Orders of Administrative Law Judge
- review
- disposition of claim when compensability disputed
- approval of director required for reimbursement of certain expenditures
Source:
Section 656.289 — Orders of Administrative Law Judge; review; disposition of claim when compensability disputed; approval of director required for reimbursement of certain expenditures, https://www.oregonlegislature.gov/bills_laws/ors/ors656.html.
Notes of Decisions
Where court found bona fide dispute over compensability and approved settlement agreement between employee and employer, no “compensable claim” existed for which employee could later bring claim for aggravation of previous injury. Seeber v. Marlette Homes, 30 Or App 233, 566 P2d 926 (1977)
Thirty-day time period for appeal from referee’s order begins to run from date of original order and not from date of order correcting irrelevancy in original order. Chisholm v. SAIF, 277 Or 51, 559 P2d 511 (1977)
Whether settlement amount is proportionate to injury and cost incurred is irrelevant where bona fide dispute exists as to compensability. Greenwade v. SAIF, 41 Or App 697, 598 P2d 1265 (1979), Sup Ct review denied
Settlement entered into by one insurer and claimant on issue of responsibility after issuance of order under ORS 656.307 was invalid where there was dispute as to which insurer was responsible for claimant’s injury or condition. J.C. Compton Co. v. DeGraff, 52 Or App 317, 628 P2d 437 (1981), Sup Ct review denied, modified 52 Or App 1023, 630 P2d 395 (1981)
Subsequent injury to same body part does not create bona fide dispute as to claimant’s entitlement to future medical benefits for accepted original injury. EBI Companies v. Freschette, 71 Or App 526, 692 P2d 723 (1984), Sup Ct review denied
Referee cannot extend 30-day appeal period for order determining issues directly affecting claimant’s right to compensation where referee did not intend to reconsider any issue in such order. Farmers Ins. Group v. SAIF, 301 Or 612, 724 P2d 799 (1986)
Where disputed claims settlement agreement between claimant and his insurer provided, in part, that insurer would hold claimant harmless from outstanding medical bills for disputed psychiatric condition, claimant’s unilateral understanding that bill would be paid in full was not part of contract. EBI Companies v. Moore, 90 Or App 99, 750 P2d 1194 (1988)
Provision of health insurance contract requiring loan receipt agreement that insured worker would reimburse health insurance carrier directly for payments made for covered medical expenses was contrary to legislative policy that disputes between health insurance providers and workers’ compensation insurance carriers be settled by arbitration. Pacific Hospital Assn. v. Marchbanks, 91 Or App 459, 756 P2d 648 (1988)
Thirty-day deadline for issuance of order is not limitation on referee’s authority to withdraw or abate decision before time for appeal to Workers’ Compensation Board expires. Lyday v. Liberty Northwest Ins. Corp., 115 Or App 668, 839 P2d 756 (1992)
Where referee signed abatement order within 30-day period but did not mail it until time period had expired, date of abatement order was when it was mailed. Geer v. SAIF, 121 Or App 647, 855 P2d 1145 (1993)
Stipulated settlement agreement approved by administrative law judge is determination by administrative law judge regarding merits of claim and therefore allows for award of attorney fees if compensation was not disallowed or reduced. Deaton v. Hunt-Elder, 145 Or App 110, 928 P2d 992 (1996)
Disputed claim settlement may only dispose of claims that have been formally denied prior to date of settlement. Trevisan v. SAIF, 146 Or App 358, 932 P2d 1202 (1997)
Agreement that provides for claim to remain in denied status must be in form of disputed claim settlement, not stipulation. Simmons v. Lane Mass Transit District, 171 Or App 268, 15 P3d 568 (2000)
Disputed claim settlement with previous employer does not preclude workers’ compensation claimant from litigating role that previous employment might have had in determining compensability of subsequent claim against employer not bound by disputed claim settlement with claimant. Fleming v. SAIF, 302 Or App 543, 461 P3d 261 (2020)
Law Review Citations
32 WLR 217 (1996)
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