In a recent case, the Workers’ Compensation Board found that a legal assistant’s testimony established that a request to close a claim was actually mailed to an insurance company, and triggered a presumption that the request was received in the regular course of business.
Under the Oregon Workers’ Compensation statute, an injured worker or the representative can send a written request to the insurance company demanding that the insurance company issue a Notice of Closure on a claim. The insurance company must respond within 10 days of receipt of that request. The insurance company can either refuse to close the claim, or not respond whatsoever. If the insurance company fails to respond, then an injured worker can request penalties and attorney fees upon a showing that the refusal to close was unreasonable.
Insurance companies often say they do not have sufficient information upon which to calculate the benefits at closure, which include permanent partial disability. However, there are some good Board decisions that confirm the insurance company cannot just sit around and do nothing in order to prepare case for closure. Even if the insurance company does not have the information is close case, if an injured worker can show that the inaction was unreasonable, the injured worker can obtain a penalty up to 25% of the amount due in permanent partial disability benefits.
We work with injured workers to make sure that claims are closed in a timely fashion, and if they are not, that the insurance company is properly assessed the penalty. If you have an open Workers’ Compensation case, and you wonder whether the insurance company is stalling on a notice of closure, call us at 503-325-8600. We can review your file, and explain your options. Even if we are not able to pursue an issue on your behalf, you will at least know where you stand on your case, and there is no fee.