Chapter 350 Oregon Laws 2001

AN ACT

SB 316

Relating to time limitations for requesting certain actions in workers’ compensation claims; amending ORS 656.273 and 656.277.

Be It Enacted by the People of the State of Oregon:

SECTION 1. ORS 656.273 is amended to read:

656.273. (1) After the last award or arrangement of compensation, an injured worker is entitled to additional compensation for worsened conditions resulting from the original injury. A worsened condition resulting from the original injury is established by medical evidence of an actual worsening of the compensable condition supported by objective findings. However, if the major contributing cause of the worsened condition is an injury not occurring within the course and scope of employment, the worsening is not compensable. A worsened condition is not established by either or both of the following:

(a) The worker’s absence from work for any given amount of time as a result of the worker’s condition from the original injury; or

(b) Inpatient treatment of the worker at a hospital for the worker’s condition from the original injury.

(2) To obtain additional medical services or disability compensation, the injured worker must file a claim for aggravation with the insurer or self-insured employer. In the event the insurer or self-insured employer cannot be located, is unknown, or has ceased to exist, the claim shall be filed with the Director of the Department of Consumer and Business Services.

(3) A claim for aggravation must be in writing in a form and format prescribed by the director and signed by the worker or the worker’s representative. The claim for aggravation must be accompanied by the attending physician’s report establishing by written medical evidence supported by objective findings that the claimant has suffered a worsened condition attributable to the compensable injury.

(4)[(a)] The claim for aggravation must be filed within five years:

(a) After the first notice of closure made under ORS 656.268 for a disabling claim; or

(b) [The claim for aggravation must be filed within five years] After the date of injury, provided [that] the claim has been classified as nondisabling for [more than] at least one year after the date of acceptance [injury or more than 60 days after the date of first classification by the insurer or self-insured employer, whichever is later].

(5) The director may order the claimant, the insurer or self-insured employer to pay for such medical opinion.

(6) A claim submitted in accordance with this section shall be processed by the insurer or self-insured employer in accordance with the provisions of ORS 656.262, except that the first installment of compensation due under ORS 656.262 shall be paid no later than the 14th day after the subject employer has notice or knowledge of medically verified inability to work resulting from a compensable worsening under subsection (1) of this section.

(7) A request for hearing on any issue involving a claim for aggravation must be made to the Workers’ Compensation Board in accordance with ORS 656.283.

(8) If the worker submits a claim for aggravation of an injury or disease for which permanent disability has been previously awarded, the worker must establish that the worsening is more than waxing and waning of symptoms of the condition contemplated by the previous permanent disability award.

SECTION 2. ORS 656.277 is amended to read:

656.277. (1) A request for reclassification by the worker of an accepted nondisabling injury that the worker believes was or has become disabling must be submitted to the insurer or self-insured employer. The insurer or self-insured employer shall classify the claim as disabling or nondisabling within 14 days of the request [if the request is received within one year after the date of acceptance]. A notice of such classification shall be mailed to the worker and the worker’s attorney if the worker is represented. The worker may ask the Director of the Department of Consumer and Business Services to review the classification by the insurer or self-insured employer by submitting a request for review within 60 days of the mailing of the classification notice by the insurer or self-insured employer. If any party objects to the classification of the director, the party may request a hearing under ORS 656.283 within 30 days from the date of the director’s order.

(2) A request by the worker that an accepted nondisabling injury was or has become disabling shall be made pursuant to ORS 656.273 as a claim for aggravation, provided the claim has been classified as nondisabling for at least one year after the date of acceptance [if made more than one year after the date of acceptance].

(3) A claim for a nondisabling injury shall not be reported to the director by the insurer or self-insured employer except:

(a) When a notice of claim denial is filed;

(b) When the status of the claim is as described in subsection (1) or (2) of this section; or

Approved by the Governor June 8, 2001

Filed in the office of Secretary of State June 8, 2001

Effective date January 1, 2002

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