2015 ORS 656.267¹
Claims for new and omitted medical conditions

(1) To initiate omitted medical condition claims under ORS 656.262 (Processing of claims and payment of compensation) (6)(d) or new medical condition claims under this section, the worker must clearly request formal written acceptance of a new medical condition or an omitted medical condition from the insurer or self-insured employer. A claim for a new medical condition or an omitted condition is not made by the receipt of medical billings, nor by requests for authorization to provide medical services for the new or omitted condition, nor by actually providing such medical services. The insurer or self-insured employer is not required to accept each and every diagnosis or medical condition with particularity, as long as the acceptance tendered reasonably apprises the claimant and the medical providers of the nature of the compensable conditions. Notwithstanding any other provision of this chapter, the worker may initiate a new medical or omitted condition claim at any time.

(2)(a) Claims properly initiated for new medical conditions and omitted medical conditions related to an initially accepted claim shall be processed pursuant to ORS 656.262 (Processing of claims and payment of compensation).

(b) If an insurer or self-insured employer denies a claim for a new medical or omitted medical condition, the claimant may request a hearing on the denial pursuant to ORS 656.283 (Hearing rights and procedure).

(3) Notwithstanding subsection (2) of this section, claims for new medical or omitted medical conditions related to an initially accepted claim that have been determined to be compensable and that were initiated after the rights under ORS 656.273 (Aggravation for worsened conditions) expired shall be processed as requests for relief under the Workers’ Compensation Board’s own motion jurisdiction pursuant to ORS 656.278 (Board has continuing authority to alter earlier action on claim) (1)(b). [2001 c.865 §10; 2005 c.188 §1]

Note: See notes under 656.202 (Compensation payable to subject worker in accordance with law in effect at time of injury).

Notes of Decisions

Under Former Similar Statute (Ors 656.262 (Processing of claims and payment of compensation))

Clause permitting worker to file new claim at any time prevents applica­tion of claim preclusion doctrine to claim, but does not prevent applica­tion of issue preclusion doctrine. Evangelical Lutheran Good Samaritan Society v. Bonham, 176 Or App 490, 32 P3d 899 (2001), Sup Ct review denied

In General

New medical condi­tion claim for worsened condi­tion is subject to time limita­tions for aggrava­tion rights under claim for original injury. Davis v. SAIF, 185 Or App 500, 60 P3d 578 (2002)

Where worker files claim for new medical condi­tion, pro­vi­sion that insurer need not accept each and every diagnosis or medical condi­tion with particularity if acceptance reasonably apprises claimant of nature of compensable condi­tions refers to acceptance of new medical condi­tion claim, not acceptance pre­vi­ously issued by insurer. Rose v. SAIF, 200 Or App 654, 116 P3d 913 (2005)

Where claimant suffered compensable knee injury and, after claim closed, developed separate condi­tion in same knee that doctors stated was consequential condi­tion, and claimant brought aggrava­tion claim for consequential condi­tion, claim was properly denied because aggrava­tion claim must be based on worsening of underlying condi­tion instead of on consequential condi­tion. Nacoste v. Halton Co., 275 Or App 600, 365 P3d 1098 (2015)

Law Review Cita­tions

55 OLR 432-445 (1976); 16 WLR 519 (1979); 22 WLR 559 (1986)

Chapter 656

Notes of Decisions

Party having af­firm­a­tive of any issue must prove it by preponderance of evidence unless legislature fixes some different quantum of proof. Hutcheson v. Weyerhaeuser Co., 288 Or 51, 602 P2d 268 (1979)

Amend­ments to existing statutes and enact­ment of addi­tional statutes by 1995 legisla­tion generally apply to pending cases and to orders still ap­pealable on June 7, 1995, effective date. Volk v. America West Air­lines, 135 Or App 565, 899 P2d 746 (1995), Sup Ct review denied

Amend­ments to existing statutes and enact­ment of addi­tional statutes by 1995 legisla­tion do not extend or shorten procedural time limita­tions with regard to ac­tions taken prior to June 7, 1995, effective date. Motel 6 v. McMasters, 135 Or App 583, 899 P2d 1212 (1995)

Atty. Gen. Opinions

Benefit unavailability for inmates engaged in prison work programs, (1996) Vol 48, p 134

Law Review Cita­tions

24 WLR 321, 341 (1988); 32 WLR 217 (1996)


1 Legislative Counsel Committee, CHAPTER 656—Workers' Compensation, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors656.­html (2015) (last ac­cessed Jul. 16, 2016).
 
2 Legislative Counsel Committee, Annotations to the Oregon Revised Stat­utes, Cumulative Supplement - 2015, Chapter 656, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ano656.­html (2015) (last ac­cessed Jul. 16, 2016).
 
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.