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 is Personal Injury Protection?
Personal Injury Protection, also referred to as "PIP" is a no-fault medical and insurance policy available for anyone insured in Oregon. In Washington, this coverage is not required, but you may have personal injury protection on your auto insurance policy. Here are the basics on all PIP.
In Oregon, there are minimum amounts of coverage for PIP. At a minimum, you have $15,000 in medical insurance. The medical insurance will cover any necessary medical care for injuries that resulted from the auto collision. Also, this coverage is "no-fault." This means that it does not matter whether you were at fault, your driver was at fault, or the other driver was at fault. All you need to prove is that you were in the car, and that you suffered an injury that requires medical care.
An insurance company may question whether your care is necessary, or whether the care is related to the auto collision. In these cases, the auto insurance carrier can have you seen by a doctor of its choice to determine whether your ongoing care is reasonable and necessary. Sometimes, it may be better for you not to attend these examinations because the doctors are often strongly biased against the injured party, and are paid by the insurance company.
The Oregon personal injury protection policy also provides a disability benefit. This disability benefit will pay you for your lost wages at a rate of 70% of your average weekly wage. In order to qualify for these benefits, you must have written authorization from your treating physician to be off work. Also, you must be disabled for a minimum of 14 days consecutively for this coverage to start payment. Again, this is a claim with your own insurance company, and you still have the right to make a lost income claim against the responsible party's insurance carrier. The coverage is available for 52 weeks of disability, and there is a limit on the total amount of benefit you can claim for any given month.
You do not have to be the policyholder or the owner of the car to be covered for all PIP. If you are a passenger, or if you are using a friend or family member's car with their permission, you are insured under these provisions.
If you are a pedestrian, it is possible that you may be covered by the personal injury protection insurance policy of the car who struck you and caused her injuries. This depends on whether you have access to health care through other health coverage.
Washington does not require insurance companies to provide this coverage, but it is optional. Our experience is that the coverage is very from policy to policy. We recommend that you take a look at your insurance policy to see what your coverage provides in case you are injured in a Washington auto collision.
Both Washington and Oregon will allow you to buy more coverage. Whether you should have more coverage depends upon whether you have access to medical care through an employer sponsored health plan, or other health coverage.
If you are facing an issue regarding personal injury protection coverage because of a Washington or Oregon auto collision, and you have questions, give us a call at 503-325-8600. We handle these issues every day, and are happy to answer any questions you may have.
What if I have future medical care needs after I resolve my Oregon or Washington Injury Claim?
Medical care is expensive, and getting more expensive all the time. If you have been injured in a motor vehicle collision in Washington or Oregon, you are able to make a claim for your damages, which includes medical expenses. In Washington, this is part of the "special damages" claim, and in Oregon, we refer to this as part of your "economic damages" claim. Part of your claim involves the medical expenses you have incurred, but what happens when you have future medical care needs?
Generally, you can make a claim for your future medical expenses. However, you must prove the need for those expenses. It is not enough for you or your doctor to testify that you may need a surgery in the future. Instead, a medical expert must provide an opinion that you will need a specific type of medical care within a foreseeable or predictable period of time in the future. But that is only half of the issue.
The other challenge is to estimate the cost of the future care. This is a complicated issue, because we are looking out into the future to determine what kind of care you may require. If you have been seriously injured, and are left with a life changing disability, we will often work with a "life care planner" to determine the actual cost and type of future care you may require. Life care planners will consider all of your needs, and your particular circumstances in arriving at a life care plan. This plan is often times the centerpiece of your claim for future economic losses. If your case goes to trial, the life care planner will likely testify about the cost of future medical care.
If you are facing a life changing injury because of a motor vehicle collision or other negligence, and you have questions, give us a call at 503-325-8600. We have experience with catastrophic in life changing injury claims, and are here to help.
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?
I do not know the value of an auto injury claim unless I have all of the information I can possibly obtain to evaluate the claim. This would include the facts of the collision, my client's medical history, the medical records, and in some cases, medical opinions about whether the injury will result in some permanent impairment. However, there are some factors we consider in evaluating a case's value.
Although a person can suffer serious injury in a "lower impact" collision, the force of the collision is a factor in evaluating the claim. The higher the force, the more potential for injury, and the stronger the connection between the collision and the resulting injury.
In most medical records, a patient is going to describe their symptoms, and then a doctor or other health care professional will perform an examination. Findings on an examination or called "objective findings," which means that the health care provider can observe the injury without patient feedback. MRI studies, x-rays, or other tests are also considered "objective." Insurance companies like this kind of evidence because it is comparable to other cases. However, there are injuries that can be serious, but lacked strong objective findings.
Prognosis or Permanency
When somebody is injured in an auto collision in Oregon, they have a claim for "non-economic" damages. Essentially, this is compensation for the loss of your health, which includes pain, suffering, and interference with activities. If a health care provider believes your injuries will cause some permanent loss of health, then you may be entitled to compensation for not only the loss of your health from the date of the collision up until the resolution of your claim, but for the future. If you prove a claim for permanent injury in court, a jury is allowed to consider the average lifespan of a person of the same gender and race in evaluating have compensate you for your lost health.
These are just a few factors we consider in evaluating cases for our clients. Again, every case is different, and there is much to think about.
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.