ORS 656.385
Attorney fees in cases regarding certain medical service or vocational rehabilitation matters
- rules
- limitation
- penalties
(1)
In all cases involving a dispute over compensation benefits pursuant to 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), 656.327 (Review of medical treatment of worker) or 656.340 (Vocational assistance procedure), where a claimant finally prevails after a proceeding has commenced, the Director of the Department of Consumer and Business Services, the Administrative Law Judge or the court shall require the insurer or self-insured employer to pay a reasonable attorney fee to the claimant’s attorney. In such cases, where an attorney is instrumental in obtaining a settlement of the dispute prior to a decision by the director, an Administrative Law Judge or the court, the director, Administrative Law Judge or court shall require the insurer or self-insured employer to pay a reasonable attorney fee to the claimant’s attorney. The attorney fee must be based on all work the claimant’s attorney has done relative to the proceeding at all levels before the department or court. The attorney fee assessed under this section must be proportionate to the benefit to the injured worker. The director shall adopt rules for establishing the amount of the attorney fee, giving primary consideration to the results achieved and to the time devoted to the case. An attorney fee awarded pursuant to this subsection may not exceed $4,000 absent a showing of extraordinary circumstances. The maximum attorney fee awarded under this subsection shall be adjusted annually on July 1 by the same percentage increase as made to the average weekly wage defined in ORS 656.211 (“Average weekly wage” defined), if any.(2)
If an insurer or self-insured employer refuses to pay compensation due under, or attorney fees related to, 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), 656.327 (Review of medical treatment of worker) or 656.340 (Vocational assistance procedure) pursuant to an order of the director, an Administrative Law Judge or the court or otherwise unreasonably resists the payment of such compensation or attorney fees, the insurer or self-insured employer shall pay to the attorney of the claimant a reasonable attorney fee as provided in subsection (3) of this section. To the extent an employer has caused the insurer to be charged such fees, such employer may be charged with those fees.(3)
If a request for a contested case hearing, review on appeal or cross-appeal to the Court of Appeals or petition for review to the Supreme Court is initiated by an insurer or self-insured employer, and the director, Administrative Law Judge or court finds that all or part of the compensation awarded 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), 656.327 (Review of medical treatment of worker) or 656.340 (Vocational assistance procedure) to a claimant, or attorney fees under this section, should not be disallowed or reduced, the insurer or self-insured employer shall be required to pay to the attorney of the claimant a reasonable attorney fee in an amount set by the director, Administrative Law Judge or court for legal representation by an attorney for the claimant at the contested case hearing, review on appeal or cross-appeal.(4)
If upon reaching a final contested case decision where such contested case was initiated by an insurer or self-insured employer it is found that the insurer or self-insured employer initiated the contested case hearing for the purpose of delay or other vexatious reason or without reasonable ground, the director, Administrative Law Judge or court may order the insurer or self-insured employer to pay to the claimant such penalty not exceeding $750 and not less than $100 as may be reasonable in the circumstances.(5)
Penalties and attorney fees awarded pursuant to this section by the director, an Administrative Law Judge or the courts shall be paid for by the employer or insurer in addition to compensation found to be due to the claimant. [1995 c.332 §42d; 2003 c.756 §2; 2005 c.26 §13; 2009 c.526 §4; 2015 c.521 §6]
Source:
Section 656.385 — Attorney fees in cases regarding certain medical service or vocational rehabilitation matters; rules; limitation; penalties, https://www.oregonlegislature.gov/bills_laws/ors/ors656.html.
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