Washington State HTCC Decisions: Is Additional Medical Support Required to Defend Treatment Denial?
I know what you are thinking: what is the HTCC? In 2006, Washington State created the Health Technology Committee (HTCC) to make coverage decisions for selected health technologies. Governed by the Washington State Health Care Authority, the HTCC’s decisions are followed by state purchased health care programs including the Department…
From Rigging to Raising: Washington L&I’s New Crane Rules
On August 5, 2025, the Department of Labor & Industries Division of Occupational Safety and Health (DOSH) filed a Permanent Rulemaking (CR-103) related to cranes, rigging, and personnel lifting. This rulemaking became effective on September 5, 2025, and seeks to provide clarity on the Department of Labor & Industries’ interpretation…
Age Discrimination in Hiring and Pay Stub Requirements- New Oregon Employment Laws for 2026
The Oregon Legislature has been busy this session! Two important bills to note are HB 3187 and SB 906. HB 3187 addresses age discrimination in hiring by prohibiting employers from requesting or requiring an applicant’s age, date of birth, or date of graduation from any educational institution prior to completing an…
They are injured in Washington but are they a worker?
The Washington Industrial Insurance Act provides sure and certain relief for Washington workers injured in the course of their employment. The current no-fault system was created as part of the grand bargain between employers and workers, in which workers receive medical care and indemnity benefits in exchange for giving up…
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…
Recent Oregon Court of Appeals decision clarifies the minimum standard to establish a claim for aiding and abetting
In an opinion issued on November 20, 2024, the Oregon Court of Appeals outlined the required legal standard to state a claim for aiding and abetting under ORS 659A.030(1)(g). The court held the correct standard emulates the criminal law standard as outlined by the Oregon Supreme Court in Granewich v….
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…
Changes to the Washington Department of Labor & Industries Loss of Earning Power Compensation Policy
Loss of Earning Power (LEP) under RCW 51.32.090 requires the self-insurer to compensate a worker when the worker’s earning capacity has decreased as a result of the industrial injury or occupational disease. The Department instituted a new LEP policy effective July 1, 2025. Policy 5.81 states that the worker must…
Washington Department of Labor & Industries Creates Guideline for Post-Traumatic Stress Disorder Claims
Prior to June 2018, all occupational disease claims alleging mental health conditions due to stress were completely barred. However, that changed in 2018 when the legislature created exceptions allowing law enforcement officers and firefighters who met specific criteria to file occupational exposure claims for post-traumatic stress disorder (PTSD). This exception…
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…
Recent Washington Court of Appeals decisions help us understand when an industrial injury aggravates a preexisting condition
It is common for workers to have preexisting conditions at the time of their industrial injury. When assessing the scope of conditions related to the claim, a question often arises as to whether the industrial injury aggravated a preexisting condition. Generally, a worker must establish a causal connection between the…
ICYMI: Washington workers’ compensation COLA increase goes into effect as of 7/1/2025
It’s that time of year again: COLA increase! Every year, the Department recalculates benefits to reflect the annual changes in the state’s average wage as determined by the Washington State Employment Security Department. As of July 1, 2025, the COLA increase of 6.8 % went into effect, raising the maximum…
Voluntary Retirement as a Basis to End Time Loss in Washington
Under Washington law, after a worker removes themselves from the labor market by voluntarily retiring, time-loss benefits are not payable. WAC 296-14-100. However, even in claims where the individual is of retirement age and indicates no intention of re-joining the workforce, it can be difficult to establish voluntary retirement as…
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…
Psychologists Now Allowed to Serve as Attending Providers in Washington
Previously, psychologists were not permitted to serve as an attending provider in Washington workers’ compensation claims. However, House Bill 1197, which was passed during the 2023 legislative session, will update RCW 51.28.020 to allow psychologists to serve as an attending provider for workers’ compensation claims that solely involve mental health…
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…
WA Changes to Claim Administration to Tighten Deadlines
In Washington, the workers’ compensation system is designed to provide prompt medical treatment to affected workers so that the worker can return to work as promptly as possible. As a result, while the employer has the right to investigate claims prior to accepting a claim, the employer is held to…
Accuracy in job descriptions is critical to a successful claim closure in Oregon
In a recent Board decision, the Order on Reconsideration and Opinion & Order denying a penalty was set aside for failure to provide an accurate job description. Dawn Price 77 Van Natta 203 (2025). On review claimant contested the accuracy of the job description’s physical requirements for job at injury…
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…
In Oregon, Medical Dispute Denials Are Now a Valid Basis for a WRME Request
In Cheri L. Goss, 77 Van Natta 159 (2025), the Oregon Workers’ Compensation Board reversed an Administrative Law Judge’s (ALJ) decision to uphold the Workers’ Compensation Division’s denial of a worker requested medical examination (WRME). The worker sought review of an ALJ’s Order. On review, the Board considered whether a…
Shhh… or You’ll Waive It: Confidentiality Pitfalls in Oregon Workplace Investigations
When an internal investigation kicks off in an Oregon workplace, confidentiality becomes the name of the game—but too often, no one knows the actual rules. Employers and attorneys alike make the mistake of thinking confidentiality is automatic or absolute. In reality, the Oregon Rules of Professional Conduct (ORPC) require intentional action…
Oregon Time Loss Refresher
In Oregon, time-loss benefits, also known as temporary disability or lost wages, are paid to workers who are unable to work due to a work-related injury or illness. These benefits compensate for lost income while the worker is under a doctor’s care and authorized to remain off work or modified duty….
WA BIIA 2024 Significant Decisions
Every year the Washington Board of Industrial Insurance Appeals designates several notable decisions each year as significant. A significant decision is one which the Board considers to have an analysis or decision of substantial importance to the Board. For 2024, the Board designated the following decision as significant: In re…
Oregon Court of Appeals Gives Clarity to Complicated Pre-Existing Condition Cases
In an opinion issued on April 2, 2025, the Oregon Court of Appeals clarified the causation standard that applies when a new/omitted medical condition claim involves a standalone pre-existing condition that is exacerbated by a work injury. In Barnes v. Cache Electric, 339 Or App 371 (2025), the Court of…
