When workers' compensation carrier accepts a claim, it will issue a Notice of Acceptance, which describes what medical conditions are part of your claim. In this document, the carrier is defining its responsibility for your workers' compensation benefits.
In many cases, a carrier will accept some, but not all of the medical conditions. For example, a carrier may accept a "knee strain" when in fact you also suffered a torn knee ligament. This is critical because technically, you are only entitled to access medical care for the strain, and not the torn ligament. This is not the only benefit that may be underpaid or not provided at all. You may have a permanent partial disability, but only if your knee ligament tear is accepted does the carrier have to account for the permanent partial disability that condition causes. There are options, however.
An injured worker in Oregon can, at any time, make a new medical condition claim, or an omitted medical conditions. An omitted medical condition is a claim that you suffered the medical condition at the time of your original injury, and it was not included in the original notice of acceptance. A new medical condition claim is a claim that a new medical condition was discovered or diagnosed after the notice of acceptance. Taking our knee example, a strain may have been accepted, but then after the original notice of acceptance is issued, an arthroscopic surgery or MRI shows the tear. If this is the result of the original injury, then you can make the new medical condition claim.
Many times, the doctor's opinion and other medical evidence is critical to proving these claims. If you have an accepted claim for an on the job injury in Oregon, and you are not sure if your insurance company is taking full responsibility for your claim, call us at 503-325-8600. We work with Oregon Workers' Compensation claimants every day.