Author: Andrew Evenson
New denial appeal and hearing rights language requirements in Oregon Workers’ Compensation
As a reminder, the Oregon Workers’ Compensation Board recently revised Oregon Administrative Rule (OAR) 438-005-0055 to reflect changes to the required denial and hearing rights language that must issue with any denial. As always, all notices of denial must specify the factual and legal reasons for the denial and, effective…
Ordered to accept a new/omitted condition in Oregon? Combined condition processing remains a responsive option
On January 9, 2024, the Workers’ Compensation Board ruled in Maria F. Opferman, 76 Van Natta 10 (2024), that the employer’s post-litigation acceptance of a concussion combined with a preexisting condition was valid. Through prior litigation, an administrative law judge (ALJ) ordered the employer to accept a concussion. In lieu…
Investigations and Compensability Standards
Industrial Injury? Occupational Disease? Combined Condition? Under what theory of compensability should you investigate an initial claim for compensation? All of them! Under Oregon Administrative Rule 436-060-0140, the insurer is obligated to conduct a “reasonable” investigation upon receipt of a worker’s claim for compensation. This may include a recorded statement…
Oregon State Legislature likely to pass House Bill 3471, creating new law for future “global” workers’ compensation settlements
Oregon workers’ compensation claim settlements come in many forms. Claim Disposition Agreements (CDAs) resolve disability entitlements related to an accepted claim, such as temporary and permanent disability benefits, aggravation rights, and entitlement to vocational services. Disputed Claim Settlement Agreements (DCSs) affirm partial and complete claim denials and, if a current…
Processing a stress claim in Oregon and taking a recorded statement? Here are some recommendations.
As an occupational disease, to establish compensability of a mental disorder/stress claim, the Oregon worker must prove that his/her employment conditions are the major contributing cause (greater than 50%) of the alleged disorder. ORS 656.802(2)(a). Further, the worker must also establish that there is a diagnosis of a mental or…
Oregon WCB Issues Troubling Decision Regarding New/Omitted Claim Processing Obligations
The Oregon Workers’ Compensation Board recently issued a troubling decision in Luis F. Nava, 74 Van Natta 372 (2022), which impacts how it finds employers/insurers/administrators must process compensable injury claims. In Nava, claimant sustained a compensable work injury on March 13, 2017. Two days later, a left knee MRI showed…
Navigating the maze of “combined condition” claim processing in Oregon
Last week, Evan Novotny provided analysis of numerous recent Board and Court of Appeals decisions, which highlight some of the multiple difficulties that employers/insurers/administrators face when processing “combined conditions,” as well as when defending combined condition denials in litigation. These rulings are cause for ongoing frustration, because they seem to…
Oregon Court of Appeals issues favorable decision for employers regarding combined condition processing
Under ORS 656.005(7)(a)(B), “if an otherwise compensable injury combines at any time with a preexisting condition to cause or prolong disability or a need for treatment, the combined condition is compensable only if, so long as and to the extent that the otherwise compensable injury is the major contributing cause…
The Future of Live Hearings in Oregon Workers’ Compensation
Last September, I wrote about the Oregon Workers’ Compensation Board’s (WCB) announcement of its upcoming utilization of Zoom for Government to facilitate administrative hearings and mediations via videoconference. By all accounts, the videoconference feature was widely accepted and considered largely successful, and the technological aspects were mostly seamless. As COVID-related…
As COVID-19 cases continue to surge, keep in mind OAR 436-060-0141 requirements before issuing a denial
As COVID-19 cases continue to surge in Oregon, it is reasonable to anticipate a corresponding surge in workers’ compensation claims related to confirmed COVID-19 cases and/or presumed exposures that require quarantine. When processing these claims, keep in mind the Workers’ Compensation Division’s temporary rule, OAR 436-060-0141, that went into effect…
Oregon Workers’ Compensation Board now administering hearings and mediations via “Zoom” platform
Since April, under Governor Brown’s “Stay home, Save lives” Executive Orders, the Workers’ Compensation Board (WCB) hearings divisions have not administered any in-person hearings or mediations. Quite obviously, this development and ongoing complication has presented many hurdles for all parties seeking to obtain expeditious resolutions to litigated claims and issues….
Oregon Employee Injured While Working from Home? Best Practices to Determine Compensability
With the onset of COVID-19 and statewide stay-at-home orders, a high percentage of today’s workforce is operating from home, or in some variation of remote setup. Even as employees begin to return to a more traditional work setting, it is reasonable to anticipate that the pandemic-related response will have long-term…
Oregon Supreme Court rules that medical services for conditions caused in material part by the work injury incident, not just accepted conditions, are compensable
In a much-awaited decision, the Oregon Supreme Court recently ruled in Garcia-Solis v. Farmers Ins. Co., 365 Or 26 (2019) that medical services for conditions caused in material part by the work injury incident, not just accepted conditions, are compensable under ORS 656.245(1)(a). In relevant part, ORS 656.245(1)(a) states that…
Oregon Workers’ Compensation Division announces new administrative rules in response to Brown v. SAIF
On March 30, 2017, the Oregon Supreme Court issued a much-awaited decision in Brown v. SAIF Corporation, 361 Or 241 (2017), ruling that the term “compensable injury” shall be interpreted to mean only the medical conditions accepted by the insurer or self-insured employer. Since then, however, there has been some…
What can Brown do for you? In a long-awaited decision, the Oregon Supreme Court reverses Brown v. SAIF
It has been almost three years since the Oregon Court of Appeals issued its decision in Brown v. SAIF, 262 Or App 640 (2014), finding that a “compensable work injury” referred to the injurious incident and all the conditions that flowed from it, accepted or not. The case was appealed…
“Good cause” for untimely injury filing does not require medical evidence
Under ORS 656.265, notice of an accident resulting in an injury must be given immediately by the worker, but not later than 90 days after the accident. Failure to give notice of a workplace incident bars an injury claim unless the employer already had knowledge of the injury or death;…
When is an injury sustained in an employer-controlled parking lot NOT compensable?
As a general rule, injuries sustained by employees when going to and coming from their regular workplace are not deemed to arise out of and in the course of their employment. SAIF v. Reel, 303 Or 210, 216 (1987). One exception is the “parking lot rule.” This rule states that…
Portland passes new “ban the box” ordinance
Last month, the Portland City Council unanimously approved a more stringent “ban the box” ordinance than its State counterpart. The Portland ordinance is designed to provide job applicants with criminal histories a better opportunity at employment by protecting them from having to discuss or disclose their criminal background during the…
2015 Legislative Update: Changes in Oregon Workers’ Compensation
A couple of weeks ago, I presented a legislative update related to Oregon employment law and what effects new legislation has on your employment policy both now and in the new year. The 2015 legislative session also included the passage of numerous bills affecting Oregon workers’ compensation law. Among others,…
2015 Legislative Update: What’s New for Oregon Employers
The 2015 Oregon State Legislative session included the passage of several bills affecting Oregon employers, employees, and the relationship they share. Most relevant to Oregon employers are: House Bill 3025 (Criminal Conviction History), House Bill 3236 (Non-Compete Limitation), House Bill 2600 (Health Benefits Continuation), and Senate Bill 454 (Paid Sick…
Up in smoke? What Measure 91 means for your Employment Policy
On July 1, 2015, Measure 91 goes into effect in Oregon, signifying recreational marijuana’s legality statewide. Of course, its “legality” comes with several limitations. Measure 91 allows Oregonians to grow limited amounts of marijuana on their property, to possess up to eight ounces of usable marijuana in their homes, and…
