Category: Oregon Workers Compensation
When is Enough, Enough? Weighing the Benefits and Risks of Raising a Request for Administrative Review in Oregon
The goal of the Workers’ Compensation System in Oregon is to ensure that workers receive prompt medical care to allow workers to heal from workplace injuries or occupational diseases. Ideally, when there has been a compensable workplace injury, quality medical care should be provided so the injured worker can appropriately…
Sending Workers Out of State? What Oregon Employers Need to Know
If your Oregon business is growing, you might eventually find yourself sending an employee across the border. Maybe it’s a quick repair job in Vancouver, Washington, or a month-long project in Idaho. When this happens, a critical question arises: Whose rules apply if they get hurt? Do you keep paying…
Let’s Talk Overpayments…(in Oregon)
One of the most significant areas of exposure over the life of a claim is temporary disability benefits. Recent changes to the administrative rules and statutes now impose a significant burden on the insurer/TPA before they can end temporary disability benefits. Oftentimes the insurer/TPA continues paying procedural temporary disability when…
Oregon Expands “Attending Physician” – What HB 4040 Actually Changes
House Bill 4040 (2026) marks a significant shift in Oregon workers’ compensation practice by expanding who may serve as an “attending physician.” Effective immediately upon passage in April 2026, the law amends ORS 656.005(12) to fully include nurse practitioners (NPs) and physician associates (PAs) within that role, eliminating the longstanding…
60 Days Means 60 Days in Oregon: New Board Decision Addresses the Medically Stationary Date and Overpayments
On March 18, 2026, the Workers’ Compensation Board issued an Order on Review further clarifying the finality of medically stationary dates listed on notices of closure. Christopher L. Shute, WCB Case No. 25-01824 (Order on Review, March 18, 2026). In Christopher L. Shute, WCB Case No. 25-01824 (Opinion and Order,…
Oregon Court of Appeals Offers New Guidance on Back Up Denials under ORS 656.262(6)(a)
In a rare instance, the Oregon Court of Appeals affirmed the Board’s conclusion that SAIF provided substantial evidence to support a backup denial under ORS 656.262(6)(a). The court held substantial evidence supported the Board’s conclusion that SAIF could have reasonably come to a different conclusion regarding initial compensability if it…
New Oregon Medical Service/Billing Rules in Effect this Week
In February, I sent out an update about some possible changes to the medical billing, treatment, and MCO rules. The WCD is moving forward with implementing some of those changes, which take effect this week (April 1, 2026). You can find the text here. These changes include: Changes to medical…
An Update on Standards for Compensability for Preexisting Conditions In Oregon Post-Barnes
In 2025, the Barnes decision shook up the workers’ compensation standards when the Oregon Court of Appeals held that a pre-existing condition that is exacerbated by a work injury can be compensable, but only if the work injury is the major contributing cause of a pathological worsening of the pre-existing…
2026 Special Session Comes to an End in Oregon
The legislature convened for a session on February 2, 2026, and adjourned on March 6, 2026. The short session saw a few changes to the workers’ compensation system. There was one main bill directed at the Average Weekly Wage calculation, but a few others also related to the workers’ compensation…
What can the Oregon Workers’ Compensation Board consider before applying the First Responders Presumption under ORS 656.802(7)(b)?
Certain first responders are entitled to a presumption of compensability when a preponderance of medical evidence from a psychiatrist or psychologist establishes the worker has more likely than not satisfied the DSM-5 diagnostic criteria for post-traumatic stress disorder (“PTSD”) or acute stress disorder. ORS 656.802(7)(b). Applicable roles include full time…
Oregon WCD Formal Rulemaking – Medical Treatment
The WCD met in November to discuss some issues regarding medical billing, treatment, and MCO procedures. The WCD is moving forward with formal rulemaking on some of these topics. A meeting is set for February 18, 2026, and it will be the last opportunity to provide input on these proposed…
Was that Oregon Claim Closure Unreasonable?
The Court of Appeals issued an important decision which addressed in part an employer’s reliance upon an attending physician’s repeated determinations of medically stationary status when issuing a notice of closure. An insurer must close an Oregon Workers’ Compensation claim when a worker is medically stationary. OAR 436-030-0020(1). Proper notice…
Oregon IME Appointment Notices: Strict Compliance with Administrative Rules: The All-or-Nothing Game
While standardized boilerplate templates for documents such as IME appointment notices can be an efficient tool in an employer’s or insurer’s claims-handling arsenal, case law continues to underscore a critical point: efficiency cannot come at the expense of strict regulatory compliance. Oregon’s workers’ compensation system leaves little margin for error…
Got Paystubs? You May Need More When Navigating Time Loss and AWW Disputes in Oregon
You have done it! You have finally mastered calculating the worker’s average weekly wage calculation for both regular and irregular pay. Time loss payments are issuing, claim processing is moving along, and then, you see the dreaded piece of mail: a request for hearing generically marking the issue as “temporary…
Nothing Average About It: Oregon Average Weekly Wage Calculations
In Oregon workers’ compensation, calculation of an injured worker’s average weekly wage is often litigated and often misunderstood. The first step in calculating an average weekly wage is the most important—establishing whether the worker was earning regular or irregular wages at the time of injury. Regular and irregular wages have…
In Oregon, Hearing Requests from Former Opposing Counsel May Haunt You!
Generally, if a claimant does not timely file a hearing request, they will lose their right to compensation unless they can show good cause. The Supreme Court of Oregon has long held that an attorney’s failure to file a hearing request does not constitute good cause. Sekermestrovich v. SAIF, 280…
Navigating Responses to Requests for Lump-Sum Payments of Permanent Disability Awards in Oregon
Updated to reflect changes coming January 1, 2026. You’ve done it – the claim has closed. This is a difficult feat in and of itself. A permanent partial disability (PPD) has been accurately determined and will be awarded in installments. You are ready to begin installments (or you have already…
Oregon WCD Rulemaking Meetings Set for November 18-19, 2025
The WCD scheduled a public advisory meeting for November 18, 2025, 1:00 – 4:00 PM to address potential changes to medical treatment, billing, and MCO rules. You can find the agenda here. Some of the proposed changes stem from MLAC’s subcommittee on medical treatment issues and issues related to finding…
Oregon Supreme Court Affirms Broad WRME Entitlement
A common tool of administrators and employers in obtaining information necessary to process a workers’ compensation claim is an independent medical examination (IME), whereby a physician without any prior tie to the worker provides a medical opinion. In Oregon, if certain conditions are met, injured workers are entitled to a…
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…
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…
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…
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…
Oregon Workers’ Compensation: What Happens if Claimant Passes Away?
In Oregon, when a claimant passes away that may not mean immediate claim resolution. Sometimes additional work up of the claim may be necessary before the claim can close. When a claimant dies the date of death is substituted for the medically stationary date, if claimant’s attending physician has not…
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…
