Injured workers who found themselves without a remedy when their work injury claims were denied were given another option when the Oregon Supreme Court issued its opinion in Smothers v. Gresham Transfer, Inc.(1) in May 2001. Terry Smothers filed an “occupational disease” claim for a lung disorder developed after exposure to fumes and mist containing … Read more
Your patient suffered an injury on the job. The injury is an accepted Workers’ Compensation claim. The workers’ comp insurance carrier (“the insurer”) has been paying your bills. Now, you think your patient needs surgery. The surgery is not needed as an emergency measure to preserve life, function or health, but you believe surgery will … Read more
This is the third in our series reviewing basic medical-legal aspects of our legal specialties. The focus of this edition is Oregon Workers’ Compensation law. Issues frequently arising in Workers’ Compensation disputes include “preexisting conditions” and “major cause.” The bulk of Volume 27 of our Medical-Legal Journal is devoted to sorting out the various applications … Read more
Workers’ Compensation claims involving injuries on or after January 1, 2002, have been subject to changes in the law, including a new definition of “pre-existing condition.” Generally, a “preexisting condition” is a medical condition which a worker had prior to a claimed work injury or occupational disease, and which contributed to it. The definition … Read more
Injured workers who found themselves without a remedy when their work injury claims were denied were given another option when the Oregon Supreme Court issued its opinion in Smothers v. Gresham Transfer, Inc. in May 2001. Terry Smothers filed an “occupational disease” claim for a lung disorder developed after exposure to fumes and mist containing sulfuric … Read more
Your patient suffered an injury on the job. The injury is an accepted Workers’ Compensation claim. The comp insurance carrier (“the insurer”) has been paying your bills. Now, you think your patient needs surgery. Although not needed as an emergency measure to preserve life, function or health, you believe surgery is required to help your … Read more
A map of the area gives us the big picture and helps us to understand where we are. Likewise, an overview showing how a Workers’ Compensation claim unfolds in Oregon may be helpful to doctors – who play a very critical role in certain stages of the claim. First, the work event occurs. This may … Read more
Getting medical bills paid has become very complex. Billing for treating injured workers is no exception. This article offers guidelines in how you are paid for treating injured workers. You may wish to give this information to your billing office. The form required for billing is either DCBS Form UB-92 or Form HCFA-1500, “Health Insurance … Read more
This Journal has looked at a number of issues and terms of art used to consider medical evidence in Workers’ Compensation claims. This article is a quick review of some of these concepts, with references to past issues which discuss these matters in more detail. Medical evidence is critical in deciding these issues: Diagnosis … Read more
If you are treating a patient with a work injury, it is important to establish yourself as the “attending physician.” This is important to get paid for your services, as well as to proper processing of your patient’s Workers’ Compensation claim. The “attending physician” is the doctor or physician who is primarily responsible for the … Read more