Requests. In 1996 there were 1,381 requests for Oregon Workers’ Compensation Board review of decisions by the board’s Hearings Division, down 11.1 percent from last year’s count and the fewest since 1985 (Figure 1).
Orders. The board issued 1,676 orders during the year, 1.3 percent more than in 1995. This figure includes 34 remands, but excludes disputes assigned non-numeric case numbers such as the 7 third party orders and 8 crime victim orders. The data below (except Figure 1) exclude remands and cases not directly dealing with worker claims.
The worker was the appellant in 57.1 percent of the
orders. The breakout by insurer was as follows: SAIF,
38.2 percent; private insurers, 40.4 percent; and self-insured
employers, 21.0 percent (these values exclude six orders where
the insurer was coded as “noncomplying” or “multiple”).
The order types were order on review, 86.7 percent; stipulation
(includes disputed claim settlement), 4.2 percent; and dismissal,
Issues. The table (“percentage of orders” column) gives issue relative frequencies for orders on review. Compensability (claim denial and partial denial) had the highest relative frequency on record for the fourth consecutive year, while aggravation had its lowest on record. Figure 2 gives historical information on the number of compensability disputes.
The table (right column) gives issue dispositions, while Figure
2 gives historical acceptance rates for compensability. The “increase”
rates for permanent and temporary disability were 10.5 and 14.1
percent, respectively; these values are fairly typical. The 23.2
percent acceptance rate for aggravation is the lowest value on
Hearings affirmation rates. For extent of disability, the rates are given in the table (percentage disposition of “affirm”). For compensability, aggravation, and penalty issues, the rates were 82.9, 73.2, and 74.6 percent, respectively. (These figures for 1995 were 81.8, 88.6, and 74.7 percent.) The small numbers of cases with the remaining issues precludes determination of meaningful rates.
Disputed claim settlements. In 1996 the board approved 55 DCSs, constituting most of the 68 stipulations. In these DCSs, insurers paid over $608,000 to claimants as consideration for not contesting denials. The average settlement amount was about $11,100. (These figures exclude DCSs approved by the board’s Hearings Division, where most DCSs are approved.)
Time lags. The median time from request to order, for orders on review, was 170 days (5.6 months), 45 days shorter than in 1995 and the shortest time on record going back to 1979. The median time from ready for review (to board docket) to review (before the board for review) was 70 days, and the median time from review to order was 16 days.
Attorney fees. The board directed payment of fees to claimants’ attorneys totaling $857,000, up 8.0 percent from 1995. The average fee was $1,607, smaller than the 1995 average by 1.7 percent. Some 81.8 percent of attorney fees were assessed against the insurer, rather than paid out of compensation.
In 1996 the board approved 3,561 claim disposition agreements totaling over $45.0 million. See Figure 3. The average agreement was for over $12,600. More information about CDAs is available in a separate report.
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