If you have been injured on the job, and you filed a claim, certain timelines are triggered before the insurance company to investigate and make a decision on your claim. In the case of a new claim, the Worker's Compensation carrier has sixty days from the date it received notice of your claim to make a decision.
This period of time is referred to as the "deferred status period." The insurance company will obtain your medical records, possibly speak with your doctor, and also has the right to take a statement from you regarding the facts and circumstances surrounding your injury. Do not be surprised if you're asked questions about your past medical history as well. You may also be asked to see an insurance retained Doctor for an examination. Many of these doctors are biased against the injured worker, but some are genuinely objective.
If you are physician has taken you off work, and confirmed your disability in writing, you may be entitled to a temporary total disability benefit during the deferred status period. In some cases, you may be only missing some work, and will receive temporary partial disability benefits. In many cases, the employer may find something for you to do within your physical limitations, which would disqualify you from any temporary total or temporary partial disability benefits.
The insurance company must make a decision within sixty days by issuing a written notice of acceptance, or some form of a claim denial. The rules require that these letters be put together in a certain format, and advise you of your right to appeal any adverse decision.
If you have a recent claim denial, or suspect a denial is coming in, give us a call at 503-325-8600. We can review your file, and let you know if it makes sense to contest the denial. Please note that there are time limits for appealing a denial, so even if you do not call us, appeal that denial. You can always withdraw the appeal at a later date.
