Requests

In 1998 there were 1,187 requests for Oregon Workers’ Compensation Board review of decisions by the board’s Hearings Division. That’s about 9.2 percent fewer requests than were received in 1997. The worker was the appellant in 55.9 percent of the cases.

Orders

The board issued 1,358 orders during the year, 10.5 percent more than the previous year. This figure includes 25 remands to the hearings division and one attorney fee case, but it excludes nine third party cases. The data below, except Figure1, exclude remands and cases not directly dealing with worker claims. Board own motion orders and claim disposition agreements are not considered here; information about them is available in separate reports.

The breakout of orders by order type was as follows: orders on review, 90.5 percent; stipulations (including disputed claim settlements), 3.1 percent; and dismissal, 6.4 percent. The breakout by insurer: SAIF, 30.3 percent (the second lowest percentage on record); private insurers, 51.2 percent (the second highest percentage on record); and self-insured employers, 18.5 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 order on review cases with the compensability issue (claim denial and partial denial) was 63.2 percent, the second highest on record (after 1996’s 64.8). On the other hand, the percentages of cases with the issues of permanent disability and aggravation were just one-tenth of a percentage point above their record-low values. The percentage of cases with the penalty issue, 10.0 percent, was the lowest since 1983. There were no cases with the issue of medical services or vocational assistance.

Issue dispositions

The table, in the right column, gives issue dispositions for orders on review, and Figure 2 gives historical acceptance rates for compensability. The percentage of extent of permanent and temporary disability cases awarding an increase was the lowest since the mid-1980s. The aggravation acceptance rate was up from 1996’s record-low 23.2 percent, and the penalty “yes” rate was the second lowest on record.

Permanent disability

The board in 1998 issued 173 orders on extent of permanent disability, including one stipulation. For orders on review, dispositions were 8.1 percent increase, 13.4 percent decrease, and 78.5 percent affirm. The 14 permanent partial disability award increases and 22 award decreases (includes the stipulation) resulted in a net PPD decrease of $61,000. The average decreases were 20.5 scheduled degrees and 33.2 unscheduled degrees. Combining these two award types, the average decrease was 27.1 degrees, the third smallest on record. There were four orders on permanent total disability: the board granted no PTD awards, rescinded two PTD awards, and affirmed two PTD awards.

Hearings affirmations rates

For extent of disability, the rates are given in the table (percent disposition of “affirm”). For the issues of compensability, aggravation, and penalty, the 1998 rates are 79, 81, and 57 percent, respectively. (These rates for 1997 were 80, 79, and 64 percent.)

The following overall rates are based on the affirm/reverse/modify (A/R/M) codes that are entered by the board staff; they apply to orders on review and are not edited. Over 73.5 percent of the orders on review affirmed the administrative law judge on all issues (compared to 70 percent in 1997), 12.6 percent reversed the judge, and 13.9 percent affirmed part of the judge’s order (A/R/M code of “modify”).

Disputed claim settlements

The board approved 35 DCSs, in which insurers paid over $374,000 in consideration for not contesting denials. The average settlement was about $10,700.

Time lags

The median time from request to order for orders on review was 136 days (4.5 months), 29 days shorter than for 1997 and by far the shortest time on record.

Attorney fees

The board directed payment of fees to claimant attorneys totaling $802,000, a 6.4 percent increase over 1997. The average fee was $1,716, about 3.9 percent less than in 1997. About 87 percent of fees were assessed against the insurer, as opposed to paid out of worker compensation. In addition to awarding attorney fees, the board reduced hearings-awarded fees by $366,000 (about 4.1 percent of 1998 hearings fees). An estimated 75 percent of this amount was due to reversal of hearings decisions on the primary issue (e.g., compensability), eliminating the basis for the fees. The other 25 percent was due to challenges to fee amounts and subsequent reduction of hearings-awarded fees.

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 March 2000.
[Printed form: 440-2363(03/00/IMD)]

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