Navigating claim compensability for injuries outside the State of Washington
Under the Industrial Insurance Act, workers for Washington employers are entitled to benefits for injuries sustained in the course of employment. Under Washington’s extraterritorial statute, this remains true even if the injury occurs outside the territorial limits of the state. Washington courts have recently placed limitations on the extraterritorial statute….
Important Changes to Oregon IME Appointment Notices in Effect as of October 1, 2024
Have you updated the bold language and formatting in your Oregon IME appointment notice template? In case you missed it, the Oregon Workers’ Compensation Division updated the language and formatting that must be used when issuing an IME appointment notice to an injured worker. These changes went into effect on…
Washington L&I Expands Coverage for Acupuncture Treatment
The Washington Department of Labor & Industries recently adopted a new policy approving acupuncture as a covered treatment for chronic migraine when accepted under a workers compensation claim. Previously, acupuncture was a covered benefit only for treatment of accepted lumbar conditions. The Department adopted its lumbar coverage policy for acupuncture…
New denial appeal and hearing rights language requirements in Oregon Workers’ Compensation
As a reminder, the Oregon Workers’ Compensation Board recently revised Oregon Administrative Rule (OAR) 438-005-0055 to reflect changes to the required denial and hearing rights language that must issue with any denial. As always, all notices of denial must specify the factual and legal reasons for the denial and, effective…
What constitutes a valid light duty job offer in Washington?
If an injured worker is not able to perform their job of injury, but is able to perform some type of work, offering a light duty job is often a good option. For a light duty job offer to be “valid” pursuant to RCW 51.32.090(b): A job description or job…
Stress of Navigating Oregon Workers’ Compensation: Possible Ground for Mental Health Condition?
Filing an Oregon Workers’ Compensation claim includes a range of administrative processes, from injury reports to claim closure, encompassing medical treatment, independent medical evaluations, entitlement issues, and several other factors critical to successfully processing a claim. Can this process alone be a valid basis for a compensable mental health condition,…
Oregon Workers’ Compensation Division Reviewing Medical Service and Billing Rules Nov. 5th
The WCD is hosting an advisory committee meeting on November 5, 2024. You can find the agenda here including information about how to participate in the meeting. The WCD regularly reviews these rules to make sure medical service billings are appropriately updated, but there are several topics being discussed including:…
Bridging Borders: Oregon’s Workers’ Compensation Reciprocity Explained
Out-of-State Employers When an out-of-state employee travels to Oregon for work and sustains an injury, it may result in an Oregon workers’ compensation claim, depending on key factors. Pursuant to ORS 656.126(2) any out-of-state worker is exempted from the provisions of this chapter while that worker is temporarily within the…
In Washington, willful or not, misrepresentation puts you on the spot
Everyone can agree, when you take something that you are not entitled to, there are consequences that follow. In Washington worker’s compensation claims it is no different. The Washington Administrative Code speaks to when an injured worker willfully, intentionally, and/or deliberately takes or accepts benefits that they are not entitled…
Oregon Workers’ Compensation Board issues decision expanding right to WRME
On September 16, 2024, a WCB Order on Review, Jon C. Landry, 76 Van Natta 462 (2024), expanded on the Court of Appeals ruling in Teitelman v. SAIF to identify what qualifies as a “post-denial IME report” and when an attending physician does concur with the IME report which denial…
The Oregonian Names SBH Legal A Winner Of The Oregon And Southwestern Washington Top Workplaces, Second Year In A Row!
SBH Legal has been awarded a Top Workplaces 2024 honor by The Oregonian for the second consecutive year. Check out the full list: The Oregonian. This award is based solely on employee feedback gathered through a third-party survey. The confidential survey uniquely measures 15 culture drivers that are critical to the…
Oregon WCB clarifies carrier’s obligation to accept or deny encompassed conditions
A WCB Order on Review, Collin Stringer, 76 Van Natta 462 (2024), distinguished conditions encompassed within previously accepted conditions are not new or omitted conditions. The Board affirmed and supplemented ALJ Naugle’s order to confirm encompassed conditions may be denied where the accepted conditions adequately informed claimant and medical providers…
To Confer or Not to Confer? Understanding Conferral Requirements in Oregon and Washington
Both Oregon and Washington courts emphasize the need for attorneys to confer before filing certain motions, but their specific requirements differ. This post highlights the key distinctions between the Washington State Court Rules and Oregon’s Uniform Trial Court Rules. Oregon: UTCR 5.010 and UTCR 5.100 In Oregon, conferral requirements are…
Oregon Workers’ Compensation Rules change attorney fee caps in settlement and changes to mandatory denial language.
Previously, OAR 438-015-0050(1) and OAR 438-015-0052(1) allowed a workers’ attorney to receive up to 25% of the first $50,000 of DCS and CDA proceeds and only 10% of any additional settlement funds. The Board recently amended these rules to remove the 10% attorney fee limit. The alterations were made with…
Washington Proposed Rule-Making for Third Party Recording: Additional Red Tape in an Already Onerous System?
Since the implementation of new rules allowing claimants to record examinations requested by the Department or Self-Insurer in 2023 employers have encountered increased difficulty in obtaining an independent medical examination (IMEs). Many providers expressed concerns about the unpredictable nature of claimants’ use of the recordings, and are not assuaged by…
Federal Judge Strikes Down FTC’s Ban on Worker Noncompete Agreements: What It Means for Employers
In January 2023, the Federal Trade Commission (FTC) proposed a sweeping federal ban on noncompete agreements in nearly all employment contracts—a move poised to significantly reshape the American labor landscape. Here’s what you need to know about the proposed ban, the recent federal decision, and its implications. Understanding Noncompete Agreements…
Oregon Workers’ Compensation: Does it make sense for an insurer to appeal its own Notice of Closure?
In Oregon, the attending physician plays a crucial role throughout the duration of a workers’ compensation claim. For better or worse, the importance of the attending physician is especially evident when it comes to claim closure. Unless the worker is actively engaged in an authorized training plan, the insurer must…
What type of medical services are compensable after a worker is medically stationary in Oregon?
A common question which arises in Oregon workers’ compensation claims process is what type of medical services will continue to be compensable once a worker has reached a medically stationary status. The Workers’ Compensation Division recently providing some clarification when an insurer will be held liable to compensate a proposed…
Washington Court of Appeals: New Insight on Notice and the Authority of DLI Policies
In the State of Washington, employers are required to give notice of a mandatory IME at least 14 to 60 days prior to the examination, and must provide the worker with the date, time, and location of the exam. But is the worker free to miss the exam without penalty…
Oregon Workers Compensation: Is the deposition of a medical arbiter a thing?
An impartial medical examination is typically scheduled as part of reconsideration proceedings when there is a disagreement about the impairment findings used to close a claim. This examination is known as a medical arbiter examination. A physician or a panel of physicians is assigned by the Appellate Review Unit (“ARU”)…
Washington State Approves Spinal Cord Stimulation for Certain Pain Conditions
On June 14, 2024, there was a final adoption of new guidelines for spinal cord stimulation (SCS). Spinal cord stimulation is a treatment for chronic pain involving the insertion of electrodes into the epidural space near the spinal cord that are connected to an internal or external electrical pulse generator….
New Oregon Rule Governing Subsequent Temporary Disability Payments Beginning July 1, 2024
On July 15, 2024, the Oregon Workers’ Compensation Division issued an Industry Notice outlining the rule change for the payment of subsequent temporary disability benefits. The due date for the first payment of temporary disability benefits has not changed. If the attending physician or authorized nurse practitioner has authorized temporary…
Oregon Attorney Fees in Certain Workers’ Compensation Matters Increased as of July 1, 2024
In Oregon Workers’ Compensation, attorney fees for representation of a claimant are controlled by statute. Certain attorney fees associated with penalties for unreasonable claim processing and attorney representation in a responsibility denial have statutory caps. Those statutory caps are adjusted each year based on the increase of the state’s average…
How exclusive is the exclusive remedy in Oregon Workers’ Compensation?
At the core of the Oregon workers’ compensation system is a compromise between workers’ and employers. Employers must provide benefits for work-related injuries even when there was no negligence by the employer which led to the incident. But these work-related injuries cannot serve as the basis of a lawsuit against…
Washington House Bill 1927 Passed to Adjust Time-Loss Eligibility for Injured Workers
Washington State Governor Jay Inslee signed into law House Bill 1927 which makes it easier for injured workers to qualify for workers’ compensation benefits for the first few days following their injury. This change took effect on June 6, 2024 and impacts all claims with dates of injury or manifestation…
