Washington Board of Industrial Insurance Appeals Identifies Significant Decision that Provides Guidance on When a Worker is Voluntarily Retired
On April 8, 2026, the Board of Industrial Insurance Appeals announced it had identified six 2025 Decision & Orders as significant and delisted three prior Decisions & Orders. Significant decisions are ones the Board determines have analysis or decision of substantial importance. Among the identified significant decisions is the case…
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…
A Refresher on How to Collect Overpayments in Washington
In the administration of a workers’ compensation claim, overpayments may occur for a variety of reasons, some of which include, a clerical error, an innocent misrepresentation, or willful misrepresentation. See RCW 51.32.240. For instances when a payment of benefits was made due to clerical error, innocent misrepresentation, or other circumstances…
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…
What constitutes an appealable decision in Washington?
Each year the Washington Board of Industrial Insurance Appeals designates a few select decisions as “significant.” A significant decision is generally one the Board deems to have precedential importance. The Board has not yet identified its 2025 significant decisions. However, In re Marc Denbo, Dckt. No. 25 13319 (November 25,…
Washington Legislature Passes PTSD Pilot Project Set to Apply to State Fund Employers and Participating Self-Insured Employers
In 2018, the Washington legislature passed SB 6214 which created what has become known as the PTSD presumption amendments for first responders. This presumption was later expanded to include direct care registered nurses in 2024. These amendments have resulted in claims that have proven costly for both state funded and…
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…
Is That Claim Valid in Washington? A Brief Refresher
When a claim is initially filed, the first determination must be whether the claim is an injury or occupational disease. These two claim types are handled differently and have separate requirements. We can break down validity for both an injury and an occupational disease. Industrial Injury Claim When confirming validity,…
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…
Washington Employers – Time to Review Policies and Procedures Related to Personnel Files!
There are new compliance deadlines in effect in Washington related to personnel files, which means it is time for employers to review their policies and procedures related to personnel files. In 2025, Washington State Legislature HB 1308 amended RCW 49.12.250 regarding employers’ obligations to respond to personnel records requests. It is critical…
The Washington Supreme Court and the Traveling Employee Doctrine – a Recent Case Sheds Light on the Scope and Application of This Doctrine
It is common for jobs to require employees to travel out of state for work. A Washington employee traveling for work is subject to workers’ compensation coverage if he or she is injured throughout the duration of the business trip, including during travel, hotel stays and meals at restaurants. The…
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…
Mark Your Calendars: Inflation Adjustments Take Effect July 1, 2026, for Washington Employers
Washington’s statutory inflation adjustment to penalties for certain violations of workers’ compensation laws will take effect July 1, 2026. The anticipated adjustment for 2026 is 12%. Inflation adjustments are relatively new to workers’ compensation penalties in Washington. Most penalties remained stable from 1985 until September 1, 2020, when the Washington…
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…
Postmark Defined: How a New USPS Rule Could Affect Mail Delivery Dates in Washington
A new United States Postal Service (USPS) rule which went into effect on December 24, 2025, formally defines the meaning of a postmark and seeks to clarify the relationship between postmarks and the date of mailing. The rule, which added section 608.22, “Postmarks and Postal Possession,” to the Domestic Mail…
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…
Is your IME Appointment Notice Compliant for the Requirements Provided for Washington Self-Insured Employers?
In recent years, the Department of Labor and Industries has increased its scrutiny of how self-insured employers schedule and send notice for Independent Medical Examinations (IMEs). Failure to follow the rules can result in cancellation of examinations, penalties, and delayed claim processing. RCW 51.36.070 outlines when the self-insured employer may…
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…
Updated Guidance on Washington Wage Order Disputes and Issuance of Time Loss
The general principle is that a document must be reasonably calculated to put the Department on notice that the party was taking issue with a Department decision to qualify as a dispute. Boyd v. City of Olympia, 1 Wash.App.2d 17 (2017). Applying this standard the Court of Appeals reached separate…
Beginning January 1, Oregon Striking Workers may be Eligible to Receive Unemployment Benefits
On June 24, 2025, Oregon Senate Bill 916 (“SB 916”) was signed into law by Governor Tina Kotek. Effective January 1, 2026, this statute will eliminate the longstanding “labor dispute” disqualification in Oregon’s unemployment insurance (UI) law, meaning that workers who are unemployed due to a strike or lockout may,…
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…
