ORS 656.245
Medical services to be provided

  • services by providers not members of managed care organizations
  • authorizing temporary disability compensation and making finding of impairment for disability rating purposes by certain providers
  • review of disputed claims for medical services
  • rules

(1)

Intentionally left blank —Ed.

(a)

For every compensable injury, the insurer or the self-insured employer shall cause to be provided medical services for conditions caused in material part by the injury for such period as the nature of the injury or the process of the recovery requires, subject to the limitations in ORS 656.225 (Compensability of certain preexisting conditions), including such medical services as may be required after a determination of permanent disability. In addition, for consequential and combined conditions described in ORS 656.005 (Definitions) (7), the insurer or the self-insured employer shall cause to be provided only those medical services directed to medical conditions caused in major part by the injury.

(b)

Compensable medical services shall include medical, surgical, hospital, nursing, ambulances and other related services, and drugs, medicine, crutches and prosthetic appliances, braces and supports and where necessary, physical restorative services. A pharmacist or dispensing physician shall dispense generic drugs to the worker in accordance with ORS 689.515 (Regulation of generic drugs). The duty to provide such medical services continues for the life of the worker.

(c)

Notwithstanding any other provision of this chapter, medical services after the worker’s condition is medically stationary are not compensable except for the following:

(A)

Services provided to a worker who has been determined to be permanently and totally disabled.

(B)

Prescription medications.

(C)

Services necessary to administer prescription medication or monitor the administration of prescription medication.

(D)

Prosthetic devices, braces and supports.

(E)

Services necessary to monitor the status, replacement or repair of prosthetic devices, braces and supports.

(F)

Services provided pursuant to an accepted claim for aggravation under ORS 656.273 (Aggravation for worsened conditions).

(G)

Services provided pursuant to an order issued under ORS 656.278 (Board has continuing authority to alter earlier action on claim).

(H)

Services that are necessary to diagnose the worker’s condition.

(I)

Life-preserving modalities similar to insulin therapy, dialysis and transfusions.

(J)

With the approval of the insurer or self-insured employer, palliative care that the worker’s attending physician referred to in ORS 656.005 (Definitions) (12)(b)(A) prescribes and that is necessary to enable the worker to continue current employment or a vocational training program. If the insurer or self-insured employer does not approve, the attending physician or the worker may request approval from the Director of the Department of Consumer and Business Services for such treatment. The director may order a medical review by a physician or panel of physicians pursuant to ORS 656.327 (Review of medical treatment of worker) (3) to aid in the review of such treatment. The decision of the director is subject to review under ORS 656.704 (Actions and orders regarding matters concerning claim and matters other than matters concerning claim).

(K)

With the approval of the director, curative care arising from a generally recognized, nonexperimental advance in medical science since the worker’s claim was closed that is highly likely to improve the worker’s condition and that is otherwise justified by the circumstances of the claim. The decision of the director is subject to review under ORS 656.704 (Actions and orders regarding matters concerning claim and matters other than matters concerning claim).

(L)

Curative care provided to a worker to stabilize a temporary and acute waxing and waning of symptoms of the worker’s condition.

(d)

When the medically stationary date in a disabling claim is established by the insurer or self-insured employer and is not based on the findings of the attending physician, the insurer or self-insured employer is responsible for reimbursement to affected medical service providers for otherwise compensable services rendered until the insurer or self-insured employer provides written notice to the attending physician of the worker’s medically stationary status.

(e)

Except for services provided under a managed care contract, out-of-pocket expense reimbursement to receive care from the attending physician or nurse practitioner authorized to provide compensable medical services under this section shall not exceed the amount required to seek care from an appropriate nurse practitioner or attending physician of the same specialty who is in a medical community geographically closer to the worker’s home. For the purposes of this paragraph, all physicians and nurse practitioners within a metropolitan area are considered to be part of the same medical community.

(2)

Intentionally left blank —Ed.

(a)

The worker may choose an attending doctor, physician or nurse practitioner within the State of Oregon. The worker may choose the initial attending physician or nurse practitioner and may subsequently change attending physician or nurse practitioner two times without approval from the director. If the worker thereafter selects another attending physician or nurse practitioner, the insurer or self-insured employer may require the director’s approval of the selection. The decision of the director is subject to review under ORS 656.704 (Actions and orders regarding matters concerning claim and matters other than matters concerning claim). The worker also may choose an attending doctor or physician in another country or in any state or territory or possession of the United States with the prior approval of the insurer or self-insured employer.

(b)

A medical service provider who is not a member of a managed care organization is subject to the following provisions:

(A)

A medical service provider who is not qualified to be an attending physician may provide compensable medical service to an injured worker for a period of 30 days from the date of the first visit on the initial claim or for 12 visits, whichever first occurs, without the authorization of an attending physician. Thereafter, medical service provided to an injured worker without the written authorization of an attending physician is not compensable.

(B)

A medical service provider who is not an attending physician cannot authorize the payment of temporary disability compensation. However, an emergency room physician who is not authorized to serve as an attending physician under ORS 656.005 (Definitions) (12)(c) may authorize temporary disability benefits for a maximum of 14 days. A medical service provider qualified to serve as an attending physician under ORS 656.005 (Definitions) (12)(b)(B) may authorize the payment of temporary disability compensation for a period not to exceed 30 days from the date of the first visit on the initial claim.

(C)

Except as otherwise provided in this chapter, only a physician qualified to serve as an attending physician under ORS 656.005 (Definitions) (12)(b)(A) or (B)(i) who is serving as the attending physician at the time of claim closure may make findings regarding the worker’s impairment for the purpose of evaluating the worker’s disability.

(D)

Notwithstanding subparagraphs (A) and (B) of this paragraph, a nurse practitioner licensed under ORS 678.375 (Nurse practitioners) to 678.390 (Authority of nurse practitioner and clinical nurse specialist to write prescriptions or dispense drugs):
(i)
May provide compensable medical services for 180 days from the date of the first visit on the initial claim;
(ii)
May authorize the payment of temporary disability benefits for a period not to exceed 180 days from the date of the first visit on the initial claim; and
(iii)
When an injured worker treating with a nurse practitioner authorized to provide compensable services under this section becomes medically stationary within the 180-day period in which the nurse practitioner is authorized to treat the injured worker, shall refer the injured worker to a physician qualified to be an attending physician as defined in ORS 656.005 (Definitions) for the purpose of making findings regarding the worker’s impairment for the purpose of evaluating the worker’s disability. If a worker returns to the nurse practitioner after initial claim closure for evaluation of a possible worsening of the worker’s condition, the nurse practitioner shall refer the worker to an attending physician and the insurer shall compensate the nurse practitioner for the examination performed.

(3)

Notwithstanding any other provision of this chapter, the director, by rule, upon the advice of the committee created by ORS 656.794 (Advisory committee on medical care) and upon the advice of the professional licensing boards of practitioners affected by the rule, may exclude from compensability any medical treatment the director finds to be unscientific, unproven, outmoded or experimental. The decision of the director is subject to review under ORS 656.704 (Actions and orders regarding matters concerning claim and matters other than matters concerning claim).

(4)

Notwithstanding subsection (2)(a) of this section, when a self-insured employer or the insurer of an employer contracts with a managed care organization certified pursuant to ORS 656.260 (Certification procedure for managed health care provider) for medical services required by this chapter to be provided to injured workers:

(a)

Those workers who are subject to the contract shall receive medical services in the manner prescribed in the contract. Workers subject to the contract include those who are receiving medical treatment for an accepted compensable injury or occupational disease, regardless of the date of injury or medically stationary status, on or after the effective date of the contract. If the managed care organization determines that the change in provider would be medically detrimental to the worker, the worker shall not become subject to the contract until the worker is found to be medically stationary, the worker changes physicians or nurse practitioners, or the managed care organization determines that the change in provider is no longer medically detrimental, whichever event first occurs. A worker becomes subject to the contract upon the worker’s receipt of actual notice of the worker’s enrollment in the managed care organization, or upon the third day after the notice was sent by regular mail by the insurer or self-insured employer, whichever event first occurs. A worker shall not be subject to a contract after it expires or terminates without renewal. A worker may continue to treat with the attending physician or nurse practitioner authorized to provide compensable medical services under this section under an expired or terminated managed care organization contract if the physician or nurse practitioner agrees to comply with the rules, terms and conditions regarding services performed under any subsequent managed care organization contract to which the worker is subject. A worker shall not be subject to a contract if the worker’s primary residence is more than 100 miles outside the managed care organization’s certified geographical area. Each such contract must comply with the certification standards provided in ORS 656.260 (Certification procedure for managed health care provider). However, a worker may receive immediate emergency medical treatment that is compensable from a medical service provider who is not a member of the managed care organization. Insurers or self-insured employers who contract with a managed care organization for medical services shall give notice to the workers of eligible medical service providers and such other information regarding the contract and manner of receiving medical services as the director may prescribe. Notwithstanding any provision of law or rule to the contrary, a worker of a noncomplying employer is considered to be subject to a contract between the State Accident Insurance Fund Corporation as a processing agent or the assigned claims agent and a managed care organization.

(b)

Intentionally left blank —Ed.

(A)

For initial or aggravation claims filed after June 7, 1995, the insurer or self-insured employer may require an injured worker, on a case-by-case basis, immediately to receive medical services from the managed care organization.

(B)

If the insurer or self-insured employer gives notice that the worker is required to receive treatment from the managed care organization, the insurer or self-insured employer must guarantee that any reasonable and necessary services so received, that are not otherwise covered by health insurance, will be paid as provided in ORS 656.248 (Medical service fee schedules), even if the claim is denied, until the worker receives actual notice of the denial or until three days after the denial is mailed, whichever event first occurs. The worker may elect to receive care from a primary care physician or nurse practitioner authorized to provide compensable medical services under this section who agrees to the conditions of ORS 656.260 (Certification procedure for managed health care provider) (4)(g). However, guarantee of payment is not required by the insurer or self-insured employer if this election is made.

(C)

If the insurer or self-insured employer does not give notice that the worker is required to receive treatment from the managed care organization, the insurer or self-insured employer is under no obligation to pay for services received by the worker unless the claim is later accepted.

(D)

If the claim is denied, the worker may receive medical services after the date of denial from sources other than the managed care organization until the denial is reversed. Reasonable and necessary medical services received from sources other than the managed care organization after the date of claim denial must be paid as provided in ORS 656.248 (Medical service fee schedules) by the insurer or self-insured employer if the claim is finally determined to be compensable.

(5)

Intentionally left blank —Ed.

(a)

A nurse practitioner licensed under ORS 678.375 (Nurse practitioners) to 678.390 (Authority of nurse practitioner and clinical nurse specialist to write prescriptions or dispense drugs) who is not a member of the managed care organization is authorized to provide the same level of services as a primary care physician as established by ORS 656.260 (Certification procedure for managed health care provider) (4) if the nurse practitioner maintains the worker’s medical records and with whom the worker has a documented history of treatment, if that nurse practitioner agrees to refer the worker to the managed care organization for any specialized treatment, including physical therapy, to be furnished by another provider that the worker may require and if that nurse practitioner agrees to comply with all the rules, terms and conditions regarding services performed by the managed care organization.

(b)

A nurse practitioner authorized to provide medical services to a worker enrolled in the managed care organization may provide medical treatment to the worker if the treatment is determined to be medically appropriate according to the service utilization review process of the managed care organization and may authorize temporary disability payments as provided in subsection (2)(b)(D) of this section. However, the managed care organization may authorize the nurse practitioner to provide medical services and authorize temporary disability payments beyond the periods established in subsection (2)(b)(D) of this section.

(6)

Subject to the provisions of ORS 656.704 (Actions and orders regarding matters concerning claim and matters other than matters concerning claim), if a claim for medical services is disapproved, the injured worker, insurer or self-insured employer may request administrative review by the director pursuant to ORS 656.260 (Certification procedure for managed health care provider) or 656.327 (Review of medical treatment of worker). [1965 c.285 §23; 1979 c.839 §32; 1981 c.535 §31; 1981 c.854 §14; 1985 c.739 §4; 1987 c.884 §24; 1990 c.2 §10; 1995 c.332 §25; amendments by 1995 c.332 §25a repealed by 1999 c.6 §1; 1999 c.6 §10; 1999 c.582 §12; 1999 c.868 §1; 1999 c.926 §1; 2003 c.811 §§3,4; 2005 c.26 §§3,4; 2007 c.252 §§3,4; 2007 c.270 §§2,3; 2007 c.365 §2a; 2007 c.505 §§3,4; 2009 c.32 §1; 2009 c.36 §1; 2013 c.179 §1]

Source: Section 656.245 — Medical services to be provided; services by providers not members of managed care organizations; authorizing temporary disability compensation and making finding of impairment for disability rating purposes by certain providers; review of disputed claims for medical services; rules, https://www.­oregonlegislature.­gov/bills_laws/ors/ors656.­html.

Notes of Decisions

In general

Medical expenses are not compensable if they are result of pre-existing disability that contributed to award of permanent total disability but not result of compensable injury. Francoeur v. SAIF, 17 Or App 37, 520 P2d 477 (1974), Sup Ct review denied

Right to medical services for compensable injury does not terminate upon finding of no permanent disability. Bowser v. Evans Prod. Co., 270 Or 841, 530 P2d 44 (1974)

Where third party paid medical bills after insurer’s denial of claim, order could properly provide for reimbursement by insurer directly to third party. Francoeur v. SAIF, 20 Or App 604, 532 P2d 1148 (1975)

Lack of general acceptance by medical profession does not prevent finding that treatment method is reasonable and necessary. McGarry v. SAIF, 24 Or App 883, 547 P2d 654 (1976)

Payment of medical expenses for claim of aggravation does not amount to acceptance of aggravation claim and does not estop employer from contesting claim. Jacobson v. SAIF, 36 Or App 789, 585 P2d 1146 (1978), Sup Ct review denied

Insurer could refuse to pay for medical services rendered by claimant-selected out-of-state physician not approved by insurer. Rivers v. SAIF, 45 Or App 1105, 610 P2d 288 (1980)

Psychotherapy considered necessary by licensed psychologist, to whom claimant had been referred by physician for job counseling, was medical service for which carrier was responsible. Kemery v. SAIF, 51 Or App 813, 627 P2d 34 (1981)

Exploratory surgery performed as result of industrial injury was compensable even though surgery revealed noncompensable condition. Brooks v. D & R Timber, 55 Or App 688, 639 P2d 700 (1982)

Neither worker’s election to pursue third party recovery nor worker’s receipt of share of proceeds recovered absolved insurance carrier of duty to provide continued medical services. SAIF v. Parker, 61 Or App 47, 656 P2d 335 (1982)

Claimant impliedly can have only one attending physician at given time. Kemp v. Workers’ Comp. Dept., 65 Or App 659, 672 P2d 1343 (1983), modified 67 Or App 270, 677 P2d 725 (1984), Sup Ct review denied

If insurer gives claimant reasonable basis to believe that it has approved claimant’s choice of doctor, claimant need not obtain insurer’s consent to medical services that doctor provides for conditions that result from compensable injury. Mogliotti v. Reynolds Metals, 67 Or App 142, 676 P2d 919 (1984)

Insurer may not deny worker choice of treatments by restricting approval of out-of-state physician to certain categories of service provider. Reynaga v. Northwest Farm Bureau, 300 Or 255, 709 P2d 1071 (1985); Day v. S & S Pizza Co., 77 Or App 711, 714 P2d 275 (1986), Sup Ct review denied

Exposure to substance capable of causing occupational disease is not, by itself, injury absent subsequent development of occupational disease. Brown v. SAIF, 79 Or App 205, 717 P2d 1289 (1986), Sup Ct review denied

Even after claim closure, employer cannot deny its future responsibility for payment of medical services for previously accepted claim. Evanite Fiber Corp. v. Striplin, 99 Or App 353, 781 P2d 1262 (1989)

Where treatment request has previously been denied, claimant renewing request for treatment must show that condition has changed and that request is supported by new facts unavailable at time of earlier request. Liberty Northwest Ins. Corp. v. Bird, 99 Or App 560, 783 P2d 33 (1989), Sup Ct review denied

Cost of palliative care is compensable where there is substantial evidence in record that service is reasonable and necessary as result of compensable injury. Elixir Industries v. Lange, 100 Or App 492, 786 P2d 1301 (1990)

Special review standard is allowable where items recommended for palliative care purposes are not usually viewed as medical services. Rager v. EBI Companies, 102 Or App 457, 795 P2d 573 (1990), modified 107 Or App 22, 810 P2d 1315 (1991)

Open status of claim does not prevent employer from denying request for ongoing care. Green Thumb, Inc. v. Basl, 106 Or App 98, 806 P2d 186 (1991)

Employer can deny current need for particular treatment and specific unpaid services, but cannot deny responsibility for possible future needs. Green Thumb, Inc. v. Basl, 106 Or App 98, 806 P2d 186 (1991)

Employers have only limited right to veto claimant’s choice of out-of-state physician, and only adequate basis for veto is when out-of-state doctor would be unlikely to comply with reporting requirements. Safeway Stores, Inc. v. Dupape, 106 Or App 126, 806 P2d 191 (1991), Sup Ct review denied

Claim is subject to statute provisions and rules making certain medical treatment noncompensable, notwithstanding that provisions and rules were adopted after time of injury. Thorpe v. Seige Logging, 115 Or App 335, 838 P2d 628 (1992), Sup Ct review denied

Where claimant fell at home and damaged sutures, claimant suffered no new “injury” or condition different from compensable carpal tunnel syndrome and emergency room treatment necessary to resuture wound is compensable. Roseburg Forest Products v. Ferguson, 117 Or App 601, 845 P2d 930 (1993), Sup Ct review denied

Where no new injury has occurred and compensable injury is material cause of need for continuing medical treatment, major contributing cause standard does not apply. Roseburg Forest Products v. Ferguson, 117 Or App 601, 845 P2d 930 (1993), Sup Ct review denied; Beck v. James River Corp., 124 Or App 484, 863 P2d 526 (1993), Sup Ct review denied; Fred Meyer, Inc. v. Crompton, 150 Or App 531, 946 P2d 1171 (1997)

Use of independent medical examination to impeach attending physician’s assessment of claimant’s disability was improper. Koitzsch v. Liberty Northwest Ins. Corp., 125 Or App 666, 866 P2d 514 (1994)

Exclusive ability of attending physician to make findings on medical condition does not require acceptance of physician findings or prevent reliance on nonmedical evidence. Libbett v. Roseburg Forest Products, 130 Or App 50, 880 P2d 935 (1994), Sup Ct review denied

Where permanent total disability claim is based on unscheduled disability, impairment finding is not required and testimony of physician other than attending physician is permissible. EBI Companies v. Hunt, 132 Or App 128, 887 P2d 372 (1994)

Physician request for approval of noncompensable type of palliative care does not constitute “claim.” Hathaway v. Health Future Enterprises, 320 Or 383, 884 P2d 549 (1994); Nicholson v. Salem Area Transit, 320 Or 391, 884 P2d 864 (1994)

Director has exclusive power to review appropriateness of ongoing or proposed medical treatment. Liberty Northwest Ins. Corp. v. Yon, 137 Or App 413, 904 P2d 645 (1995)

“Other related services” that are compensable are limited to services of same kind or class as those listed. Baar v. Fairview Training Center, 139 Or App 196, 911 P2d 1232 (1996), Sup Ct review denied

Requirement that director make physician change determination with “advice of one or more physicians” does not prohibit use of generalized medical guidelines in place of claimant-specific advice. Liberty Northwest Ins. Corp. v. Vasquez, 147 Or App 704, 938 P2d 237 (1997)

Referral for consultation does not place subsequent change to consulting physician outside limitation on attending physician changes. Country Mutual Insurance Co. v. Mendoza, 148 Or App 397, 939 P2d 674 (1997)

Where remodeling of claimant’s residence is reasonable and necessary to further claimant’s self-sufficient status, remodeling services are compensable medical services. SAIF v. Glubrecht, 156 Or App 339, 967 P2d 490 (1998)

Provisions for use of managed care organization or in-lieu services apply to all forms of claims, not just initial or aggravation claims. SAIF v. Reid, 160 Or App 383, 982 P2d 14 (1999); Travelers Indemnity of Illinois v. Curtis, 195 Or App 305, 97 P3d 673 (2004), Sup Ct review denied

Limitation on compensability of treatment rendered by medical service provider not qualifying as attending physician applies to both accepted and denied claims. SAIF v. Jensen, 183 Or App 439, 52 P3d 1118 (2002)

Where work-related injury is fact of consequence regarding claimant’s need of medical services, injury may be “material” regardless of amount of contribution. Mize v. Comcast Corp-AT&T Broadband, 208 Or App 563, 145 P3d 315 (2006)

Where prescribed type of modified vehicle was uniquely suited to accommodating claimant’s disability resulting from compensable injury, vehicle was medical service. Sedgwick Claims Management Services v. Jones, 214 Or App 446, 166 P3d 547 (2007)

Where treatment is necessitated in material part by accepted condition, treatment of condition other than accepted condition is compensable. SAIF v. Martinez, 219 Or App 182, 182 P3d 873 (2008); SAIF v. Sprague, 221 Or App 413, 190 P3d 443 (2008), aff’d 346 Or 661, 217 P3d 644 (2009)

Medical services to determine cause or extent of compensable injury are compensable even if condition discovered is not compensable. SAIF v. Martinez, 219 Or App 182, 182 P3d 873 (2008)

Compensability of medical service is governed by causation standard that applies to condition that particular service is “directed to.” Slater v. SAIF Corp. (In re Slater), 287 Or App 84, 400 P3d 969 (2017), Sup Ct review denied

Where section requires insurer to provide medical services for conditions caused in material part by injury, term “injury” means work accident that caused medical condition and resulted in need for medical services. Garcia-Solis v. Farmers Ins. Co, 365 Or 26, 441 P3d 573 (2019)

First sentence of this section, which governs coverage for medical services for ordinary conditions, requires evaluation of whether medical services were for original condition caused by workplace accident, not evaluation regarding whether medical services were directed to medical conditions caused by original condition. Edwards v. Cavenham Forest Industries, 312 Or App 153, 492 P3d 750 (2021), Sup Ct review denied

Burden of proof

Frequency of treatment cannot be limited so long as treatment is reasonable and necessary. West v. SAIF, 74 Or App 317, 702 P2d 1148 (1985)

Claimant bears burden of proof with regard to required frequency of treatment. Freres Lumber Co., Inc. v. Murphy, 101 Or App 92, 789 P2d 674 (1990), Sup Ct review denied

Attorney General Opinions

Services rendered by clinical social worker independently and not at direction of doctor or physician as constituting medical services required to be provided claimants, (1981) Vol 42, p 167

Law Review Citations

27 WLR 81 (1991); 32 WLR 217 (1996)

656.001
Short title 656.003
Application of definitions to construction of chapter 656.005
Definitions 656.006
Effect on employers’ liability law 656.008
Extension of laws relating to workers’ compensation to federal lands and projects within state 656.010
Treatment by spiritual means 656.012
Findings and policy 656.017
Employer required to pay compensation and perform other duties 656.018
Effect of providing coverage 656.019
Civil negligence action for claim denied on basis of failure to meet major contributing cause standard 656.020
Damage actions by workers against noncomplying employers 656.021
Coverage exception for laborers under contracts with construction and landscape contractor licensees 656.023
Who are subject employers 656.025
Individuals engaged in commuter ridesharing not subject workers 656.027
Who are subject workers 656.029
Obligation of person awarding contract to provide coverage for workers under contract 656.031
Coverage for municipal volunteer personnel 656.033
Coverage for participants in work experience or school directed professional training programs 656.035
Status of workers in separate occupations of employer 656.037
Exemption from coverage for persons engaged in certain real estate activities 656.039
Election of coverage for workers not subject to law 656.041
City or county may elect to provide coverage for adults in custody 656.043
Governmental agency paying wages responsible for providing coverage 656.044
State Accident Insurance Fund Corporation may insure liability under Longshoremen’s and Harbor Workers’ Compensation Act 656.046
Coverage of persons in college work experience and professional education programs 656.052
Prohibition against employment without coverage 656.054
Claim of injured worker of noncomplying employer 656.056
Subject employers must post notice of manner of compliance 656.070
Definitions for ORS 656.027, 656.070 and 656.075 656.075
Exemption from coverage for newspaper carriers 656.126
Coverage while temporarily in or out of state 656.128
Sole proprietors, limited liability company members, partners, independent contractors may elect coverage by insurer 656.132
Coverage of minors 656.135
Coverage of deaf school work experience trainees 656.138
Coverage of apprentices, trainees participating in related instruction classes 656.140
Coverage of persons operating equipment for hire 656.154
Injury due to negligence or wrong of a person not in the same employ as injured worker 656.156
Intentional injuries 656.160
Effect of incarceration on receipt of compensation 656.170
Validity of provisions of certain collective bargaining agreements 656.172
Applicability of and criteria for establishing program under ORS 656.170 656.174
Rules 656.202
Compensation payable to subject worker in accordance with law in effect at time of injury 656.204
Death 656.206
Permanent total disability 656.208
Death during permanent total disability 656.209
Offsetting permanent total disability benefits against Social Security benefits 656.210
Temporary total disability 656.211
“Average weekly wage” defined 656.212
Temporary partial disability 656.214
Permanent partial disability 656.216
Permanent partial disability 656.218
Continuance of permanent partial disability payments to survivors 656.222
Compensation for additional accident 656.225
Compensability of certain preexisting conditions 656.226
Cohabitants and children entitled to compensation 656.228
Payments directly to beneficiary or custodian 656.230
Lump sum award payments 656.232
Payments to aliens residing outside of United States 656.234
Compensation not assignable nor to pass by operation of law 656.236
Compromise and release of claim matters except for medical benefits 656.240
Deduction of benefits from sick leave payments paid to employees 656.245
Medical services to be provided 656.247
Payment for medical services prior to claim acceptance or denial 656.248
Medical service fee schedules 656.250
Limitation on compensability of physical therapist services 656.252
Medical report regulation 656.254
Medical report forms 656.256
Considerations for rules regarding certain rural hospitals 656.258
Vocational assistance service payments 656.260
Certification procedure for managed health care provider 656.262
Processing of claims and payment of compensation 656.263
To whom notices sent under ORS 656.262, 656.265, 656.268 to 656.289, 656.295 to 656.325 and 656.382 to 656.388 656.264
Compensable injury, denied claim and other reports 656.265
Notice of accident from worker 656.266
Burden of proving compensability and nature and extent of disability 656.267
Claims for new and omitted medical conditions 656.268
Claim closure 656.273
Aggravation for worsened conditions 656.277
Request for reclassification of nondisabling claim 656.278
Board has continuing authority to alter earlier action on claim 656.283
Hearing rights and procedure 656.285
Protection of witnesses at hearings 656.287
Use of vocational reports in determining loss of earning capacity at hearing 656.289
Orders of Administrative Law Judge 656.291
Expedited Claim Service 656.295
Board review of Administrative Law Judge orders 656.298
Judicial review of board orders 656.304
When acceptance of compensation precludes hearing 656.307
Determination of issues regarding responsibility for compensation payment 656.308
Responsibility for payment of claims 656.310
Presumption concerning notice of injury and self-inflicted injuries 656.313
Stay of compensation pending request for hearing or review 656.319
Time within which hearing must be requested 656.325
Required medical examination 656.327
Review of medical treatment of worker 656.328
List of authorized providers and standards of professional conduct for providers of independent medical examinations 656.331
Contact, medical examination of worker represented by attorney prohibited without written notice 656.340
Vocational assistance procedure 656.360
Confidentiality of worker medical and vocational claim records 656.362
Liability for disclosure of worker medical and vocational claim records 656.382
Penalties and attorney fees payable by insurer or employer in processing claim 656.383
Attorney fees in cases prior to decision or after request for hearing 656.385
Attorney fees in cases regarding certain medical service or vocational rehabilitation matters 656.386
Recovery of attorney fees, expenses and costs in appeal on denied claim 656.388
Approval of attorney fees required 656.390
Frivolous appeals, hearing requests or motions 656.403
Obligations of self-insured employer 656.407
Qualifications of insured employers 656.419
Workers’ compensation insurance contracts 656.423
Cancellation of coverage by employer 656.427
Termination of workers’ compensation insurance contract or surety bond liability by insurer 656.430
Certification of self-insured employer 656.434
Certification effective until canceled or revoked 656.440
Notice of certificate revocation 656.441
Advancement of funds from Workers’ Benefit Fund for compensation due workers insured by certain decertified self-insured employer groups 656.443
Procedure upon default by employer or self-insured employer group 656.445
Advancement of funds from Workers’ Benefit Fund for compensation due workers insured by insurer in default 656.447
Sanctions against insurer for failure to comply with contracts, orders or rules 656.455
Self-insured employers to process claims and make records available at authorized locations 656.502
“Fiscal year” defined 656.504
Rates, charges, fees and reports by employers insured by State Accident Insurance Fund Corporation 656.505
Estimate of payroll when employer fails to file payroll report 656.506
Assessments for programs 656.508
Authority to fix premium rates for employers 656.526
Distribution of dividends from surplus in Industrial Accident Fund 656.536
Premium charges for coverage of reforestation cooperative workers based on prevailing wage 656.552
Deposit of cash, bond or letter of credit to secure payment of employer’s premiums 656.554
Injunction against employer failing to comply with deposit requirements 656.556
Liability of person letting a contract for amounts due from contractor 656.560
Default in payment of premiums, fees, assessments or deposit 656.562
Moneys due Industrial Accident Fund as preferred claims 656.564
Lien for amounts due from employer on real property, improvements and equipment on or with which labor is performed by workers of employer 656.566
Lien on property of employer for amounts due 656.576
“Paying agency” defined 656.578
Workers’ election whether to sue third person or noncomplying employer for damages 656.580
Payment of compensation notwithstanding cause of action for damages 656.583
Paying agency may compel election and prompt action 656.587
Paying agency must join in any compromise 656.591
Election not to bring action operates as assignment of cause of action 656.593
Procedure when worker or beneficiary elects to bring action 656.595
Precedence of cause of action 656.596
Damage recovery as offset against compensation 656.602
Disbursement procedures 656.605
Workers’ Benefit Fund 656.612
Assessments for department activities 656.614
Self-Insured Employer Adjustment Reserve 656.622
Reemployment Assistance Program 656.625
Reopened Claims Program 656.628
Workers with Disabilities Program 656.630
Oregon Institute of Occupational Health Sciences funding 656.632
Industrial Accident Fund 656.634
Trust fund status of Industrial Accident Fund 656.635
Reserve accounts in Industrial Accident Fund 656.636
Reserves in Industrial Accident Fund for awards for permanent disability or death 656.640
Creation of reserves 656.642
Emergency Fund 656.644
Petty cash funds 656.702
Disclosure of records of corporation, department and insurers 656.704
Actions and orders regarding matters concerning claim and matters other than matters concerning claim 656.708
Hearings Division 656.709
Ombudsman for injured workers 656.712
Workers’ Compensation Board 656.714
Removal of board member 656.716
Board members not to engage in political or business activity that interferes with duties as board member 656.718
Chairperson 656.720
Prosecution and defense of actions by Attorney General and district attorneys 656.722
Authority to employ subordinates 656.724
Administrative Law Judges 656.725
Duties and status of Administrative Law Judges 656.726
Duties and powers to carry out workers’ compensation and occupational safety laws 656.727
Rules for administration of benefit offset 656.730
Assigned risk plan 656.732
Power to compel obedience to subpoenas and punish for misconduct 656.735
Civil penalty for noncomplying employers 656.740
Review of proposed order declaring noncomplying employer or nonsubjectivity determination 656.745
Civil penalty for inducing failure to report claims 656.751
State Accident Insurance Fund Corporation created 656.752
State Accident Insurance Fund Corporation 656.753
State Accident Insurance Fund Corporation exempt from certain financial administration laws 656.754
Manager 656.758
Inspection of books, records and payrolls 656.772
Annual audit of State Accident Insurance Fund Corporation by Secretary of State 656.774
Annual report by State Accident Insurance Fund Corporation to Secretary of State 656.776
Notice to Secretary of State regarding action on audit report 656.780
Certification and training of claims examiners 656.790
Workers’ Compensation Management-Labor Advisory Committee 656.794
Advisory committee on medical care 656.795
Informational materials for nurse practitioners 656.797
Certification by nurse practitioner of review of required materials 656.798
Duty of insurer, self-insured employer and self-insured employer group to provide information to director 656.799
Informational materials for other health care professionals 656.802
Occupational disease 656.804
Occupational disease as an injury under Workers’ Compensation Law 656.807
Time for filing of claims for occupational disease 656.850
License 656.855
Licensing system for worker leasing companies 656.990
Penalties
Green check means up to date. Up to date

Current through early 2024

§ 656.245’s source at oregon​.gov