these accidents, let's look at what you must do to prove a claim. The first step is your status on the responsible party's property. This is because the landowner's responsibility depends on your status on the property. For example, a business owner has a higher level of responsibility to make the property safe for your use if you are a customer or client. This is because the landowner benefits by having you on the property.
Building code violations or other safety rule violations are the most common cause of injuries. Stairs, decks, railings, and other structures are not built to code. Another common cause of injuries is the property manager's failure to maintain the property. Things wear out, rot, get slippery, and that makes things dangerous, especially for a first time visitor. We commonly retain an engineer or other safety expert to investigate the accident scene to determine whether the stairs, steps, ramps, or other structures were built "to code."
Insurance company adjusters or property owners almost always argue that our client was somehow at fault in failing to keep a proper lookout for hazards. Sometimes, this defense is valid, but many times, it is an effort to avoid responsibility for not doing the right thing.
If you have a question about a "slip and fall" case, call us at 503 325 8600. We answer questions about these cases every day.