Permanent Rule Changes Coming to Oregon Workers’ Compensation!
There are new and significant rule changes to Oregon Workers Compensation. These will affect the way workers’ compensation benefits are paid and calculated. Additionally, notable and significant revisions from HB 4138 (regarding overpayments) will not be in effect until January 1, 2024.
Apportionment of PPD in light of Johnson v. SAIF, 369 Or 577 (2022).
The Oregon Supreme Court held when a compensable injury is a material cause of a worker’s impairment, the worker is entitled to the full value of the total impairment, including the portion of the impairment attributed to certain denied conditions.
- Effective December 4, 2022.
- Amends OAR 436-035, Disability Rating Standards related to combined condition denials, hearing loss, and surgical findings.
- Summary of changes can be found here.
Expansion of Beneficiaries and Clarification on Payment of Benefits
OAR 436-060 amended to implement Oregon House Bill 4086 to enhance clarity and align workers’ compensation definition of beneficiaries to match Oregon family law.
- Effective January 1, 2023.
- The new rule broadens the definition of who receives benefits after a worker’s death due to an accidental workplace injury.
- Summary of changes can be found here.
Changes in Employer/Insurer Coverage Responsibility
OAR 436-050 amended to ensure appropriate security deposits by self-insured employers and self-insured employer groups are available to pay workers’ compensation benefits in case a self-insured employer or group defaults or is unable to make payment.
- Effective January 1, 2023.
- Summary of changes can be found here.
Temporary Changes to Oregon Medical Fee and Payment Rules
- Effective January 1, 2023 through June 29, 2023.
- Amends 436-009 to adopt new medical billing codes for 2023.
- Summary of changes can be found here.
Changes in the Ombuds Office, Temporary Disability Benefits, Overpayments, and Medically Stationary Date Determinations
OAR 436-030, 436-060, and 436-120 amended to implement Oregon House Bill 4138 (2022) and to:
- Change the name of the Ombudsman for Injured Workers to the Ombuds Office for Oregon Workers.
- Require written notice be sent to a worker (and their attorney if represented) with explanation for stopping temporary disability payments prior to suspending payment.
- Limit medically stationary date determinations to no more than 60 days prior to the date of determination.
- Update a citation to include the new statute ORS 656.268(16) which will:
- Limit recovery of overpayments to 50% of a PPD award, and
- Limit a declaration of overpayment to compensation paid no more than two years from the date of declaration.
The WCD has adopted these rules more than one year in advance to allow time for updating procedures, forms, and data programs.
- Effective January 1, 2024.
- Summary of changes can be found here.
If you have any questions regarding the application of these new rules, please feel free to contact me at 503-595-6108 or .
Posted by Evan Novotny.
