Compromise and release of claim matters except for medical benefits
- • approval by Administrative Law Judge or board
- • approval by director for certain reserve reimbursements
- • restriction on charging costs to workers
- • restriction on joinder as parties for responsibility determinations
(1)(a) The parties to a claim, by agreement, may make such disposition of any or all matters regarding a claim, except for medical services, as the parties consider reasonable, subject to such terms and conditions as the Workers’ Compensation Board may prescribe. For the purposes of this section, “matters regarding a claim” includes the disposition of a beneficiary’s independent claim for compensation under this chapter. Unless otherwise specified, a disposition resolves all matters and all rights to compensation, attorney fees and penalties potentially arising out of claims, except medical services, regardless of the conditions stated in the agreement. Each disposition shall be filed with the board for approval by the Administrative Law Judge who mediated the agreement or by the board. If the worker is not represented by an attorney, the worker may, at the worker’s request, personally appear before the board. Submission of a disposition shall stay all other proceedings and payment obligations, except for medical services, on that claim. The disposition shall be approved in a final order unless:
(A) The Administrative Law Judge who mediated the agreement or the board finds the proposed disposition is unreasonable as a matter of law;
(B) The Administrative Law Judge who mediated the agreement or the board finds the proposed disposition is the result of an intentional misrepresentation of material fact; or
(C) Within 30 days of submitting the disposition for approval, the worker, the insurer or self-insured employer requests the Administrative Law Judge who mediated the agreement or the board to disapprove the disposition.
(b) Notwithstanding paragraph (a)(C) of this subsection, a disposition may provide for waiver of the provisions of that subparagraph if the worker was represented by an attorney at the time the worker signed the disposition.
(2) Notwithstanding any other provision of this chapter, an order approving disposition of a claim pursuant to this section is not subject to review. However, an order disapproving a disposition is subject to review pursuant to ORS 656.298 (Judicial review of board orders). The board shall file with the Department of Consumer and Business Services a copy of each disposition that the Administrative Law Judge who mediated the agreement or the board approves. If the Administrative Law Judge who mediated the agreement or the board does not approve a disposition, the Administrative Law Judge or the board shall enter an order setting aside the disposition.
(3) Unless the terms of the disposition expressly provide otherwise, no payments, except for medical services, pursuant to a disposition are payable until the Administrative Law Judge who mediated the agreement or the board approves the disposition.
(4) If a worker is represented by an attorney in the negotiation of a disposition under this section, the insurer or self-insured employer shall pay to the attorney a fee prescribed by the Administrative Law Judge who mediated the agreement or the board.
(5) Except as otherwise provided in this chapter, none of the cost of workers’ compensation to employers under this chapter, or in the court review of any claim therefor, shall be charged to a subject worker.
(6) Any claim in which the parties enter into a disposition under this section shall not be eligible for reimbursement of expenditures authorized by law from the Workers’ Benefit Fund without the prior approval of the Director of the Department of Consumer and Business Services.
(7) Insurers or self-insured employers who are parties to an approved claim disposition agreement under this section shall not be joined as parties in subsequent proceedings under this chapter to determine responsibility for payment for any matter for which disposition is made by the agreement. Insurers or self-insured employers may be joined as parties in subsequent proceedings under this chapter to determine responsibility for medical services for claim conditions for which disposition is made by an approved claim disposition agreement, but no order in any subsequent proceedings may alter the obligations of an insurer or self-insured employer set forth in an approved claims disposition agreement, except as those obligations concern medical services.
(8) No release by a worker or beneficiary of any rights under this chapter is valid, except pursuant to a claim disposition agreement under this section or a release pursuant to ORS 656.593 (Procedure when worker or beneficiary elects to bring action).
(9) Notwithstanding ORS 656.005 (Definitions) (21), as used in this section, “party” does not include a noncomplying employer. [1965 c.285 §28; 1985 c.212 §5; 1987 c.250 §4; 1990 c.2 §9; 1995 c.332 §24; 1995 c.641 §18; 1997 c.639 §5; 2007 c.17 §2; 2007 c.491 §1]
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.