Author: Christopher Moore
Feb, 8th 2018
Don’t wait too long to hire an attorney!
In the past couple of weeks, I had the opportunity to meet with two people who had waited too long to hire an attorney, and as a consequence were poorly served by the workers compensation system. In one case, a person failed to get their claim accepted and it will be very tricky to help that person get significant medical bills paid. In the other case, a person had his claim accepted but his disability was rated very poorly because the insurance company sent him to a doctor who was not fair, and his doctor simply agreed with it. There are ways around that, but he did not understand that, and as a consequence lost a significant amount of money.
What I’d like to do is to explain how Oregon’s workers’ compensation attorney fee system works.
First, it needs to be made clear that attorney fees in this state are very highly regulated. Every attorney representing injured workers gets paid in the same way. First, we are all contingent fee lawyers. That is simply a fancy way of saying we have to win or get a good result of some kind in order to get paid. Unlike, for instance, motor vehicle accident attorneys, we are not only contingent fee lawyers, but we are also in some instances paid by the insurance company in addition to the benefit gotten for the worker as well.
If a denial issues in a case and the attorney is successful in getting that denial set aside, then the attorney gets paid by the insurance company. That payment is in addition to any and all benefits that go to the injured worker.
Additionally, if the claim is accepted and there is a debate about time loss (the time loss rate, the dates that should be paid, etc.) and the attorney gets an increase in the amount of time loss paid to the injured worker, then the attorney gets paid in addition to any benefit by the insurance company.
If the insurance company acts unreasonably (they’re late paying a medical bill or time loss or permanent disability) a penalty can be assessed against the insurance company of up to 25 percent of whatever is late paid, and that goes to the claimant. Again, the attorney gets paid in addition to rather than out of.
With respect to permanent disability, generally speaking, whatever the worker gets on the Notice of Closure belongs to the worker. If the Notice of Closure is challenged and there is an increase at the reconsideration proceeding, the attorney gets 10 percent of the increase. If the increase happens at the hearing, then the attorney gets 25 percent of the increase.
If there is a lump sum settlement, then the attorney is going to get 25 percent of the first $50,000 and 10 percent of anything past that. The only money that an injured worker has to pay is for the costs that are advanced in case preparation. While I can’t speak for other law firms, I know that I never spend that money without making sure the client is aware I am spending it, and get their permission to spend it. I should also say that if the claim is a denied claim and the money is being spent to have a doctor support the claim, if that denial is ultimately set aside, then the insurance company has to pay the worker back the costs advanced.
Bottom line is it is a good idea to hire a lawyer because this system is so complex. I don’t mind giving that advice, understanding that we are, for all practical purposes, free, until and unless we win something for the injured worker.