Category: Oregon Workers Compensation
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…
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…
Oregon Workers’ Compensation End of Year Wrap Up: Let’s End on a High Note!
We welcomed 2024 with a slew of changes to the Oregon Revised Statutes and Oregon Administrative rules on Workers’ Compensation that impact and change how we process claims. As the year evolved, additional requirements came into effect. We at SBH Legal want all of our clients to be successful in…
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…
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…
Stress of Navigating Oregon Workers’ Compensation: Possible Ground for Mental Health Condition?
Filing an Oregon Workers’ Compensation claim includes a range of administrative processes, from injury reports to claim closure, encompassing medical treatment, independent medical evaluations, entitlement issues, and several other factors critical to successfully processing a claim. Can this process alone be a valid basis for a compensable mental health condition,…
Oregon Workers’ Compensation Division Reviewing Medical Service and Billing Rules Nov. 5th
The WCD is hosting an advisory committee meeting on November 5, 2024. You can find the agenda here including information about how to participate in the meeting. The WCD regularly reviews these rules to make sure medical service billings are appropriately updated, but there are several topics being discussed including:…
Bridging Borders: Oregon’s Workers’ Compensation Reciprocity Explained
Out-of-State Employers When an out-of-state employee travels to Oregon for work and sustains an injury, it may result in an Oregon workers’ compensation claim, depending on key factors. Pursuant to ORS 656.126(2) any out-of-state worker is exempted from the provisions of this chapter while that worker is temporarily within the…
Oregon Workers’ Compensation Board issues decision expanding right to WRME
On September 16, 2024, a WCB Order on Review, Jon C. Landry, 76 Van Natta 462 (2024), expanded on the Court of Appeals ruling in Teitelman v. SAIF to identify what qualifies as a “post-denial IME report” and when an attending physician does concur with the IME report which denial…
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. The Board affirmed and supplemented ALJ Naugle’s order to confirm encompassed conditions may be denied where the accepted conditions adequately informed claimant and medical providers…
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…
Oregon Workers’ Compensation: Does it make sense for an insurer to appeal its own Notice of Closure?
In Oregon, the attending physician plays a crucial role throughout the duration of a workers’ compensation claim. For better or worse, the importance of the attending physician is especially evident when it comes to claim closure. Unless the worker is actively engaged in an authorized training plan, the insurer must…
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 has reached a medically stationary status. The Workers’ Compensation Division recently providing some clarification when an insurer will be held liable to compensate a proposed…
Oregon Workers Compensation: Is the deposition of a medical arbiter a thing?
An impartial medical examination is typically scheduled as part of reconsideration proceedings when there is a disagreement about the impairment findings used to close a claim. This examination is known as a medical arbiter examination. A physician or a panel of physicians is assigned by the Appellate Review Unit (“ARU”)…
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…
