EXHIBIT A

General Definitions
          438-005-0040
(1) "Administrative Law Judge" means an individual appointed by the Board to perform the duties, functions and powers provided in ORS 654, 655 and 656, and such other duties, functions and powers as may be prescribed by the Board.
          (2) "Aggravation" means an actual worsening of the compensable condition(s) after the last award or arrangement of compensation, which is established by medical evidence supported by objective findings, and otherwise satisfies the statutory requirements of ORS 656.273.
          (3) "Aggravation rights" means the time periods specified in ORS 656.273 during which an injured worker is entitled to additional compensation for worsened conditions as a matter of right.
          (4) "Benefits Section" means the Benefits Section of the Workers’ Compensation Division of the Department of Consumer & Business Services.
          (5) "Board" means the Workers’ Compensation Board.
          (6) "Claimant" means an injured worker or any other person entitled to initiate or continue a claim for compensation.
          (7) "Director" means the Director of the Department of Consumer & Business Services or his/her designee.
          [(8) "Evaluation" means the Evaluation Unit of the Workers’ Compensation Division of the Department of Consumer & Business Services.]
          ([9]8) "Hearings Division" means the Hearings Division of the Workers’ Compensation Board.
          ([10]9) "Insurer" means the State Accident Insurance Fund Corporation, [or] an insurer authorized under ORS Chapter 731 to transact workers’ compensation insurance in this state, or, except where the context requires otherwise, an assigned claims agent in cases under ORS 656.054.
          ([11]10) "Party" means a claimant, an employer, including a noncomplying employer, [the SAIF Corporation as processing] an assigned claims agent in cases under ORS 656.054, and an insurer.
           ([12]11) "Self-insured employer" means an employer or group of employers certified under ORS  656.430 as meeting the qualifications set out in ORS 656.407.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.726(5); 656.054
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 1-1994, f. 11-1-94, cert. ef. 1-1-95; WCB 2-1995, f. 11-13-95, cert. ef. 1-1-96

EXHIBIT B

Notice of Claim Denial and Hearing Rights
          438-005-0055
(1) Except for a denial issued under ORS 656.262(15), [I]in addition to the requirements of ORS 656.262, the notice of denial shall specify the factual and legal reasons for denial, and shall contain a notice, in prominent or bold-face type, as follows:
          "IF YOU THINK THIS DENIAL IS NOT RIGHT, WITHIN 60 DAYS AFTER THE MAILING OF THIS DENIAL YOU MUST FILE A LETTER WITH THE WORKERS’ COMPENSATION BOARD, 2601 25TH STREET SE, SUITE 150, SALEM OREGON 97302-1282. YOUR LETTER MUST STATE THAT YOU WANT A HEARING, YOUR ADDRESS AND THE DATE OF YOUR ACCIDENT IF YOU KNOW THE DATE. IF YOUR CLAIM QUALIFIES, YOU MAY RECEIVE AN EXPEDITED HEARING WITHIN 30 DAYS. YOUR REQUEST CANNOT, BY LAW, AFFECT YOUR EMPLOYMENT. IF YOU DO NOT FILE A REQUEST WITHIN 60 DAYS, YOU WILL LOSE ANY RIGHT YOU MAY HAVE TO COMPENSATION UNLESS YOU CAN SHOW GOOD CAUSE FOR DELAY BEYOND 60 DAYS. AFTER 180 DAYS ALL YOUR RIGHTS WILL BE LOST. YOU MAY BE REPRESENTED BY AN ATTORNEY OF YOUR CHOICE AT NO COST TO YOU FOR ATTORNEY FEES.
          
IF YOU MAKE A TIMELY REQUEST FOR HEARING ON A DENIAL OF COMPENSABILITY OF YOUR CLAIM AS REQUIRED BY ORS 656.319(1)(a) that is based on one or more reports of examinations conducted at the request of the insurer or self-insured employer under ORS 656.325(1)(a) AND YOUR ATTENDING PHYSICIAN DOES NOT CONCUR WITH THE REPORT OR REPORTS, YOU MAY REQUEST AN EXAMINATION TO BE CONDUCTED BY A PHYSICIAN SELECTED BY THE DIRECTOR. tHE COST OF THE EXAMINATION AND THE EXAMINATION REPORT SHALL BE PAID BY THE INSURER OR SELF-INSURED EMPLOYER. IF YOU HAVE QUESTIONS YOU MAY CALL THE BENEFITS SECTION TOLL FREE IN OREGON 1-800-452-0288 OR IN SALEM OR FROM OUTSIDE OREGON AT (503) 947-7585."
          (2)
If an insurer or self-insured employer intends to deny a claim under ORS 656.262(15) because of a worker’s failure to cooperate in the investigation of the claim, in addition to the requirements of ORS 656.262, the notice of denial shall specify the factual and legal reasons for denial, and shall contain a notice, in prominent or bold-face type, as follows:
          "IF YOU THINK THIS DENIAL IS NOT RIGHT, WITHIN 60 DAYS AFTER THE MAILING OF THIS DENIAL YOU MUST FILE A LETTER WITH THE WORKERS’ COMPENSATION BOARD, 2601 25TH STREET SE, SUITE 150, SALEM OREGON 97302-1282. YOUR LETTER MUST STATE THAT YOU WANT AN EXPEDITED HEARING, YOUR ADDRESS AND THE DATE OF YOUR ACCIDENT IF YOU KNOW THE DATE. YOU WILL RECEIVE AN EXPEDITED HEARING WITHIN 30 DAYS. YOUR REQUEST CANNOT, BY LAW, AFFECT YOUR EMPLOYMENT. IF YOU DO NOT FILE A REQUEST WITHIN 60 DAYS, YOU WILL LOSE ANY RIGHT YOU MAY HAVE TO COMPENSATION UNLESS YOU CAN SHOW GOOD CAUSE FOR DELAY BEYOND 60 DAYS. AFTER 180 DAYS ALL YOUR RIGHTS WILL BE LOST. YOU MAY BE REPRESENTED BY AN ATTORNEY OF YOUR CHOICE AT NO COST TO YOU FOR ATTORNEY FEES. IF YOU HAVE QUESTIONS YOU MAY CALL THE BENEFITS SECTION TOLL FREE IN OREGON 1-800-452-0288 OR IN SALEM OR FROM OUTSIDE OREGON AT (503) 947-7585."

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.262(6), (15); 656.325
Hist.: WCB 1-1984, f. 4-5-84, ef. 5-1-84; WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 11-1990, f. 12-13-90, cert. ef. 12-31-90; WCB 1-1994, f. 11-1-94, cert. ef. 1-1-95; WCB 2-1995, f. 11-13-95, cert. ef. 1-1-96; WCB 1-1999, f. 8-24-99, cert. ef. 11-1-99

EXHIBIT C

Prehearing Conference
          438-006-0062 (1) An informal prehearing conference may be held by the Hearings Division as provided by, and for the purposes stated in, ORS 656.726([4]5).
          (2) The parties shall be given not less than ten days notice of the date of the conference.
          (3) At the conference, any party may participate in the conference with or without an attorney.
          (4) If a party is represented by counsel at the conference, a client representative with settlement authority (claimant, employer or claims examiner, as applicable) must attend the conference with counsel, or be available by telephone during that time.
          (5) The Administrative Law Judge who conducts a prehearing conference on the merits shall not conduct the hearing on the matter over objection by any party.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.726(5), 656.283(9)
Hist.: WCB 7-1990 (Temp), f. 6-14-90, cert. ef. 7-1-90; WCB 11-1990, f. 12-13-90, cert. ef. 12-31-90; WCB 1-1994, f. 11-1-94, cert. ef. 1-1-95

EXHIBIT D

Medical and Vocational and Other Documentary Evidence
          438-007-0005 (1) Statutory references: Medical reports as evidence, ORS 656.310(2); vocational reports, ORS 656.287.
          (2) To avoid unnecessary delay and expense medical evidence should be presented in the form of written reports and should include:
          (a) History of the injury or disease;
          (b) Pertinent medical history;
          (c) Present complaints;
          (d) All sources of history and complaints;
          (e) Date of examination;
          (f) Findings on examination;
          (g) Impairment of physical or mental function including loss of reserve capacity;
          (h) Restrictions of activities, such as lifting, bending, twisting, sitting, standing and repetitive use;
          (i) Cause of the impairment and opinion whether the impairment is all or in part work related;
          (j) Medical treatment indicated;
          (k) Likelihood of permanent impairment and opinion whether the condition is likely to change; and
          (l) The reason for the opinion.
          (3) The insurer or self-insured employer may subpoena the claimant’s attending or consulting physician(s) and vocational expert(s) for cross-examination. Medical, surgical, hospital and vocational reports offered by the insurer or self-insured employer will also be accepted as prima facie evidence provided the insurer or self-insured employer agrees to produce the medical and vocational expert(s) for cross-examination upon request of the claimant.  The reports of any medical or vocational expert who has refused to make herself or himself available for cross-examination shall be excluded from the record unless good cause is shown why such evidence should be received. The cost of cross-examination of any medical or vocational expert(s) under this section shall be paid by the insurer or self-insured employer.
          (4) To avoid unnecessary cost and delay, the Board encourages the use of written interrogatories or depositions to secure medical or vocational expert testimony.
          (5) The Administrative Law Judge may appoint a medical or vocational expert to examine the claimant and to file a report with the Administrative Law Judge. The parties may also agree in advance to be bound by such expert’s findings. The cost of examination and reports under this rule shall be paid by the insurer.

Stat. Auth.: ORS 656.307, 656.388, 656.593, 656.726(5)
Stats. Implemented: ORS 656.287, 656.310(2)
Hist.: WCB 1-1984, f. 4-5-84, ef. 5-1-84; WCB 1-1987, f. 3-4-87, ef. 4-15-87; WCB 2-1987 (Temp), f.  4-13-87, ef. 4-15-87; WCB 4-1987, f. 11-6-87, ef. 11-16-87; WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 1-1997, f. 3-20-97, cert. ef. 7-1-97

EXHIBIT E

Exchange and Admission of Exhibits at Hearing
          438-007-0018 (1) Not later than 28 days before the hearing, the insurer or self-insured employer shall provide the claimant and other insurer or self-insured employer legible copies of all documents that are relevant and material to the matters in dispute in the hearing, together with an index. The index shall include the document numbers, description of each document, author, number of pages and date of the document. The documents shall be arranged in chronological order and numbered, in Arabic numerals, in the lower right corner of each page, beginning with the document of earliest date. The numbers shall be preceded by the designation "Ex," and pagination of multiple-page documents shall be designated by a hyphen followed by the page number. For example, page two of document two shall be designated "Ex 2-2." A physician’s chart notes constitute a multi-page document to the extent that the date of each individual chart note is subsequent to the date of the preceding exhibit and is earlier than the date of the next exhibit. However, for deposition transcripts, only the cover page of the deposition need be numbered; i.e., "Ex. 3."
          (2) Not less than 14 days before the hearing, or within seven days of receipt of the insurer document index and documents, whichever is later, the claimant shall provide the insurer(s) or self-insured employer(s) legible copies of any additional documents that are relevant and material to the matters in dispute in the hearing. The additional documents shall be marked and accompanied by a supplemental document index, prepared in the same manner as the insurer documents and index and numbered to coincide in chronological order with the insurer’s documents. Letter subdesignations shall be used to ensure chronological numbering. For example, a document which is chronologically between documents six and seven of the insurer documents shall be designated "Ex 6A."
          (3) Before or at the hearing, the parties shall delete from their indexes and packets of documents those documents which are cumulative, or which no party can in good faith represent to be relevant and material to the issues, and the revised indexes and packets of documents shall be submitted to the Administrative Law Judge. For compliance with this rule, it is sufficient for the parties to mark neatly through the index description of the documents not being offered in evidence with ink, and to remove the corresponding documents from the packets submitted to the Administrative Law Judge.
          (4) Subject to ORS 656.287(l), at the hearing the Administrative Law Judge may in his or her discretion allow admission of additional medical reports or other documentary evidence not disclosed as required by OAR 438-007-0015. In the exercise of this discretion, the Administrative Law Judge shall determine whether material prejudice has resulted from the timing of the disclosure and, if so, whether there is good cause for the failure to timely disclose that outweighs any prejudice to the other party or parties. Following a finding of material prejudice, the Administrative Law Judge may exclude a document or continue the hearing for such action as is appropriate to cure the material prejudice caused by the late disclosure of the document.
          (5) Within the time provided for the initial exchanges of exhibits and indexes under Section (1), if a party intends to present any portion of the "reconsideration record" obtained from the Director for admission under ORS 656.283(7) at the hearing, that party shall notify the other parties.
          (6) The notifying party’s copy of the Director’s reconsideration record is subject to the "disclosure" requirements of OAR 438-007-0015. However, presentation of the Director’s reconsideration record is not subject to the "exchange and admission" requirements of OAR 438-007-0018.
          (7) At the hearing, rather than presenting the Director’s reconsideration record for admission, the parties shall present their oral or written stipulation identifying the exhibits in the hearing record which were also included in the Director’s reconsideration record under ORS 656.283(7). If the parties cannot reach an agreement, any disputed portions of the Director’s reconsideration record may be presented for admission.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.726(5)
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 2-1989, f. 3-3-89, ef. 4-1-89; WCB 1-1994, f. 11-1-94, cert. ef.  1-1-95; WCB 2-1995, f. 11-13-95. cert. ef. 1-1-96

EXHIBIT F

Electronic Documents
          OAR 438-007-0040 (1) If any party, in the regular course of the party’s business or activity, has kept or recorded any memorandum, writing, entry, print, reproduction or a combination thereof, of any act, transaction, occurrence or event, and in the regular course of the party’s business or activity has caused any or all of the same to be recorded, copied or reproduced by any photographic, photostatic, microfilm, micro-card, miniature photographic, optical imaging or other process that accurately reproduces or forms a durable medium for so reproducing the original, the original may be destroyed in the regular course of business. Such reproduction, when satisfactorily identified, is as admissible in evidence as the original itself whether the original is in existence or not at the time a party introduces into evidence such reproduction. The introduction of a reproduced record, enlargement or facsimile does not preclude admission of the original.
          (2) If a party introduces into evidence a reproduction described in subsection (1), the exhibit index described in OAR 438-007-0018 will include the following certification: "The attached exhibits contain reproductions as described in OAR 438-007-0040. I hereby certify that the reproductions were created in the regular course of a party’s business or activity."

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.726(5); 656.283(7)

EXHIBIT G

Special Definitions
          438-009-0001 As used in this Division:
          (1) "Claim Disposition Agreement" means a written agreement pursuant to ORS 656.236(1), executed by all parties in which a claimant agrees to release rights, or agrees to release an insurer or self-insured employer from obligations, under ORS 656.001 to 656.794 except for medical services, in an accepted claim.
          (2) "Disputed Claim Settlement" means a written agreement pursuant to ORS 656.289(4), executed by all parties in which the parties agree to make a reasonable disposition of all or part of a claim in which there is a bona fide dispute over the compensability of the claim.
          (3) "Settlement Stipulation" means a written agreement or an oral agreement if made on the oral record of a hearing and approved in writing by an Administrative Law Judge, in which any matter contested between the parties, other than matters resolvable in a claim disposition agreement or disputed claim settlement, are resolved by agreement of the parties.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.236, 656.289(4), 656.726(5)
Hist.: WCB 7-1990 (Temp), f. 6-14-90, cert. ef. 7-1-90; WCB 11-1990, f. 12-13-90. cert. ef. 12-31-90

EXHIBIT H

Settlement Stipulations
          438-009-0005 (1) Contested matters arising out of a claim closure may be resolved by the parties at any time after the conclusion of the reconsideration proceeding [by Evaluation] under ORS  656.268, whether or not a hearing has been requested by a party.
          (2) Any contested matters not arising out of a claim closure may be resolved by the parties at any time, whether or not a hearing has been requested by a party.
          (3) All settlement stipulations that provide for an award of compensation for permanent partial disability shall recite the body part(s) for which the award(s) is (are) made and shall recite all awards in both degrees and percent of loss. In the event there is any inconsistency between the stated degrees and percent of loss awarded in a settlement stipulation, the stated percent of loss shall be controlling.
          (4) For purposes of ORS 656.289(1)-(3), an Administrative Law Judge’s order approving a settlement stipulation is a determination of all matters included within the terms of the settlement stipulation.
          (5) All settlement stipulations shall recite whether a claim disposition agreement in the claim has been filed for approval by the Board.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.268, 656.289(1-3)
Hist.: WCB 1-1984, f. 4-5-84, ef. 5-1-84; WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 7-1990 (Temp), f.  6-14-90, cert. ef. 7-1-90; WCB 11-1990, f. 12-13-90, cert. ef. 12-31-90

EXHIBIT I

Disputed Claim Settlements
          438-009-0010 (1) Any document submitted for approval by the Board or the Hearings Division as a settlement of a denied or disputed claim shall be in the form specified by this rule.
          (2) A disputed claim settlement shall recite, at a minimum:
          (a) The date and nature of the claim;
          (b) That the claim has been denied and the date of the denial;
          (c) That a bona fide dispute as to the compensability of all or part of the claim exists and that the parties have agreed to compromise and settle all or part of the denied and disputed claim under the provisions of ORS 656.289(4);
          (d) The factual allegations and legal positions in support of the claim;
          (e) The factual allegations and legal positions in support of the denial of the claim;
          (f) That each of the parties has substantial evidence to support the factual allegations of that party;
          (g) A list of medical service providers who shall receive reimbursement in accordance with ORS 656.313(4), including the specific amount each provider shall be reimbursed, and the parties’ acknowledgment that this reimbursement allocation complies with the reimbursement formula prescribed in ORS 656.313(4)(d); and
          (h) The terms of the settlement, including the specific date on which those terms were agreed.
          (3) If an accepted claim is later denied entirely at any time based on fraud, misrepresentation or other illegal activity by the worker, the disputed claim settlement shall further recite the specific factual allegations and legal positions of the parties concerning the fraud, misrepresentation or other illegal activity.
          (4) If a claim was previously accepted in good faith but later denied, in whole or in part, based on later obtained evidence that the claim is not compensable or evidence that the paying agent is not responsible for the claim, the disputed claim settlement shall further recite:
          (a) If the accepted claim is later denied entirely at any time up to two years from the date of claim acceptance, an allegation that the self-insured employer or insurer has obtained later evidence that the claim is not compensable or that the paying agent is not responsible for the claim; or
          (b) If the denial is a denial of aggravation, current need for medical services or a partial denial of a medical condition on the ground that the condition is not related to the accepted injury, that the claimant retains all rights that may later arise under ORS  656.245, 656.273, 656.278 and 656.340, insofar as these rights may be related to the original accepted claim.
          (5) If the claimant is unrepresented, the denial of the claim which is being settled by any document described in section (1) of this rule shall not be contained within that document, but rather shall be issued separately. In addition, any document described in section (1) of this rule shall recite that the unrepresented claimant has been orally advised of the following matters:
          (a) The right to an attorney of the claimant’s choice at no cost to the claimant for attorney fees; [and]
          (b) The existence of the office of the Ombudsman pursuant to ORS 656.709[.];
          (c) Except with the consent of the worker, reimbursement made to medical service providers from the proceeds of a disputed claim settlement shall not exceed 40 percent of the total present value of the settlement amount; and
          (d) Reimbursement from the proceeds of a disputed claim settlement made to medical service providers shall not prevent a medical service provider or health insurance provider from recovering the balance of amounts owing for such services directly from the worker.
          (6) Any document described in section (1) of this rule shall also recite that the claimant has been orally advised that:
          (a) The claimant has the right to request a hearing concerning the claim, after which an Administrative Law Judge will determine whether the claimant will receive workers’ compensation benefits;
          (b) If, following the hearing, the claim is finally determined compensable, the claimant would be entitled to workers’ compensation benefits, which could include temporary disability, permanent disability, medical treatment, and vocational rehabilitation;
          (c) If, following the hearing, the claim is finally determined not compensable, the claimant would not be entitled to workers’ compensation benefits;
          (d) As a result of this agreement, the claimant’s rights to seek workers’ compensation benefits concerning this claim would be extinguished;
          (e) Both parties agree that the terms of the agreement are reasonable; and
          (f) The agreement shall not be binding upon the parties unless and until the agreement is signed by an Administrative Law Judge or the Board, depending upon which forum is considering the dispute.
          (7) No document described in section (1) of this rule shall be approved unless the document submitted by the parties establishes that a bona fide dispute as to compensability exists and the proposed disposition of the dispute is reasonable. If an Administrative Law Judge or the Board is not satisfied that a bona fide dispute exists or that disposition of the dispute is reasonable, the Administrative Law Judge or Board may reject the agreement or specify the manner in which objection(s) can be cured.
          (8) All disputed claim settlements shall recite whether a claim disposition agreement in the claim has been filed for approval by the Board. All disputed claim settlements shall be in a separate document from a claim disposition agreement.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.236, 656.289(4); 656.726(5); 656.313(4)
Hist.: WCB 1-1984, f. 4-5-84, ef. 5-1-84; WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 5-1990, f. 4-19-90. cert. ef. 5-21-90; WCB 7-1990 (Temp), f. 6-14-90. cert. ef. 7-1-90; WCB 11-1990, f. 12-13-90, cert. ef.  12-31-90; WCB 3-1993, f. 10-27-93. cert. ef. 11-4-93; WCB 2-1995, f. 11-13-95, cert. ef. 1-1-96

EXHIBIT J

Notice of Settlement; Submission of Documents
          438-009-0015 (1) The party that requested the hearing shall promptly notify the Presiding Administrative Law Judge, or his or her delegate, when a case is settled in whole or in part.
          (2) The party that requested Board review shall promptly notify the Board’s Closing and Appeals Division in writing when a case is settled in whole or in part.
          (3) The Presiding Administrative Law Judge, or his or her delegate, may require written notice of settlement as a condition of cancellation of a scheduled hearing.
          (4) With the consent of the assigned Administrative Law Judge, the parties may enter a settlement on the oral record at the time and place scheduled for the hearing. With the exception of a disputed claim settlement, the Administrative Law Judge may enter an order reciting and approving the settlement in such cases, without the submission of documents by the parties. With the consent of the parties, the official oral record, including the Administrative Law Judge’s approval, which is subject to transcription if necessary, is sufficient authority for the payment of settlement amounts in advance of the formal written order.
          (5) Notwithstanding OAR 438-005-0046(1)(d), in all cases settled by written stipulation of the parties, the original and six legible copies of the settlement document shall be mailed or delivered to the Administrative Law Judge or the Board for approval. If the written stipulation pertains to the resolution of disputes pending before both the Hearings Division and the Board, the settlement document shall recite the issues resolved by the Opinion and Order which is pending before the Board. If the written stipulation is mailed or delivered to the Hearings Division for approval and the agreement either formally or effectively modifies a dispute which is pending before the Board, the stipulation shall be submitted in a format to provide for both Hearings Division and Board approval. The original document shall be retained in the Board’s file and necessary copies shall be conformed and distributed to the parties, their attorneys and the Director.
          (6) Unless a party has filed prior written notice with the Hearings Division or the Board that the party wants an exhibit returned to them, all exhibits (with the exception of exhibit lists) may be discarded from the record following:
          (a) Administrative Law Judge or Board approval of a settlement stipulation or disputed claim settlement;
          (b) An Administrative Law Judge order dismissing a party’s hearing request in response to that party’s withdrawal of the request; or
          (c) A Board order dismissing a party’s request for Board review in response to that party’s withdrawal of the request for Board review.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.236,656.289(4), 656.726(5)
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 1-1990, f. 1-24-90, cert. ef. 2-28-90; WCB 1-1994, f.  11-1-94, cert. ef. 1-1-95; WCB 1-1999, f. 8-24-99, cert. ef. 11-1-99

EXHIBIT K

[Applicability of the Permanent Disability Rating Standards for Rating Extent of Disability]
          [438-010-0000 The disability rating standards adopted by the Director, OAR Chapter 436, Division 035, pursuant to Oregon Laws 1987, Chapter 884, Section 2, for rating permanent disability shall apply to hearings conducted on and after July 1, 1988 and shall apply only to claims closed and evaluated by the Evaluation Section, Workers’ Compensation Division, Department of Consumer and Business Services, insurers and self-insured employers on and after July 1, 1988 where the claimant last became medically stationary on and after January 1, 1988.]

Stat. Auth.: ORS 656.307, 656.388, 656.593, 656.726(5)
Stats. Implemented: ORS 656.283(7); 656.295(5)
Hist.: WCB 2-1988 (Temp), f. 6-30-88, ef. 7-1-88; WCB 5-1988, f. 12-22-88, ef. 12-28-88; WCB 2-1989, f.  3-3-89, ef. 4-1-89

EXHIBIT L

Review; Board Order; Reconsideration
          438-011-0035 (l) The Board order on review shall set forth:
          (a) the parties[,];
          (b) the issues[,];
          (c) the reviewing members;
          (d) the Board’s decision and
          (e) shall advise all parties of appeal rights.
          (2) A request for reconsideration of a Board order shall include a concise statement of the reason(s) reconsideration is requested. An order on reconsideration shall state whether or not the original order is withdrawn for reconsideration.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.295(5); 656.718
Hist.: WCB 5-1986 (Temp), f. 10-30-86, ef. 11-1-86; WCB 1-1987, f. 3-4-87, ef. 4-15-87; WCB 2-1987 (Temp), f. 4-13-87, ef. 4-15-87; WCB 4-1987, f. 11-6-87, ef. 11-16-87; WCB 5-1987, f. 12-18-87, ef. 1-1-88

EXHIBIT M

Board Will Act Unless Claimant Has Not Exhausted Other Available Remedies
          438-012-0050 (1) The Board will act promptly upon a request for relief under the provisions of ORS 656.278 and these rules unless:
          (a) The claimant has available administrative remedies under the provisions of ORS 656.273;
          (b) The claimant’s condition is the subject of a contested case under ORS 656.283 to 656.298, ORS 656.307 or ORS 656.308, or an arbitration or mediation proceeding under ORS 656.307; or
          (c) The claimant’s request for payment of temporary disability compensation is based on surgery or hospitalization that is the subject of either a managed care dispute resolution review process or a Director’s medical review under ORS 656.245, 656.260 or 656.327.
          (2) The Board may postpone its review of the merits of the claimant’s request for relief if the available remedies set forth in section (1) of this rule could affect the Board’s authority to award compensation under the provisions of ORS 656.278.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.278(1), 656.726(5)
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 1-1994, f. 11-1-94, cert. ef. 1-1-95; WCB 2-1995, f. 11-13-95, cert. ef. 1-1-96

EXHIBIT N

Referral of Request for Hearing to Expedited Claim Service
          438-013-0010 (1) A request for hearing shall be referred to the Expedited Claims Service if:
          (a) The request does not involve the compensability of or responsibility for a claim, and the total amount in controversy, exclusive of penalties and/or related attorney fees, is $1,000 or less;
          (b) The only issue in the case is entitlement to penalties and/or related attorney fees; or
          (c) The request is for an expedited hearing to appeal [involves] a denial under ORS 656.262(15) for a worker’s failure to cooperate in a claim investigation.
          (2) If an Administrative Law Judge finds at the hearing or at any time prior to the hearing that the case should not have been referred to the Expedited Claims Service, the Administrative Law Judge shall refer the case for decision under the ordinary hearing process. With the consent of the Administrative Law Judge, the parties may agree on the oral record to proceed with the hearing as referred to the ordinary hearing process without further delay. Such an agreement to proceed is a waiver of any claim of defect as to notice of hearing or issues.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.291(2)
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 2-1989, f. 3-3-89. ef. 4-1-89; WCB 2-1995, f. 11-13-95, cert. ef. 1-1-96

EXHIBIT O

General Principles
          438-015-0010 (1) Attorney fees for an attorney representing a claimant before the Board or its Hearings Division shall be authorized only if an executed attorney retainer agreement has been filed with the Administrative Law Judge or Board.
          (2) Attorney fees for an attorney representing a claimant shall be paid out of the claimant’s compensation award except as provided by ORS 656.307, 656.382 and 656.386.
          (3) An approved fee awarded or allowed to an attorney representing a claimant shall be a lien upon the claimant’s compensation.
          (4) In any case where an Administrative Law Judge or the Board is required to determine a reasonable attorney fee, the following factors shall be considered:
          (a) The time devoted to the case;
          (b) The complexity of the issue(s) involved;
          (c) The value of the interest involved;
          (d) The skill of the attorneys;
          (e) The nature of the proceedings;
          (f) The benefit secured for the represented party;
          (g) The risk in a particular case that an attorney’s efforts may go uncompensated; and
          (h) The assertion of frivolous issues or defenses.
          (5) Percentage limitations on fees established by these rules apply to the amount of compensation paid the claimant exclusive of medical, hospital or other expenses of treatment.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.388(3)
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 2-1989, f. 3-3-89, ef. 4-1-89; WCB 7-1990 (Temp), f.  6-14-90, cert. ef. 7-1-90; WCB 11-1990, f. 12-13-90, cert. ef. 12-31-90

EXHIBIT P

Charge for Legal Services Must Be Authorized
          438-015-0015 No charge for legal services for representation of claimants in connection with any matter concerning a claim before the Board or its Hearings Division under ORS Chapter 656 is valid unless the charge has been authorized in accordance with ORS 656.307, 656.382 to 656.390 or 656.593 or these rules.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.388(1)
Hist.: WCB 5-1987, f. 12-18-87, ef. 1-1-88; WCB 4-1988 (Temp), f. & ef. 11-15-88; WCB 2-1989, f.  3-3-89, ef. 4-1-89; WCB 7-1990 (Temp), f. 6-14-90, cert. ef. 7-1-90; WCB 11-1990, f. 12-13-0, cert. ef.  12-31-90

EXHIBIT Q

Special Definitions
          438-019-0000 (1) Mediation. Mediation is a voluntary process for resolving disputes by which an independent neutral third person, in the role of mediator, assists two or more parties to a controversy in reaching a mutually acceptable resolution. For purposes of OAR Division 019, mediation does not pertain to dispute resolution governed by ORS 656.307(6).
          (2) Mediator. A mediator is an independent neutral third [party] person whose role is to assist the parties in resolving their dispute by mutual agreement. The mediator has no authority to decide the outcome of the controversy or to force settlement upon the parties. The mediator, for purposes of these rules, is an employee of the Workers’ Compensation Board, with the authority of an Administrative Law Judge, who satisfies the qualifications prescribed in OAR 438-019-0010(1) and (2).
          (3) Party. For purposes of OAR 438 Division 019, party means any person identified in OAR 438-005-0040(11) and any other person identified by the mediator as necessary to the mediation.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.012(2)(b); 656.283(1), (9); 656.289(4).
Hist.: WCB 1-1997, f. 3-20-97, cert. ef. 7-1-97

EXHIBIT R

DIVISION 021

BOARD MEETINGS

Purpose
          OAR 438-021-0005 The purpose of these rules is to establish a standard procedure for regular open meetings of the Workers’ Compensation Board. With the exception of its review of contested cases and any other confidential or privileged matter, it is the specific intent of the Board to make the public aware of its deliberations, decisions, and the information upon which such decisions are made.

Regularly Scheduled Meetings
          OAR 438-021-0010 (1) In consultation with the Board and in accordance with ORS 192.610 to 192.690, the Chairperson shall establish the time, date, and place for the Board or Committees of the Board to meet. In any event, the Chairperson shall call a meeting of the Board:
          (a) within 30 days of adoption of this rule;
          (b) within 30 days of a reconstitution of the Board;
          (c) within 30 days of written notice from a majority of Board Members that a Board meeting must be held; and
          (d) at least once within every quarter of the calendar year.
          (2) Nothing in this rule will prevent the Chairperson from calling more frequent meetings of the Board.

Duties of the Chairperson
          OAR 438-021-0015 (1) The Chairperson, or the Board Members calling the meeting, shall prepare the agenda for each meeting.
          (2) The order of business for Board meetings shall be as follows:
          (a) Call to order;
          (b) Approval of the agenda and order of business;
          (c) Approval of minutes of the previous meetings;
          (d) Reports of the administrative staff;
          (e) Any unfinished business;
          (f) New business;
          (g) Public comment;
          (h) Announcements; and
          (i) Adjournment.

Consultation of the Board
          OAR 438-021-0020 (1) The Chairperson shall consult with the Board on all matters requiring such consultation under ORS 656.001 to 656.990 during meetings as set forth in these rules.
          (2) These consultations shall be made prior to any decision by the Chairperson.

Stat. Auth.: ORS 656.726(5)
Stats. Implemented: ORS 656.726(5)