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 17, 2025. If you want to provide any feedback on these proposed changes, please contact me or you can contact WCD directly here. A copy of the full agenda and detailed breakdown of the issues can be found here. More briefly, these are some of the changes they are considering:
· HB 2802 changed the statute regarding requesting lump sum payments of PPD, the proposed rules were to match the language in the statute, clarify claimant must waive their right to request reconsideration (not just waive the right to contest the adequacy of the PPD award), and clarify a lump sum payment is not appropriate when either party timely requests reconsideration. There were some concerns about the timing being based on when claimant “cashed” a payment as opposed to when it was issued.
· Whether there should be a deadline to request suspension of benefits for missed IMEs. SBH had actually proposed this after getting somewhat conflicting decisions from the WCD about how much time constitutes a delay in submitting a request. We originally proposed a 30-day window, but the WCD has an informal policy of looking at 21 days from a missed IME. The WCD also asked about applying the deadline to missed vocational exams for PTD, a claimant’s refusal to cooperate with an investigation, and claimant’s injurious or insanitary practices.
· Whether to remove the heightened investigation requirements related to COVID claims, given the declining number of claims seen for COVID.
· Whether to require an insurer to send a misdirected claimant to the correct insurer instead of the WCD. I testified against this to avoid adding further delay into a claim if an insurer believes it identified the correct insurer, but in fact was not the correct party. There was additional discussion about whether to include TPAs on the state coverage database search.
· Whether to allow for MNOA to be combined with UNOAC. Currently, the rules allow for issuing a INOA and UNOAC in the same document, though there was testimony suggesting the process was confusing for workers. SBH testified in favor of allowing the documents to be combined for both efficiency for the insurer and clarity for the worker.
· Time Loss Rules
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- Whether to include a rule addressing varying overtime pay rates for AWW. Most parties involved agreed the current irregular wage rules would cover this and further changes could complicate and confuse an already difficult process of calculating AWW.
- Whether to exclude signing bonuses and relocation bonuses from the AWW as they do not accurately reflect a worker’s wages at injury. There was testimony from claimants’ attorneys saying it should be considered as it is a part of the overall compensation package. There was testimony from the employer side saying it should be excluded because temporary disability is supposed to be based on what would be paid had they not been injured.
- There were other clarifications suggested to address post-injury wages and clarify that because it includes unemployment and paid leave, the definition should not state it is wages “from any kind of work.”
- There was another clarification for job offers that are withdrawn. Currently, the rule states TTD should be reinstated, but the clarification would be the TTD is still subject to other reductions to TPD based on post-injury wages.
· Whether to clarify provisions of PTD/death benefit rules about whether they are paid to the date of death or through the date of death.
· Whether to require WCD approval of a DCS seeking to resolve supplemental disability benefits (current rules require it for CDAs and stipulations).
· Whether to require a 14-day deadline to provide an objection to a WRME request. Claimants’ attorneys were in support of the rule to avoid worker confusion about being found eligible and then later having eligibility taken away. Defense counsel objected to the deadline as the WRME is supposed to be a “tiebreaker” and if the AP does concur with the IME, even if the report comes in late, the basis for the WRME is no longer there.
Again, the public has until September 17, 2025, to submit input on these issues. Depending on the feedback received, the WCD may or may not proceed with formal rulemaking on these issues. If you want to submit any testimony, please contact me at (503) 595-2130 or with any questions or concerns.
Posted by Kevin Anderson.
