Hopefully you are reading this blog post from the safety of your computer and not while driving. If you are using your cell phone to read this while on your morning commute, you could be violating a newly passed Washington Law. Governor Jay Inslee signed a measure that will prohibit Washington drivers from holding an electronic device while driving. Current law in Washington only prohibits texting or holding a phone to the ear while driving. The expanded law prohibits drivers from holding an electronic device while driving, including while in traffic or waiting for a traffic light. This means, no checking Facebook, no reading or sending emails, or using apps. Drivers are allowed to minimally use a finger to activate,… Continue reading
Oregon Court of Appeals further defines susceptibilities or predispositions vs. preexisting conditions.
The Oregon Court of Appeals recently decided another case addressing what qualifies as a preexisting condition. Doris L. Lowells v. SAIF, 285 Or App 161 (2017). In Lowells, the court confirmed “chronic pain disorder” was not a compensable occupational disease because the major cause of the condition was claimant’s weight, deconditioning, and chronic tobacco use. Claimant argued on appeal that those personal factors should not be considered because they were “mere susceptibilities or predispositions.” The court previously discussed preexisting conditions and confirmed if a condition merely renders a worker more susceptible to an injury, but does not actively contribute to damaging the body part, it cannot qualify as a preexisting condition. Corkum v. Bi-Mart Corp., 271 Or App 411, 419,… Continue reading
In our efforts to keep you apprised of the latest developments regarding the Oregon Supreme Court’s decision in Brown (see Andrew’s blog on the case here.) and how the decision could affect claim processing (see Megan’s blog on the issue here.), we are forwarding the temporary administrative rules issued by the WCD. As expected, the rules confirm that medically stationary status, permanent impairment, and permanent work restrictions must relate to the accepted condition or to a direct medical sequela of the accepted condition. The temporary rules remove the phrase “a condition directly resulting from the work injury.” The WCD also revised Bulletin 239, the claim closure guide provided to medical arbiters. The bulletin provides useful information to ask the attending… Continue reading
The Oregon Supreme Court’s recent decision in Brown v. SAIF, 361 Or 241 (2017) calls into doubt the applicability of the Workers’ Compensation Division rules involving claim closure. Specifically, the WCD amended closure rules in 2015 to require an impairment rating based on the compensable injury rather than the accepted conditions. Brown held that a compensable injury refers only to the accepted conditions. (For more information on the recent decision see Andrew Evenson’s post here.) The WCD issued an industry notice on April 3, 2017 to address the case. The WCD is reviewing the rules and will be holding its first meeting to discuss rule changes in light of the recent decision on April 20, 2017. The WCD stated they… Continue reading
What can Brown do for you? In a long-awaited decision, the Oregon Supreme Court reverses Brown v. SAIF
It has been almost three years since the Oregon Court of Appeals issued its decision in Brown v. SAIF, 262 Or App 640 (2014), finding that a “compensable work injury” referred to the injurious incident and all the conditions that flowed from it, accepted or not. The case was appealed to the Oregon Supreme Court, which issued its decision on March 30, 2017, reversing the Court of Appeals’ decision and affirming the Workers’ Compensation Board decision. In a lengthy opinion, the Supreme Court ruled that the term “compensable injury” shall be interpreted to mean only the medical conditions accepted by the insurer or self-insured employer. This case involved a combined condition denial. The claim was accepted for a lumbar strain… Continue reading
Lauren Oda will be presenting with orthopaedic surgeon Scott Kitchel, M.D. at four WSIA Region Meetings in April. Lauren and Dr. Kitchel will discuss common orthopaedic injuries of the spine and various mechanisms of injuries. The presentation will also discuss strategies for writing clear and concise IME cover letters to obtain persuasive IME reports. Information on the meetings is below. Tuesday, April 4, 2017 8:00 AM- 9:45 AM WSIA Office • 828 7th Avenue Southeast • Olympia, WA 98501 Tuesday, April 4, 2017 11:00 AM – 12:30 PM Valley Medical Center • Medical Arts Center MAC A • 400 S. 43rd Street Renton, Washington 98055 Tuesday, April 25, 2017 8:00 AM – 9:30 AM US Bancorp Tower • Training Room… Continue reading
The Oregon/SW Washington chapter of the DMEC is hosting a free lunch roundtable on March 15, 2017. Employers, HR professionals, and leave administrators are encouraged to attend to discuss leave management challenges. The event is free, but registration is required. March 15, 2017 from 11:30 a.m. to 1:00 p.m. at Kaiser Town Hall – 3704 N Interstate Avenue. Register here: http://dmec.org/2016/12/20/2017-oregonsouthwest-washington-chapter-meeting-mar-15/
You may have noticed, the Oregon Workers’ Compensation Division has revised the standard Form-801 “Report of Job Injury or Illness.” This form is the normal starting place for many claims and used throughout the claims administration process. The new revisions include acknowledgements by both the worker and employer regarding the worker’s right to select their medical provider. Specifically, by signing the 801: The worker is agreeing “I understand I have a right to see a health care provider of my choice subject to certain restrictions under ORS 656.260 and ORS 656.325.” The employer is agreeing “I understand I may not restrict the worker’s choice of or access to a health care provider. If I do, it could result in… Continue reading
The following is a review of recent relevant Longshore and Harbor Workers’ Compensation Act caselaw. There were relatively few decisions and none created new law with the possible exception of the 4th Circuit’s decision in Metro Machine Corporation. The Benefits Review Board issued 13 LHWCA decisions in November, 5 in December, and has not posted January decisions on its website. All of the Board decision were designated as unpublished. They are instructive but do not set precedent. Average Weekly Wage – §10(c) No mandate to base average weekly wage exclusively on overseas earnings. Kuza v. Global Linguist Solutions, LLC, BRB 16-0227, 12/8/16 (unpublished). In 2012, for three and one-half months, claimant worked for UPS in the… Continue reading
Changes to Oregon rules regarding Employer/Insurer Coverage Responsibility effective as of January 1, 2017
OAR 436-050 governs the responsibility of employers and insurers to provide workers’ compensation coverage to subject workers for compensable injuries and illnesses. Many changes to an employer/insurers coverage responsibility went into effect at the start of the New Year. Some of these changes were stylistic and meant to provide improved clarity through better organization and use of plain language. Other changes were more substantive and are outlined below. OAR 436-050-0110/OAR 436-050-0210: Requires insurers/self-insurers to process and maintain claim records in the State of Oregon. However, insurers can receive claim reports and issue payments from outside the state so long as records are forwarded to or payments are directed from Oregon. OAR 436-050-0150(3): Requires employers to maintain a financial rating of… Continue reading
OAR 436-105 explains who qualifies for and how to request assistance and reimbursement from the Employer-at-Injury Program (EAIP). The EAIP encourages early return to work by providing incentives to employers from the Workers’ Benefit Fund. Several changes were made to the EAIP administrative rules and vocational assistance rules. The following are some of the key changes to the EAIP. OAR 436-105-0003(3): Clarifies documents can be submitted to the WCD via the US Postal Service, physical delivery to the Salem WCD office, fax, or any other method approved by the WCD (the WCD is working on developing an online portal system similar to the WCB’s portal). OAR 436-105-0006: Specifies money from the Workers’ Benefit Fund cannot be used to provide benefits… Continue reading
In 2016, the Workers’ Compensation Division drafted changes to OAR 436-060. These changes went into effect on January 1, 2017. Below, I have outlined several changes that claim’s administrators should be aware of. Please note that the below list and recommendations is not a complete list of changes to Division 060. I encourage you to review the new rules. OAR 436-060-0010(6): The worker may choose a medical service provider, attending physician or authorized nurse practitioner under ORS 656.245, 656.260, OAR 436-010 and 436-015. Except as provided under ORS 656.260 and OAR 436-015, if an employer restricts the worker’s choice of medical service provider the director may impose a civil penalty of up to $2,000. What this means for you: This… Continue reading
Earlier this year, the Oregon Workers’ Compensation Division proposed extensive changes to division rules. The rule changes go into effect on January 1, 2017. The following OAR 436 divisions include changes: – 050, Employer/Insurer Coverage Responsibility – 060, Claims Administration – 105, Employer‐at‐Injury Program – 110, Preferred Worker Program – 120, Vocational Assistance to injured Workers A complete copy of the rules and changes can be found here. Over the next couple of weeks, SBH will provide details on how the rule changes will impact claims administration. In the meantime, if you have any questions about the rule changes please contact me at email@example.com.
Attorney Fees – Entitlement Board allows fees for defending a fee petition. Baker Botts not binding on fee shifting statutes. Clisso v. Elro Coal Company, 2016 WL 3575792 (BRB 15-0010 BLA, 2016). Employer objected to payment of $300 for one hour of attorney services for defense of the fee petition. The Board held the Supreme Court’s decision in Baker Botts LLP v. ASARCO LLC, 135 S.Ct. 2158 (2015) was not applicable because §28(a) is a fee shifting statute and therefore is an exception to the American Rule that litigants pay their own attorney’s fees. The Board cited United States District Court decisions refusing to apply Baker Botts in a Fair Debt Collection Practices Act, Equal Access… Continue reading
OSHA issued a final rule regarding electronic recordkeeping that also included new anti-retaliation records. Read a prior blog post regarding this rule here: https://sbhlegal.com/new-osha-rules-address-post-accident-drug-testing-retaliation-claims-and-electronic-injuryillness-reporting/ A group of insurer and industry groups in Texas filed suit challenging OSHA’s authority to enact the anti-retaliation provisions of the new rule. They asked the court to enjoin OSHA from implementing the new rule until it could consider the merits of the challenge. Today, that federal court denied the motion for that preliminary injunction. The court found the plaintiffs failed to show that irreparable harm would result if the court did not stop implementation of the rule pending a final decision. As a result, the anti-retaliation provisions will go into effect on Thursday, December 1,… Continue reading
Please join me at the DMEC Roundtable on December 14, 2016. Mike Moses from Kaiser Permanente and I will be speaking on ADAAA and Family Leave. Please register by December 9. More information and registration is available here.
On December 1st, the Department of Labor’s new rule regarding exemptions from overtime was set to go into effect. A ruling from a federal court yesterday suspends that rule. The DOL rule in question updated exemption rules that allow employees meeting both a salary test and duties test to be exempt from receiving overtime. The rule can be found at https://www.dol.gov/WHD/overtime/final2016/. It raises the salary test from $23,660 to $47,467 for most employees, and the salary test for “highly compensated employees” to $134,004. The rule ties the standard salary level to the 40th percentile of full time salaries of employees in the lowest census region, and ties the highly compensated employees salary level to the 90th percentile of full time… Continue reading
Claimant only required to show idiopathic factors were less likely to have caused unexplained injury
The Oregon Court of Appeals established new case-law on claimant’s burden of proof in “unexplained fall” claims. If an injury is unexplained, as a matter of law, it is presumed to arise out of employment. Whether an injury is unexplained, is a question of fact. An injury is only deemed truly unexplained if the claimant eliminates idiopathic factors as causative. In Sheldon v. U.S. Bank, claimant fell in the lobby of her employer’s building. U.S. Bank denied the claim and argued her fall was caused by her diabetes and obesity. The Workers’ Compensation Board agreed and determined because there was medical evidence demonstrating diabetes and obesity can contribute to balance problems her fall was not truly unexplained.… Continue reading
Join SBH at its 15th Annual Oregon Claims Examiner Workshop on November 11, 2016 at the Multnomah Athletic club. If you have not registered, there is still time! Click here to register. We look forward to seeing you there!
Under ORS 656.265, notice of an accident resulting in an injury must be given immediately by the worker, but not later than 90 days after the accident. Failure to give notice of a workplace incident bars an injury claim unless the employer already had knowledge of the injury or death; the worker died within 180 days of the date of injury; or the worker can establish “good cause” for failure to give notice within 90 days after the alleged incident. The Court of Appeals of Oregon recently ruled in Dalia R. Lopez v. SAIF, 505 Or. App. 679 (2016), that a “good cause” showing for untimely injury filing does not require medical evidence. In this case, claimant’s regular work activities… Continue reading