Jeannie

Jeannie worked as a sleep study specialist doing sleep apnea tests when a large hospital bed weighing hundreds of pounds rolled on to her foot, crushing it. Her supervisor asked her to finish her shift before going to the emergency room for care, and when she went to the ER in the morning, they cut off her shoe because her foot was so swollen. Jeannie paid her own doctor for care and had surgery on her foot for pinched nerves, but the pain persisted. Her workers’ compensation insurer sent her to several Independent Medical Exams, or IMEs, to determine what was wrong, but they sided with the insurance company which would not cover surgery or physical therapy. Jeannie’s doctor wanted to continue to provide care and do another surgery, but the insurance company harassed him so much he eventually decided not to see her anymore. Jeannie believes if she had that surgery and physical therapy, she would have been able to return to work.

Todd

Todd is a mill worker and was injured while pulling product off the line when he stepped of the platform he worked from. He felt a pain in his hip and at first thought he had just a muscle strain. When the pain became unbearable, however, he went to his doctor who diagnosed a labral tear and said he needed surgery. His workers’ compensation insurer won’t cover the surgery because they say Todd’s hip has a congenital impingement, even though his doctor believes if he had the surgery he’d recover fully and be able to return to work.

Another issue Todd has faced is lack of timely notifications from his insurance company regarding his Lost Time Wage benefits. The insurer said he was medically stable and could return to work, even though he has not had the surgery he needs, but didn’t notify him or stop paying his Lost Time Wages. Now they are garnishing his pay due to their error.

Faith

Faith was working as a floor nurse and was hurt when a patient lost consciousness and fell. Faith tried to help him stay upright and stable, but as he went down, he grabbed her arm, pulling very hard on it with a lot of weight. Faith was originally treated for a nerve stretch, but an MRI revealed two bulging discs in her neck causing nerve pain down her arm. The workers’ compensation insurer paid for the surgery she needed, and even though all doctors – even the two doctors the insurance company sent her to for evaluation – agreed her work injury caused the nerve pain down her arm, the insurance company did not add that condition to her claim – the claim still said she had just a cervical muscle strain. What this meant for Faith is that when she was unable to return to work due to the injury, she did not get a permanent disability award because the only condition they accepted was a muscle strain, and the muscle strain isn’t what caused permanent damage. This also meant she could not tap into preferred worker benefits to help get back in the work force, and it forestalled her right to even try to get vocational benefits.

Scott

Scott was working as drywall hanger and wearing a hard hat when the lift he was on jolted upward instead of down. He hit his head on a beam, causing him pain down the side of his body – elbow, wrist and hip. An MRI revealed a herniated disc. Scott has been seeking care from his worker’s compensation insurer for ten years and has not yet received it. He had a disc removed and fusion covered by the Oregon Health Plan. His case has been to the Oregon Court of Appeals three times. Each time, the Court has sent it back to the Workers’ Compensation Board for action, but his insurer keeps appealing.

Maria

Maria is a bookkeeper for a small catering company and helps with deliveries when needed. One day, while helping with deliveries, she lifted several boxes and felt pain in her low back and leg. She went to a doctor from a list provided by her workers’ compensation insurer and was treated for a back strain. When she didn’t improve, she went to another doctor on that list who recommended an MRI revealing a bulging disc.  Both doctors told her the bulging disc was caused by the work incident.  Her workers’ compensation insurer will not cover the treatment she needs to get better because their chosen doctor says she has preexisting arthritis, even though Maria had never experienced any back pain or treatment before being hurt at work and is a young woman in her twenties.

John

John was working as a bar manager and security when he was attacked by bar customers who stomped on his knee, causing extensive injuries. The people who attacked him were convicted, but he still had to fight the workers’ compensation insurance company for his benefits. John faced an issue when he saw a doctor for tests, the doctor forgot to comment in writing about his inability to work. The time it took to get the test results and follow-up appointment meant he lost a lot of time-loss back wages because state statute limits backdated wage loss to only 14 days, harming injured workers waiting for test results or appointments with busy doctors. Curiously, there is no limit on how far back an insurer can take away wage loss already authorized.

David

David worked installing, repairing and cleaning wood stoves. During one installation he pulled apart two pipes, hurting his shoulder. A medical exam revealed he had a massive rotator cuff tear. His workers’ compensation claim was denied, however, based on undiagnosed preexisting joint disease. Because David could not get surgery, his rotator cuff tear worsened. He is still not back to regular work and likely never will be due to the delay in care.

Duane

Duane is a 76 year old who worked on-call at a cemetery in Lane County. He was called in to work to move a container with a body. While lifting the container, he injured his shoulder – his coworkers heard an audible pop. He underwent shoulder surgery, but his workers’ compensation claim was denied on the basis of preexisting age-related degenerative change in his shoulder along, with preexisting age related arthritis.

Karlynn

Karlynn Jo is a police officer in Lane County who was injured while taking an under-the- influence arrestee to jail. The person being arrested instigated a fight, and Karlynn’s knee was injured when an audible “pop” was heard. Prior to the fight, she had pre-existing arthritis in her knee, but was able to engage in activities like long distance running. Her request for surgery to treat the workplace injury recommended by her doctor was denied on the basis that surgery was for pre-existing arthritis.

Ben

Ben was doing maintenance in a restaurant in Clatsop County when he fell at work, injuring his back, and required low back surgery. His workers’ compensation insurer denied his claim, saying that the major cause for surgery was a degenerative condition that had no previous symptoms, rather than the fall. He was unable to get medical care and is now disabled.