Sam Whalen

Everything you’ve wanted to know about third-party recovery in Washington (but were afraid to ask.)

Whalen, Sam_167x222Recovering claims costs through third-party litigation in Washington can be complicated. If careless, self-insured employers (SIE) can walk away from third-party claims leaving money on the table. However, with forethought, third-party litigation can be an effective way for self-insured employers to recover the cost of processing a claim. The purpose of this post is to explain how entitlements to third-party recoveries are calculated, and what self-insured employers should think about to maximize their recovery. In Washington, where a work place injury is negligently caused by a third party, the SIE is entitled to recoup both the cost of benefits paid under the claim and future anticipated costs. Any settlement or jury verdict is subject to the SIE’s entitlement. If the… Continue reading

Attorney fees awarded when carrier rescinds denial of authorization for medical services

Whalen, Sam_167x222The Oregon Court of Appeals recently ruled that a claimant’s attorney is entitled to a fee when an insurer/self-insured employer rescinds a denial of authorization for medical services. SAIF v. Bales, 274 Or App 700 (2015). This means when a carrier denies authorization of medical treatment, rescinds the denial, and the worker’s attorney had anything to do with the rescission, the carrier will be responsible for an attorney fee. In Bales, the worker had an accepted claim for a left medial meniscus tear. The worker requested authorization to provide injections to treat left knee degenerative medial compartment arthritis. SAIF denied authorization on the basis that the injections were not intended to treat the accepted condition.… Continue reading

Corkum Adds Another Layer to Combined Condition Analysis

Whalen, Sam_167x222In the past year and a half, the Oregon Court of Appeals has done much to change the landscape of how combined condition claims are processed and litigated. While Brown v. SAIF is currently pending before the Supreme Court of Oregon, the Court of Appeals has published a new opinion that again challenges what we thought we knew about combined conditions. In Corkum v. Bi-Mart Corp., 271 Or App 411, the Court addressed the distinction between a claimant’s predisposition to an injury and the “cause” of an injury. In doing so, the Court distinguished between “active” and “passive” causes of an injury, and the impact each designation will have on the compensability of a combined condition. … Continue reading