The Hearings Division of the Oregon Workers' Compensation Board
received 14,862 requests for hearing in 1995, down 10.1 percent
from the previous year. These totals include stipulations
received without a prior hearing request. There were 888 of
these received stipulations in 1995. See figure 1.
In 1995 the Hearings Division issued 16,798 closing orders, a
6.6 percent increase above 1994's count. The number of hearings
administrative law judges was quite constant over the 1994-1995
Notes: The data below, except figure 1, include only
cases involving claimant compensation (the right to receive it,
or the amount thereof) or directly related issues. Discussions
of issues and their dispositions apply to opinion and order
(O&O) and stipulation cases only. Stipulations include disputed
claim settlements (DCSs).
The breakout of closing orders by order type was as
follows: 3,881 O&O's (23.3 percent), 7,654 stipulations (46.0
percent, the lowest percentage on record); 5,035 dismissals
(30.3 percent, the highest on record); and 65 arbitrator's
decisions (0.4 percent).
SAIF was the insurer in 35.3 percent of the cases, the
fourth consecutive record-low value. Private insurers accounted
for 47.4 percent, and self-insured employers a record-high 16.9
percent. The claimant was the hearing requester in 91.1
percent of the cases.
Figure 2 depicts the number of issues resolved at hearings.
Extent of temporary disability was an issue in 3.9 percent of
the cases, a record-low percentage. Claim denial was an issue
in 39.4 percent of the cases, and partial denial a record-high
27.5 percent of the cases.
Four measures of permanent disability awards reached record-low
values for the fifth consecutive year: number of cases
with this issue (1,200), percentage of cases with this issue
(10.4 percent), percentage of cases where the award is increased
(57.3 percent), and net amount of permanent partial disability
(PPD) awarded ($1.5 million). See figure 3. The average
PPD award increase (17.8 degrees, combining scheduled and
unscheduled awards) also reached a record low, after a slight
increase in 1994.
There were 13 permanent total disability (PTD) grants in
1995, including two reinstatements. Seven were by stipulation.
There also were two PTD rescissions and one order affirming an
earlier PTD grant. See figure 4.
The percentages of O&O cases decided in claimants' favor (all
figures are percent) were as follows: permanent disability,
44.0; temporary disability, 59.5; claim denial, 46.4; partial
denial, 42.4; aggravation, 34.7; premature closure, 50.5;
medical services, 63.2; vocational services, 61.1 (highest value
on record); insurer penalty, 41.0; and attorney fees, 50.8. For
the issues of aggravation, medical, and penalty, these are the
lowest values on record. For claim denial and partial denial,
these are the lowest values in at least five years. For
disability issues, the above percentages reflect award increases
(35.6 and 58.0 percent for permanent and temporary disability,
respectively) plus insurer or employer hearing requests where
the disability award is affirmed.
Disputed claim settlements
Figure 5 depicts the total value of DCSs, amounts paid to
claimants as consideration for not contesting a denial. Of the
4,455 cases in 1995, the issue was denial of the original claim
in 2,346 cases (52.7 percent, the smallest percentage on
record). The average amount was $5006.
For O&O cases, the median time from hearing request to order
was 162 days (5.3 months), 15 days longer than in 1994. The
median time from injury to order for all cases was 574 days (1.6
Fees awarded to claimants' attorneys totaled $10.9 million, 4.4
percent more than in 1994. The average fee was $1,348. About
46.7 percent of these fees were paid out of claimants'
compensation, the smallest such percentage on record.
If you have questions about the information contained
in this document please contact by e-mail or phone:
Research Analyst, Research & Analysis Section, Information
Management Division (503) 947-7343
This document was originally published in August
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