Summer 2008 SBH Quarterly Newsletter
PDF FormatOregon Workers’ Compensation Board Decisions
Family nurse practitioners cannot perfect an aggravation claim.
Just a reminder to consider the provider when an aggravation claim is filed. An aggravation claim must be in the form and format prescribed by the Director and signed by the worker or the worker’s representative and by the worker’s attending physician. ORS 656.273(2) and OAR 436-010-0240(14). The Oregon workers’ compensation system does not regard family nurse practitioners as attending physicians. Therefore, if a family nurse practitioner signs the aggravation claim, it is not a perfected claim and no time loss is due and owing. Toby Hersha, 60 Van Natta 1250 (2008).
Expansion requests must identify a specific condition.
A request to expand an acceptance to include a combined condition not specifically named is not enough under ORS 656.262(6)(d) and ORS 656.267(1) to perfect a new or omitted condition claim. In Rafael L. Ortiz-Lopez, claimant requested expansion of acceptance to include a combined condition based upon a concurrence report from the attending physician. No specific combined condition was evident from the letter itself. The Board held the expansion request was insufficient because it did not list the specific condition sought to be added to the scope of acceptance. Rafael L. Ortiz-Lopez, 60 Van Natta 1341 (2008).
Unfulfilled requests for personnel file can lead to penalties and attorney fees.
OAR 436-060-017 requires disclosure of copies of documents relating to a claim within 14 days. Be sure to look at the laundry list of requested documents in opposing counsel’s letter of representation. In Reman, claimant requested a complete copy of his personnel file after his shoulder claim was denied but before his request for hearing was filed. The personnel records were not supplied and claimant again requested them at hearing. The records were supplied three days after hearing. As there was no proof of the original record request at hearing, no penalty or attorney fee was awarded; however, had that evidence been submitted, a penalty could have been awarded. Mike Reman, 60 Van Natta 1298 (2008).
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