Introduction
The most difficult time for many of our Oregon auto injury clients is the first few weeks after the collision. Our client is injured, without transportation, and often not able to go back to work. First an foremost is getting necessary medical care, but then there are the realities of paying the bills while on the mend.
It Starts with Your Auto Policy
Any insurance company that provides auto insurance in Oregon must include basic coverages in the auto policy. One coverage is known as personal injury protection or “PIP.” There are a few benefits in the personal injury protection coverage, including disability benefits.
Disability benefits are available to anyone injured in an Oregon insured car if the injury causes at least fourteen days of continuous disability. It does not matter who is at fault, and the disability need not occur immediately after the collision. For example, an injury may require a surgery months after the collision. If the surgery causes more than two weeks of disability, the disability benefit is available.
You must be employed when the collision occurred. If you were about to start a job, or were between positions, you will not be covered. If you are self-employed, you are covered, but you will need to prove your income. More on that below.
The benefit covers up to 52 weeks of disability. There is a monthly cap on benefits, which is $3,000.00. Some insurance policies may offer coverage beyond the minimum amounts.
For self-employed folks, the insurer will usually want business records and tax returns to calculate the average weekly wage.
If you are injured in a car insured in Washington, insurance companies must offer this coverage, but it is not required. If you do have coverage for disability
How to Get Paid
The first step in obtaining disability coverage is to file a PIP application. The application asks about how the collision occurred, whether you are injured, and who you have seen for your medical care. The application will also ask for details about your job. Then, it’s all about documentation.
The other documents you must sign are the authorization to obtain your medical records and bills, and an authorization that allows the insurance company to contact your employer and verify that you were employed when the collision occurred.
Another critical document is your doctor’s written confirmation of disability. The auto insurer will have a specific form for the doctor to complete to verify your disability.
Tip: Some doctors may fill out an off work not by describing what you can still in a work setting. This often happens with workers’ compensation claims. However, this is little help if you have a strenuous job. So, you should explain your job requirements to the doctor, and that your insurance company needs written confirmation, up or down, on whether you can perform your job with the injuries you have. Also make sure the doctor sets out the time frame for disability. Many doctors will keep you off work until the next scheduled doctor appointment.
How Oregon PIP Benefits Amounts are Calculated
Once the insurance company has all the documentation of your disability, it will calculate your benefit by looking at your past earnings. You are entitled to 70% of your average weekly wage, but the benefit amount will not exceed the monthly benefit “cap.” The monthly benefit cap is $3,000.00.
Keeping Benefits Current
Insurance adjusters will insist on documentation before paying benefits. It can be frustrating but remember these adjusters must answer for every benefit check they approve and must have the documentation in the file. So, you need to make sure your doctor is filling out the right form the right way.
What if Benefits Run Out?
This can happen in a serious injury claim. The first place we will look is to see if our client has any other disability coverage. For example, many employers offer disability plans that provide short and long term disability coverage. These plans are usually covered under federal law and allow a lot of flexibility with what kinds of disabilities are covered.
Sometimes, the disability may be permanent, and we will explore the possibility of a Social Security Disability claim.
Remember that there is also a claim for past and future lost income against the liability carrier (the at fault driver’s insurance company), but most of the time, these damages are not paid out until the claim is resolved.
Questions?
We have lots of experience working with people disabled from an Oregon auto collision and can help you with getting back on track after a disabling injury. Contact us with questions or check out our other articles that help you know where you stand.
