Worker’s Compensation Claims and Pre-Existing Conditions

Q: I was injured on the job. I received a letter from the insurance company that said they accepted my claim. However, my doctor says I need injections in my back but the insurance company says they will not pay. They say the injections are not related to my injury. I did not have a problem until I got hurt on the job. What can I do?

A: The law says that workers’ compensation insurance companies are responsible to pay for all treatment related to a work injury. Many times an insurance company tries to limit its liability by accepting a lesser condition, such as a lumbar strain, when your doctor says you have a herniated disc, nerve, or similar problem. Consequently, workers’ compensation insurance companies sometimes deny payment for necessary medical treatment. You can appeal the insurance company’s denial with the help of the Workers’ Compensation Department. You can also seek legal assistance at no cost to you. Attorney fees are paid by the insurance company. Recent changes from the Oregon Courts require insurance companies to be responsible for any medical treatment caused by the work injury, whether or not you have “pre existing” conditions. Contact the Oregon Workers’ Compensation Department, Injured Worker’s Hotline or an attorney experienced in handling workers’ compensation cases to help you get your medical treatment.

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