Oregon Workers' Compensation Claim Denials: Combined Condition
For quite a few years, Oregon Workers Compensation insurance companies have been using a tool to deny claims mid-stream, leaving many injured Oregonians without the resources they need to return to work, or train for another occupation.
It's the combined condition denial. For about ten years or so, Oregon Workers' Compensation law allows an insurer to deny claims when a "pre-existing condition" combines with an on the job injury, and the pre-existing condition becomes the main cause of the injured workers' need for treatment. Sounds crazy? A lot of doctors will confide to me that there is no way to know when two medical conditions combine. A lot of injured workers have a hard time understanding how some finding on an x ray that never caused any pain is now responsible for their medical problem months after a serious on the job injury.
There are options, however. An injured worker can appeal a combined condition denial, and sometimes can argue that the two conditions never combined, or that there was no pre-existing condition. We review claims files looking specifically at these issues.
