Category: Caselaw Update
Oregon WCB clarifies carrier’s obligation to accept or deny encompassed conditions
A WCB Order on Review, Collin Stringer, 76 Van Natta 462 (2024), distinguished conditions encompassed within previously accepted conditions are not new or omitted conditions….
What type of medical services are compensable after a worker is medically stationary in Oregon?
A common question which arises in Oregon workers’ compensation claims process is what type of medical services will continue to be compensable once a worker…
Washington Court of Appeals: New Insight on Notice and the Authority of DLI Policies
In the State of Washington, employers are required to give notice of a mandatory IME at least 14 to 60 days prior to the examination,…
Oregon Court of Appeals Upholds Nava Rule
In Nava v. SAIF, 333 Or App 196 (2024), claimant sought judicial review of the Board’s denial of penalty and attorney fees under ORS 656.262(11)(a)…
Oregon: Processing Proposed Surgical Authorization Requests Is Not Solely Based on Accepted Conditions
In 2019, the Oregon Supreme Court held that medical services materially related to the work injury are compensable under ORS 656.245 and are not limited…
OREGON: When post-denial IME reports are submitted as evidence at hearing to bolster denial, Court of Appeals declares denial is based on the post-denial IME report.
On April 17, 2024, the Oregon Court of Appeals issued a ruling in Teitelman v. SAIF that a Worker Requested Medical Examination (WRME) can be…
Normally Reasonable: Transferring Attending Providers in Washington Workers’ Compensation Claim
Claimant’s attending physician plays an important role in assisting claimant’s return to their job of injury. Their attentiveness and skill as a provider often dictate…
In Oregon, Delay In Seeking Clarification From Attending Physician Regarding an IME, PCE, and Regular Work Release Can Result in Unreasonable Refusal to Close.
The Oregon Workers’ Compensation Board is holding carriers to a high standard when it comes to securing the evidence needed to rate impairment and work…
OREGON: “Exclusive Remedy” win for employers/administrators/insurers at Oregon Court of Appeals
On April 10, 2024, the Oregon Court of Appeals issued a ruling reiterating the importance of the exclusive remedy clause under ORS 656.018. The case,…
Oregon Board finds “going and coming” rule does not apply to worker crossing street to retrieve work clothes from her vehicle
A recent Oregon Workers’ Compensation Board case, In re Cambria Souza, 76 Van Natta 130 (2024), found a workers’ injury compensable where they were hurt…
Navigating the Pitfalls of Oregon Workers’ Compensation. The Ins and Outs of Injury under a Combined Condition.
We are all familiar with the idea of a “compensable injury” in Oregon workers’ compensation law. A compensable injury is any injury sustained while performing…
Washington Significant Vocational Board Decisions
Two significant decisions regarding the vocational process were recently determined by the Board of Industrial Insurance Appeals. In re Michael Killpatrick BIIA Dec., 21 13384…
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…
New Washington case provides limitations to Maphet
For self-insured employers in Washington, one of the most significant decisions in recent years was the Washington Court of Appeals’ 2019 opinion in Clark County…
Flare-Ups, Aggravation, and Combined Conditions: When is Arthritis Compensable in Oregon workers’ compensation?
If a worker with longstanding cervical arthritis injures her neck while lifting a box at work, can the arthritis itself be a compensable condition under…
Can a denial in Oregon based on an independent record review trigger entitlement to WRME?
Recently, the Oregon Workers’ Compensation Board confirmed that entitlement to a worker requested medical examination (WRME) is only triggered when the employer’s denial is based…
What evidence is necessary to support a ceases denial in Oregon?
ORS 656.262(6)(c) authorizes an administrator to deny an accepted combined condition if the compensable injury ceases to be the major contributing cause of the combined…
Acute Stomach Pain and the Sheepherder–Oregon Court of Appeals issues decision on course and scope
The Oregon Court of Appeals issued a non-precedential memorandum opinion on an interesting case recently involving a worker who experienced an acute medical condition, a…
Oregon Court of Appeals Rejects Claimant Argument to Expand Meaning of “Compensable Injury” for Purposes of Assigning Permanent Impairment
On June 7, 2023, the Oregon Court of Appeals issued its Opinion on Gramada v. SAIF, refusing to expand the meaning of the term “compensable…
There’s a fee for that! The Oregon Court of Appeals authorized the award of attorney fees incurred while litigating the reasonableness of an attorney fee award.
In the case of Peabody v. SAIF, 326 Or App 132 (2023), the Oregon Court of Appeals addressed appeals brought by Ms. Peabody regarding entitlement…
Complexities with CRPS as a new/omitted condition, and positioning to win the battle in Oregon Workers’ Compensation
The cause of complex regional pain syndrome (CRPS) is not well understood. It is a form of chronic pain, usually affecting an arm or leg,…
Washington’s Board of Industrial Insurance Appeals Limits Workers’ Ability to Add Occupational Disease Conditions to Industrial Injury Claims in Tentatively Significant Decision
In some Washington workers’ compensation cases, a significant hurdle can be determining whether a condition in a worker’s claim resulted from an industrial injury or…
Washington Court of Appeals Issues New Decision Which Defines Reasonable Accommodations of Religious Beliefs – and Raises New Questions For Employers
The Washington Court of Appeals, Division 3, issued a decision on September 20, 2022 defining for the first time what is a “reasonable accommodation” of…
Chronic Condition Award Does Not Automatically Result in Work Disability in Oregon
The Oregon Workers’ Compensation Board recently issued a helpful decision when it comes to determining permanent work restrictions and dealing with the reconsideration proceeding. Richard…
When can time loss payments cease in Oregon?
Time-loss payments, penalties, and ambiguous medical opinions are hallmarks of the workers’ compensation system. The Oregon Workers’ Compensation Board recently released an opinion implicating all…
