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Oregon WCD issues Temporary Rules Clarifying Claim Closure Requirements

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

WCD Adresses Supreme Court’s Brown v. SAIF decision

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

Join SBH Attorney Lauren Oda at WSIA Region Meetings

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

Disability/Leave Roundtable for Employers

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/

New 801 Form and Medical Treatment

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

LHWCA Caselaw Summary

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

White, David_160x222OAR 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

Changes to Oregon Employer-at-Injury Program effective as of January 1, 2017

Anderson, Kevin_webOAR 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

Changes to OAR 436-060 effective as of January 1, 2017

vaniman-megan-colorIn 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
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