The Oregon Workers' Compensation statute and rules specifically state that an insurance carrier can pay a medical bill to treat a medical condition, and not accept responsibility for that condition. This can lead to a lot of confusion. A real life example is helpful.
Years ago, we represented a man who suffered a low back injury at work. He filed the claim, and the insurance company accepted responsibility for a low back strain. However, his problems were more complex, and a neurosurgeon performed a multilevel surgery to relieve pressure on the nerves from bone spurs, disc bulges, and other low back conditions. The insurance company paid the surgeon for his work, which was significant, but then, weeks after the surgery, was able to get the surgeon to agree that none of the treatment provided was for the accepted medical conditions, and that none of the treatment was the result of any on the job injury.
Many times, an insurance carrier will pay a medical bill, but that does mean it is accepting the condition that required the treatment provided. To do that, you must file a new or omitted medical condition claim.
If you are in the middle of an Oregon Workers' Compensation claim, and are unsure what is accepted and what is not, call us at 503-325-8600. We can meet with you in our Astoria or Beaverton office, review your claims file to look for options, and let you know where you stand.