Personal Injury FAQs

  1. If I go to the doctor, who is going to pay my bill?
  2. What about any time off from work, can I get paid for the time I miss from work?
  3. Is it OK to talk with the insurance companies?
  4. My car is wrecked, what do I do?
  5. I have injuries, do I have a case and what is it worth?
  6. I can’t afford a lawyer, what can I do?
  7. Do I need a lawyer?

Workers’ Compensation FAQs

  1. I filed a claim that was denied. I don’t know why. What can I do?
  2. I was hurt at work several months ago. How long do I have to file a claim for workers’ compensation?
  3. My accident claim was accepted. Does my employer have to pay for all my medical care?
  4. I was hurt on the job about a year ago and my claim was accepted. Now my doctor says I need surgery and will miss a month of employment. Will I be paid for my time off?
  5. I am confused by all the paperwork I have been sent. Can you help and what will it cost me?

Social Security Disability FAQs

  1. I had to quit my job and my doctor says I won’t be able to return for at least a year. Am I eligible for Social Security Disability insurance
  2. I have been on state workers’ compensation insurance. Now my comp claim is going to be closed and I will no longer receive time loss checks. Will social security start paying me right away?
  3. I am 30 years old, with a college education, and I need back surgery. My neighbor told me to apply for Social Security Disability. What are the chances I qualify for benefits?
  4. My doctor recommended social security, and she promised to help me get benefits. Do I also need a lawyer to help me?
  5. I applied for Social Security Disability once and was turned down. Can I apply again if I still can’t work?
Answers to Personal Injury FAQs

1. If I go to the doctor, who is going to pay my bill?

Your auto insurance is required to pay all reasonable and necessary accident related medical bills for the first year after the accident, generally up to $15,000, depending on your particular policy, even if the accident is your fault. This is commonly referred to as your PIP coverage. If the accident is someone else’s fault, your insurance company will look to the bad driver to pay back the benefits they pay to you under your PIP coverage.

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2. What about any time off from work, can I get paid for the time I miss from work?

Yes, your PIP coverage also covers time off from work. After your doctor has taken you off work for 14 consecutive days, your insurance policy will pay you 70% of your lost wages up to a maximum of $3000.00 per month for a maximum of 52 weeks. You can receive these lost wages even if the accident was your fault.

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3. Is it OK to talk with the insurance companies?

It is OK to speak with your own insurance company and tell them about the accident. If you choose to speak to the insurance company for the person who caused the accident, you should be aware that insurance company is not looking out for your best interests. It may be best to give us a call before you decide whether you want to talk to the opposing insurance company.

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4. My car is wrecked, what do I do?

If your car has been damaged, the insurance company for the person who caused the accident is required to either fix the car or buy it from you for fair market value. If the car is going to be repaired, you may have it repaired at the repair shop of your choosing. Many times there are questions about rental cars, fair market value of the car and what type of parts may be used in repairing a car. The answers are not always simple, so feel free to call with your questions.

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5. I have injuries, do I have a case and what is it worth?

If you have suffered an injury, the most important thing you can do is get appropriate medical care. You may well have a claim against another person who caused the accident. Until you are all better, or at least as well as you can expect to be, it is impossible to accurately state the value of your claim. Unfortunately, there is no magic formula that decides what your claim is worth. There are many important factors we will discuss at length when it is time to put a value on your claim. It is important to remember, however, that just because an insurance adjuster tells you your claim is worth a certain amount, that is not necessarily correct. And just as important, you do not have to accept what the insurance company wants to pay you!

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5. I can’t afford a lawyer, what can I do?

In our office, we only take cases on a contingency fee basis. That means you do not have to pay for our legal services on an hourly basis. In car accident cases, our fees start at 33.33% and these fees are only paid out of any recovery we win on your behalf. If we do not win, you do not pay anything for attorney fees.

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5. Do I need a lawyer?

It is up to you. The insurance company is always very willing to deal with you directly. In fact, many times they may suggest that you will be better off if you do not have an attorney. The truth is the insurance company knows exactly what they are doing, and you do not. If you do not have an experienced attorney on your side, you are not playing on a level playing field. You have to rely on the insurance company to be honest with you and to treat you fairly. Since you do not have any experience in this area, it is pretty hard to know whether the insurance company is being fair to you.

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Answers to Workers’ Compensation FAQs

1. I filed a claim that was denied. I don’t know why. What can I do?

A claim denial is supposed to list the reasons why benefits are refused. Often the only way to know why a claim really was rejected is to obtain the claims file, which must be sent at no charge to your legal representative upon request.

A worker has 60 days to appeal a denial of their claim. If there is “good cause” for not appealing within 60 days, a hearing may be requested up to 180 days after a denial is mailed. If there is proven mental incompetency, an appeal may be filed up to 5 years after a denial.

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2. I was hurt at work several months ago. How long do I have to file a claim for workers’ compensation?

Injured workers must file their claims in writing within 90 days of their accident unless their employer knows they were hurt, in which case they have up to a year to make their claim. It always is helpful to fill out an accident report even if a claim is not filed right away. If you suffer an occupational disease, you have up to a year to file a claim.

Often, a doctor’s insurance form will be a “claim” even if the worker doesn’t personally turn it in. If there is any doubt about whether a claim was made, it is important to immediately seek legal assistance.

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3. My accident claim was accepted. Does my employer have to pay for all my medical care?

Not necessarily, depending on what medical conditions were officially accepted. If you suffered multiple injuries or conditions, not all may be listed on your claim. Workers must specifically ask, in writing, to have new or omitted conditions included in their claim. Then the insurer or employer has 60 days to respond.

You also may be enrolled in a “managed care organization” which limits the doctors and treatments you receive. If the MCO has refused to authorize treatment, an appeal must be filed with the organization first to protect your rights.

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4. I was hurt on the job about a year ago and my claim was accepted. Now my doctor says I need surgery and will miss a month of employment. Will I be paid for my time off?

Yes, as long as your claim was classified “disabling” and remains open. Because you did not miss work, your claim may be listed as “non disabling.” If your claim was accepted less than a year ago, it is fairly simple to request reclassification. If more than a year has passed, your doctor will need to verify that you now are worse and that is why you need surgery.

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5. I am confused by all the paperwork I have been sent. Can you help and what will it cost me?

Absolutely, we often can answer your questions by phone and give you tips how to navigate the red tape. We do not charge by the hour – either to give information or review your claim file. Oregon workers’ compensation is a very complex law, and claims examiners can take advantage of unrepresented injured workers. If you have been hurt at work, don’t get hurt twice by failing to protect your rights!

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Answers to Social Security Disability FAQs

1. I had to quit my job and my doctor says I won’t be able to return for at least a year. Am I eligible for Social Security Disability insurance?

Probably, as long as you have worked at least 5 years in the 10 years before you became disabled. Social Security Disability is a program for people who have been in the work force and paid into social security through their payroll taxes or as self-employed workers. You must be off work, or expected to be unable to work, for 12 months to qualify for SSD.

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2. I have been on state workers’ compensation insurance. Now my comp claim is going to be closed and I will no longer receive time loss checks. Will social security start paying me right away?

You must apply for Social Security Disability to receive benefits – payments are not sent automatically. Go to the nearest Social Security office and fill out a claim form, listing the date you last worked as when you became disabled. You may not receive social security payments when you were on workers’ compensation time loss, or your SSD payments may be reduced, but it is important to file the claim anyway. If your claim is denied, contact an attorney who practices social security law to appeal the claim.

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3. I am 30 years old, with a college education, and I need back surgery. My neighbor told me to apply for Social Security Disability. What are the chances I qualify for benefits?

Regardless of your age and education, you can obtain Social Security Disability benefits if you suffer a severe medical condition that prevents all work activity for at least 12 months. Older workers and those who have less than high school educations may qualify for SSD with less serious conditions. It is a good idea to apply if you have been off work and do not expect to return within a year.

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4. My doctor recommended social security, and she promised to help me get benefits. Do I also need a lawyer to help me?

Your doctor’s expert opinion, plus clinical tests and evaluations, are very important to prove a claim for Social Security Disability. Nevertheless, the social security system is a complex field of federal law and regulations. We can work with your doctor to best present your claim if an administrative hearing is required.

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5. I applied for Social Security Disability once and was turned down. Can I apply again if I still can’t work?

Yes. As long as you are “insured” through the Social Security system, you can repeatedly apply for disability. You also may have your former claim reexamined if you have new information, even if the claim had been denied.

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