New Bill Alters Timeline for Initial Time Loss Payment
Prior to January 1, 2016, if there was medical authorization for payment of time loss benefits, the insurer was required to begin paying benefits no later than 14 days after the employer had knowledge of the claim.
House Bill 2797 amends ORS 656.262(4)(a) and adds another layer to when the 14 day timeline begins. The bill provides that the first payment of time loss benefits is due no later than 14 days after the employer has knowledge of both the claim and the worker’s disability. The attending physician must still authorize temporary disability.
The purpose of the bill is to more accurately align employer knowledge with the first date of disability and to ease claim processing challenges when the date of knowledge and date of disability do not line up. Ultimately, the bill should require fewer adjustments to subsequent time loss payments.
The Workers’ Compensation Division has interpreted “knowledge of date disability” to mean that the employer must know, or have enough facts available to reasonably conclude, that the worker cannot perform full regular duties due to the injury or that the worker has lost time or wages due to the injury.
The new bill applies only to those claims filed on or after January 1, 2016. The Division has issued a example scenarios illustrating how the new bill works. They can be found here.
If you have any questions regarding the new bill or any other Oregon Workers’ Compensation claim questions, you can contact me at firstname.lastname@example.org.