Category: Changes in WC law
Oregon Workers’ Compensation Division is Considering Changes to Claim Processing Rules
The WCD held a public advisory meeting on September 11, 2025, to discuss potential changes to various provisions in OAR 436-060. The meeting addressed some rule-making processes stemming from recent legislative changes on lump sum payments, but also included several other issues. The public comment period remains open until September…
Changes to the Washington Department of Labor & Industries Loss of Earning Power Compensation Policy
Loss of Earning Power (LEP) under RCW 51.32.090 requires the self-insurer to compensate a worker when the worker’s earning capacity has decreased as a result of the industrial injury or occupational disease. The Department instituted a new LEP policy effective July 1, 2025. Policy 5.81 states that the worker must…
Washington Department of Labor & Industries Creates Guideline for Post-Traumatic Stress Disorder Claims
Prior to June 2018, all occupational disease claims alleging mental health conditions due to stress were completely barred. However, that changed in 2018 when the legislature created exceptions allowing law enforcement officers and firefighters who met specific criteria to file occupational exposure claims for post-traumatic stress disorder (PTSD). This exception…
Oregon Rulemaking and Work Groups
A few weeks ago, I discussed the recent legislative changes from the 2025 session. There are now a few different rulemaking and advisory groups developing the administrative framework for those statutory changes. You can see a schedule of the WCD’s meetings here. The Oregon Workers’ Compensation Division will be forming…
ICYMI: Washington workers’ compensation COLA increase goes into effect as of 7/1/2025
It’s that time of year again: COLA increase! Every year, the Department recalculates benefits to reflect the annual changes in the state’s average wage as determined by the Washington State Employment Security Department. As of July 1, 2025, the COLA increase of 6.8 % went into effect, raising the maximum…
2025 Oregon Legislative Sessions Comes to an End
The Oregon legislature adjourned as few weeks ago. While the session had some rather contentious issues to deal with as usual, there were a few workers’ compensation issues that had support through MLAC and passed through the legislature. HB 2800 (PEOs) Changes the term “worker leasing company” to “professional employer…
Psychologists Now Allowed to Serve as Attending Providers in Washington
Previously, psychologists were not permitted to serve as an attending provider in Washington workers’ compensation claims. However, House Bill 1197, which was passed during the 2023 legislative session, will update RCW 51.28.020 to allow psychologists to serve as an attending provider for workers’ compensation claims that solely involve mental health…
Overpayment In Oregon? You better explain it!
As you probably know, employers and insurers in Oregon are entitled to recover overpayments by withholding a certain percentage of future benefits that may be due to the worker on any claim. ORS 656.268(14). You may know that overpayments have to be asserted and documented in writing. OAR 436-060-0170. But…
WA Changes to Claim Administration to Tighten Deadlines
In Washington, the workers’ compensation system is designed to provide prompt medical treatment to affected workers so that the worker can return to work as promptly as possible. As a result, while the employer has the right to investigate claims prior to accepting a claim, the employer is held to…
Oregon Reminder – Update that IME Appointment Language!
Did the claimant not show up for an Independent Medical Examination (“IME”) appointment despite you sending a timely appointment notice? This can be a really frustrating scenario during the claim, especially if you are relying on the IME to guide a claims processing decision. Before insurers and claim administrators explore…
WA BIIA 2024 Significant Decisions
Every year the Washington Board of Industrial Insurance Appeals designates several notable decisions each year as significant. A significant decision is one which the Board considers to have an analysis or decision of substantial importance to the Board. For 2024, the Board designated the following decision as significant: In re…
Oregon Assessed Attorney Fees – The Vicious Circle
The Oregon’s Workers Compensation Board (“WCB”) recently issued an Order on Remand, awarding $68,300 for services litigating reasonableness of an initial attorney fee award. Karista D. Peabody v. SAIF, 77 Van Natta 67, 72 (2025). This ruling aligned with the remand from the Court of Appeals. Peabody v. SAIF Corp.,…
Oregon Vocational Assistance – Authorization to Work in the US is No Longer a Requirement for Eligibility
An injured worker must meet certain conditions to be eligible for vocational assistance, typically the costliest aspect of a workers’ compensation claim. OAR 436-120-0145(2) lays out the specific requirements for a worker to be eligible for vocational retraining. In reviewing that rule you may notice a significant change to the…
Oregon WCB Confirms, No Compensable Claim: No Rule Violation, No Unreasonable Delay
In a recent legal decision, Rosita E. Peery, 77 Van Natta 15 (January 10, 2025), the Oregon Workers’ Compensation Board affirmed an Administrative Law Judge’s (ALJ) ruling, upholding the denial of a worker’s injury and occupational disease claim for a right shoulder condition. The case also addressed whether the worker…
Oregon WCB Confirms Initial Notice of Acceptance Does Not Set a “Theory of the Case”
What is the difference between an injury, a claim, and an accepted condition? The answer, frustratingly, is “it depends.” But the Oregon Workers’ Compensation Board recently issued a decision which at least provides some clarity as to whether one condition accepted in a claim dictates the types of other conditions…
New Medical Services Rules Proposed by the OR WCD
On February 19, 2025, the WCD is holding a hearing to propose amendments to several medical services rules in OAR 436-009, 436-010, and 436-015. Many of the amendments are to address billing code issues and remove outdated notice language. However, there are several notable proposals: OAR 436-009-0010 would be amended…
Washington Department of Labor & Industries Listening Sessions Signal Changes to Claim Process
On January 7 and 23, 2025 the Department held two listening sessions open to attendance by members of the self-insured community regarding The Claims Process Project. These listening sessions were aimed at increasing efficiency and consistency of adjudication and improving accuracy, timeliness, and quality of claim management by all parties…
Important Changes to Oregon IME Appointment Notices in Effect as of October 1, 2024
Have you updated the bold language and formatting in your Oregon IME appointment notice template? In case you missed it, the Oregon Workers’ Compensation Division updated the language and formatting that must be used when issuing an IME appointment notice to an injured worker. These changes went into effect on…
Washington L&I Expands Coverage for Acupuncture Treatment
The Washington Department of Labor & Industries recently adopted a new policy approving acupuncture as a covered treatment for chronic migraine when accepted under a workers compensation claim. Previously, acupuncture was a covered benefit only for treatment of accepted lumbar conditions. The Department adopted its lumbar coverage policy for acupuncture…
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…
Oregon Workers’ Compensation Rules change attorney fee caps in settlement and changes to mandatory denial language.
Previously, OAR 438-015-0050(1) and OAR 438-015-0052(1) allowed a workers’ attorney to receive up to 25% of the first $50,000 of DCS and CDA proceeds and only 10% of any additional settlement funds. The Board recently amended these rules to remove the 10% attorney fee limit. The alterations were made with…
New Oregon Rule Governing Subsequent Temporary Disability Payments Beginning July 1, 2024
On July 15, 2024, the Oregon Workers’ Compensation Division issued an Industry Notice outlining the rule change for the payment of subsequent temporary disability benefits. The due date for the first payment of temporary disability benefits has not changed. If the attending physician or authorized nurse practitioner has authorized temporary…
Surgery in Oregon? Here’s What to Know
The Oregon Workers’ Compensation Division recently added some new deadlines to be aware of when dealing with surgery requests in the MCO context. You can read more about the changes here. But, dealing with a surgery request can still be complicated with a lot of short deadlines, so here is…
New Rules Impacting MCO Enrolled Claims in Oregon – Effective April 1, 2024 and October 1, 2024
The Department of Consumer and Business Services Workers’ Compensation Division amended several provisions of the OAR that will directly impact MCO enrolled claims in Oregon. The net effect of the amended OAR is essentially more claim processing, and in the worst-case scenario, potential exposure for increased claim costs, litigation costs,…
Have you or someone you know been negatively affected by the new Washington IME rules? Get help here!
The new Washington Independent Medical Exam (IME) recording and co-recording rules have made obtaining an IME even more difficult than when they were limited by WAC 296-23-309 last year. Here are some alternative options if you can’t get an IME under WAC 296-23-309 or if you can’t find a medical…
