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Requests

In 1997 there were 1,307 requests for Oregon Workers’ Compensation Board review of decisions by the board’s Hearings Division. That’s about 5.4 percent fewer requests than were received in 1996. The worker was the appellant in a typical 58 percent of the cases.

Orders

The board issued 1,229 orders during the year, almost 27 percent fewer than the previous year. This figure includes 18 remands to the hearings division, but it excludes 10 third party cases, 1 crime victim case, and 3 attorney fee cases. The data below, except Figure 1, exclude remands and cases not directly dealing with worker claims. Board own motion orders are not considered here, and claim disposition agreements are treated only in the final paragraph of this report.

Figure 1

The breakout of orders by order type was as follows: orders on review, 86 percent; stipulations (including disputed claim settlements), 5.0 percent; and dismissal, 8.7 percent. The breakout by insurer: SAIF, 35 percent; private insurers, 46 percent; and self-insured employers, 19 percent.

Issues

The table, in the “percentage of orders” column, gives issue relative frequencies for orders on review. Figure 2 gives historical information on the numbers of compensability disputes. The percentage of cases with the compensability issue was the third highest on record (after 1995 and 1996). On the other hand, the percentages of cases with the issues of temporary disability and aggravation were the lowest on record. There were no medical service or vocational assistance cases (jurisdiction change).

Responsibility was an issue in 45 orders on review. Of those, 20 orders also included the issue of compensability or aggravation.

Issue dispositions

The table, in the right column, gives issue dispositions for orders on review. The aggravation acceptance rate is the second lowest on record (after 1996’s 23 percent); the other disposition rates are fairly typical of recent years. Figure 2 gives historical acceptance rates for compensability.

 

 

 

 

 

 

 

 

Figure 2

 

Permanent disability

The board in 1997 issued 200 orders on extent of permanent partial disability, including four stipulations. The 25 award increases and 46 award decreases resulted in a net PPD decrease of $198,500. The average decreases were 21 scheduled degrees and 36 unscheduled degrees. There were six orders on review dealing with permanent total disability: three PTD rescinds and three affirmations of PTD grants.

Hearings affirmations rates

For extent of disability, the rates are given in the table (percentage disposition of “affirm”). For the issues of compensability, aggravation, and penalty, the 1997 rates are 80, 79, and 64 percent, respectively. (These rates for 1996 were 83, 73, and 75 percent.) Overall, 70 percent of the orders on review affirmed the administrative law judge on all issues, and another 15 percent affirmed part of the judge’s order (affirm/reverse/modify code of “modify”).

Disputed claim settlements

The board approved 49 DCSs, in which insurers paid over $622,000 in consideration for not contesting denials. The average settlement was about $12,700.

Time lags

The median time from request to order for orders on review was 165 days (5.4 months), 5 days shorter than for 1996 and the shortest time on record.

Attorney fees

The board directed payment of fees to claimant attorneys totaling $753,000, about $103,000 or 12 percent less than in 1996. About 78 percent of fees were assessed against the insurer, as opposed to paid out of worker compensation. The average fee (both types, combined) was $1,785, over 11 percent more than in 1996.

CDAsFigure 3

In 1997 the board approved 3,265 claim disposition agreements totaling over $44.0 million. See Figure 3. The average agreement was almost $13,500. More information about CDAs is available in a separate report.

 

 

 

 

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If you have questions about the information contained in this document please contact by e-mail or phone: Russell Reed, Research Analyst, Research & Analysis Section, Information Management Division (503) 947-7343.

This document was originally published in December 1998.
Document URL: http://www.cbs.state.or.us/external/imd/rasums/7_2363.html
[Printed form: 440-2363(12/98/IMD)]

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