Oregon Department of Consumer and Business Services, Workers' Compensation Division

Rule Rule 436-001-0410
Attorney Fees Awarded under ORS 656.385(1)


(1)

In cases in which the director or administrative law judge awards a fee under ORS 656.385 (Attorney fees in cases regarding certain medical service or vocational rehabilitation matters)(1):
(a) The fee must fall within the ranges of the matrix in subsection (1)(d), unless extraordinary circumstances are shown or the parties otherwise agree.
(b) Extraordinary circumstances are not established merely by exceeding eight hours or a benefit of $6,000.
(c) The matrix in subsection (1)(d) shows the maximum fee and fee ranges as percentages of the maximum fee under ORS 656.385 (Attorney fees in cases regarding certain medical service or vocational rehabilitation matters)(1), as adjusted annually by the same percentage increase, if any, to the average weekly wage defined in ORS 656.211 (“Average weekly wage” defined). Before July 1 of each year the director will publish in Bulletin 356 (available on the division’s website at http:/­/­wcd.oregon.gov/­Bulletins/­bul_356.pdf) the matrix showing the maximum fee and fee ranges as dollar amounts after the annual adjustment to the statutory maximum fee. Dollar amounts will be rounded to the nearest whole dollar. If the average weekly wage does not change or decreases, the maximum attorney fee awarded under ORS 656.385 (Attorney fees in cases regarding certain medical service or vocational rehabilitation matters)(1) will not be adjusted for that year.
(d) See attached table.
(2) For purposes of applying the matrix in medical disputes under ORS 656.245 (Medical services to be provided), 656.247 (Payment for medical services prior to claim acceptance or denial), 656.260 (Certification procedure for managed health care provider), and 656.327 (Review of medical treatment of worker), the following may be considered in determining the value of the results achieved or the benefit to the worker:
(a) The fee allowed by the medical fee schedule in OAR 436-009 for the medical service at issue.
(b) The overall cost of the medical service at issue.
(3) For purposes of applying the matrix in vocational disputes under ORS 656.340 (Vocational assistance procedure), the value of vocational assistance or a training plan, unless determined to be otherwise, falls within the highest range of the matrix for benefit achieved. In addition, the following may be considered in determining the value of the results achieved or the benefit to the worker:
(a) The actual or projected cost of the service at issue.
(b) The maximum spending limit in the fee schedule for vocational assistance costs in OAR 436-120-0720 (Fee Schedule) (as published in Bulletin 124, available on the division’s website at http:/­/­wcd.oregon.gov/­Bulletins/­bul_124.pdf) for the service at issue.
Table is attached.
[ED. NOTE: To view attachments referenced in rule text, click here to view rule.]
Source

Last accessed
Jun. 8, 2021