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 second opinion (paid for by the employer/administrator) called a worker requested medical examination (WRME). To be entitled to a WRME, the worker must establish the employer/administrator issued a denial, the denial was based on an IME, and the attending physician disagreed with the IME. ORS 656.325(1)(e).
Last year, the Court of Appeals determined a worker is entitled to a WRME even when the IME was scheduled after the denial issued. On appeal, the Supreme Court was asked to consider when a denial is “based on” an IME.
In Teitelman v. SAIF, 374 Or 271 (2025), the Supreme Court affirmed the lower court’s definition of a denial as an ongoing status, rather than a single event. The Court explained the denial itself is a procedural event which triggers the status of denial which colors the claim. The Court determined the intent of ORS 656.325(1)(e) is to provide injured workers with a WRME when the employer relies on an IME to defend the status of a denial, even if the procedural event (the notice of denial) was issued before the IME was completed. Therefore, even when an IME takes place after a denial is issued, the denial can still be “based” on the IME.
The Court noted another interesting implication of this ruling. If the employer obtains an IME with which the attending physician has not concurred, the injured worker is entitled to a WRME. If the employer then decides it does not want to rely on the IME to defend the denial, the injured worker is no longer entitled to a WRME. This is important because if the employer determines an IME is no longer necessary to defend the denial, then the worker would not be entitled to a WRME even though the elements of WRME entitlement were otherwise met.
Teitelman is another decision in a series of rulings which have expanded injured workers’ entitlement to WRMEs in recent years. For example, last year the Workers’ Compensation Board determined in Jon C. Landry, 76 Van Natta 462 (2024) that statements from the IME physician in a deposition (with which the attending physician disagreed) could serve as the basis for WRME entitlement. In essence, the IME physician’s ongoing statements were considered part of the IME for purposes of the employer’s reliance on the opinion to support the denial. There are likely to be additional changes, perhaps through rulemaking. There is potential an independent record review (without examination of the worker) will also face scrutiny, as it could also fall under the umbrella of an IME for purposes of WRME entitlement.
There may be other unforeseen implications of defining claim denial as a status, rather than an event. When the Supreme Court provides a definition for a previously ambiguous statutory term, the fallout can continue to reverberate beyond the immediate context of the case. If a denial is best understood as a status, rather than an event, there may be additional changes to case law coming down the line, beyond the immediate implications for WRME entitlement.
If you have any questions about this decision, or about any aspect of IME or WRME procedure, please do not hesitate to contact me at or 971-867-2718.
Posted by Matthew Baker.
