In 1998 there were 1,187 requests for Oregon Workers Compensation
Board review of decisions by the boards Hearings Division.
Thats about 9.2 percent fewer requests than were received
in 1997. The worker was the appellant in 55.9 percent of the
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,
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 1996s 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.
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
1996s record-low 23.2 percent, and the penalty yes
rate was the second lowest on record.
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 judges 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.
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.
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.
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This document was originally published in March 2000.
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