Changes in WC law

New Average Weekly Wage Calculation Rules

The Workers’ Compensation Division recently issued new rules for calculating average weekly wage. The new rules will apply to claims with dates of injury on or after February 21, 2018. Under the new rule: When a worker is paid irregular wages and there is an increase or decrease in the worker’s pay rate in the previous 52 weeks before the injury/occupational disease, this will not constitute a “new wage earning agreement.” The insurer must calculate the worker’s average weekly hours worked at each pay rate since the last wage earning agreement (not to exceed 52 weeks). The average hours at each pay rate will then be multiplied by the pay rate at the time of injury/occupational disease. Any irregular… Continue reading

Worker’s Compensation Division Addresses House Bill 2338 Regarding Benefits to Surviving Children

The Workers’ Compensation Division issued an Addendum to Bulletin No. 377 on December 8, 2017. The Division issued the addendum to address House Bill 2338, which changed the computation of fatal benefits to children of deceased workers or “surviving children.” The addendum does not change the monthly benefit amounts for: Surviving children receiving benefits at 25 percent of the base or average weekly wage (whichever applies) before January 1, 2018; or Surviving children or dependents with no surviving parents who are completing secondary education, a GED, or a program of higher education. The addendum does change all monthly benefits being paid at the 10 percent level before January 1, 2018. Those benefits must be increased to 25 percent for benefits… Continue reading

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 uncertainty regarding how and when the Workers’ Compensation Division (WCD) would permanently incorporate the Brown ruling into the Oregon Administrative Rules (OAR), Chapter 436. On September 8, 2017, the WCD announced and posted its final amendments to the following Divisions: OAR 436-010, Medical Services; OAR 436-030, Claim Closure and Reconsideration; and OAR 436-035, Disability Rating Standards. The permanent rules are effective October 8, 2017. As expected, the predominant change in… Continue reading

Oregon WCD issues Temporary Rules Clarifying Claim Closure Requirements

In our efforts to keep you apprised of the latest developments regarding the Oregon Supreme Court’s decision in Brown (see Andrew’s blog on the case here.) and how the decision could affect claim processing (see Megan’s blog on the issue here.), we are forwarding the temporary administrative rules issued by the WCD. As expected, the rules confirm that medically stationary status, permanent impairment, and permanent work restrictions must relate to the accepted condition or to a direct medical sequela of the accepted condition. The temporary rules remove the phrase “a condition directly resulting from the work injury.” The WCD also revised Bulletin 239, the claim closure guide provided to medical arbiters. The bulletin provides useful information to ask the attending… Continue reading

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 to the Oregon Supreme Court, which issued its decision on March 30, 2017, reversing the Court of Appeals’ decision and affirming the Workers’ Compensation Board decision. In a lengthy opinion, the Supreme Court ruled that the term “compensable injury” shall be interpreted to mean only the medical conditions accepted by the insurer or self-insured employer. This case involved a combined condition denial. The claim was accepted for a lumbar strain… Continue reading

Changes to Oregon rules regarding Employer/Insurer Coverage Responsibility effective as of January 1, 2017

White, David_160x222OAR 436-050 governs the responsibility of employers and insurers to provide workers’ compensation coverage to subject workers for compensable injuries and illnesses. Many changes to an employer/insurers coverage responsibility went into effect at the start of the New Year. Some of these changes were stylistic and meant to provide improved clarity through better organization and use of plain language. Other changes were more substantive and are outlined below. OAR 436-050-0110/OAR 436-050-0210: Requires insurers/self-insurers to process and maintain claim records in the State of Oregon. However, insurers can receive claim reports and issue payments from outside the state so long as records are forwarded to or payments are directed from Oregon. OAR 436-050-0150(3): Requires employers to maintain a financial rating of… Continue reading

Changes to Oregon Employer-at-Injury Program effective as of January 1, 2017

Anderson, Kevin_webOAR 436-105 explains who qualifies for and how to request assistance and reimbursement from the Employer-at-Injury Program (EAIP). The EAIP encourages early return to work by providing incentives to employers from the Workers’ Benefit Fund. Several changes were made to the EAIP administrative rules and vocational assistance rules. The following are some of the key changes to the EAIP. OAR 436-105-0003(3): Clarifies documents can be submitted to the WCD via the US Postal Service, physical delivery to the Salem WCD office, fax, or any other method approved by the WCD (the WCD is working on developing an online portal system similar to the WCB’s portal). OAR 436-105-0006: Specifies money from the Workers’ Benefit Fund cannot be used to provide benefits… Continue reading

Changes to OAR 436-060 effective as of January 1, 2017

vaniman-megan-colorIn 2016, the Workers’ Compensation Division drafted changes to OAR 436-060. These changes went into effect on January 1, 2017. Below, I have outlined several changes that claim’s administrators should be aware of. Please note that the below list and recommendations is not a complete list of changes to Division 060. I encourage you to review the new rules. OAR 436-060-0010(6): The worker may choose a medical service provider, attending physician or authorized nurse practitioner under ORS 656.245, 656.260, OAR 436-010 and 436-015. Except as provided under ORS 656.260 and OAR 436-015, if an employer restricts the worker’s choice of medical service provider the director may impose a civil penalty of up to $2,000. What this means for you: This… Continue reading

New Oregon WCD Rules go into effect January 1, 2017

vaniman-megan-colorEarlier this year, the Oregon Workers’ Compensation Division proposed extensive changes to division rules. The rule changes go into effect on January 1, 2017. The following OAR 436 divisions include changes: – 050, Employer/Insurer Coverage Responsibility – 060, Claims Administration – 105, Employer‐at‐Injury Program – 110, Preferred Worker Program – 120, Vocational Assistance to injured Workers A complete copy of the rules and changes can be found here. Over the next couple of weeks, SBH will provide details on how the rule changes will impact claims administration. In the meantime, if you have any questions about the rule changes please contact me at mvaniman@sbhlegal.com.

Board’s new attorney fee rules go into effect on November 1.

vaniman-megan-colorThe Oregon Workers’ Compensation Board passed revised attorney fee rules on October 13, 2016. The most significant changes involve increased attorney fees for disputed claims settlements and claims disposition agreements. The Board increased attorney fees on Disputed Claim Settlements and Claims Disposition Agreements. Previously attorneys were awarded 25% of the first $17,500 of the settlement process plus 10% of any amount of proceeds in excess. The Board revised the rules to allow 25% of the first $50,000 of the settlement proceeds plus 10% of any amount of proceeds in excess of $50,000. The Board also increased the amount of attorney fees received in PPD and PTD cases. Previously awards were limited to 25% of increased compensation not to exceed… Continue reading