(2)(a) "Beneficiary" means an injured worker, and the spouse in a marriage, child or dependent of a worker, who is entitled to receive payments under this chapter.
(b) "Beneficiary" does not include:
(A) A spouse of an injured worker living in a state of abandonment for more than one year at the time of the injury or subsequently. A spouse who has lived separate and apart from the worker for a period of two years and who has not during that time received or attempted by process of law to collect funds for support or maintenance is considered living in a state of abandonment.
(B) A person who intentionally causes the compensable injury to or death of an injured worker.
(3) "Board" means the Workers’ Compensation Board.
(4) "Carrier-insured employer" means an employer who provides workers’ compensation coverage with the State Accident Insurance Fund Corporation or an insurer authorized under ORS chapter 731 to transact workers’ compensation insurance in this state.
(5) "Child" means a child of an injured worker, including:
(a) A posthumous child;
(b) A child legally adopted before the injury;
(c) A child toward whom the worker stands in loco parentis;
(d) A child born out of wedlock;
(e) A stepchild, if the stepchild was, at the time of the injury, a member of the worker’s family and substantially dependent upon the worker for support; and
(f) A child of any age who was an invalid at the time of the accident and thereafter remains an invalid substantially dependent on the worker for support.
(6) "Claim" means a written request for compensation from a subject worker or someone on the worker’s behalf, or any compensable injury of which a subject employer has notice or knowledge.
(7)(a) A "compensable injury" is an accidental injury, or accidental injury to prosthetic appliances, arising out of and in the course of employment requiring medical services or resulting in disability or death. An injury is accidental if the result is an accident, whether or not due to accidental means, if it is established by medical evidence supported by objective findings, subject to the following limitations:
(A) An injury or disease is not compensable as a consequence of a compensable injury unless the compensable injury is the major contributing cause of the consequential condition.
(B) If an otherwise compensable injury combines at any time with a preexisting condition to cause or prolong disability or a need for treatment, the combined condition is compensable only if, so long as and to the extent that the otherwise compensable injury is the major contributing cause of the disability of the combined condition or the major contributing cause of the need for treatment of the combined condition.
(b) "Compensable injury" does not include:
(A) Injury to any active participant in assaults or combats that are not connected to the job assignment and that amount to a deviation from customary duties;
(B) Injury incurred while engaging in or performing, or as the result of engaging in or performing, any recreational or social activities primarily for the worker’s personal pleasure; or
(C) Injury the major contributing cause of which is demonstrated to be by a preponderance of the evidence the injured worker’s consumption of alcoholic beverages or cannabis or the unlawful consumption of any controlled substance, unless the employer permitted, encouraged or had actual knowledge of such consumption.
(c) A "disabling compensable injury" is an injury that entitles the worker to compensation for disability or death. An injury is not disabling if no temporary benefits are due and payable, unless there is a reasonable expectation that permanent disability will result from the injury.
(d) A "nondisabling compensable injury" is any injury that requires medical services only.
(8) "Compensation" includes all benefits, including medical services, provided for a compensable injury to a subject worker or the worker’s beneficiaries by an insurer or self-insured employer pursuant to this chapter.
(9) "Department" means the Department of Consumer and Business Services.
(10)(a) "Dependent" means any of the following relatives of the worker who, at the time of an accident, depended in whole or in part for the relative’s support on the earnings of a worker who dies as a result of an injury:
(A) A parent, grandparent or stepparent;
(B) A grandson or granddaughter;
(C) A brother or sister or half-brother or half-sister; and
(D) A niece or nephew.
(b) "Dependent" does not include an alien who does not reside within the United States at the time of the accident, other than a parent, a spouse or children, unless a treaty provides otherwise.
(11) "Director" means the Director of the Department of Consumer and Business Services.
(12)(a) "Doctor" or "physician" means a person duly licensed to practice one or more of the healing arts in any country or in any state, territory or possession of the United States within the limits of the license of the licensee.
(b) Except as otherwise provided for workers subject to a managed care contract, "attending physician" means a doctor, physician or physician assistant who is primarily responsible for the treatment of a worker’s compensable injury and who is:
(A) A physician licensed under ORS 677.100 to 677.228 by the Oregon Medical Board, or a podiatric physician and surgeon licensed under ORS 677.805 to 677.840 by the Oregon Medical Board, an oral and maxillofacial surgeon licensed by the Oregon Board of Dentistry or a similarly licensed doctor in any country or in any state, territory or possession of the United States; or
(B) For a cumulative total of 60 days from the first visit on the initial claim or for a cumulative total of 18 visits, whichever occurs first, to any of the medical service providers listed in this subparagraph, a:
(i) Doctor or physician licensed by the State Board of Chiropractic Examiners for the State of Oregon under ORS chapter 684 or a similarly licensed doctor or physician in any country or in any state, territory or possession of the United States;
(ii) Physician assistant licensed by the Oregon Medical Board in accordance with ORS 677.505 to 677.525 or a similarly licensed physician assistant in any country or in any state, territory or possession of the United States; or
(iii) Doctor of naturopathy or naturopathic physician licensed by the Oregon Board of Naturopathic Medicine under ORS chapter 685 or a similarly licensed doctor or physician in any country or in any state, territory or possession of the United States.
(c) Except as otherwise provided for workers subject to a managed care contract, "attending physician" does not include a physician who provides care in a hospital emergency room and refers the injured worker to a primary care physician for follow-up care and treatment.
(d) "Consulting physician" means a doctor or physician who examines a worker or the worker’s medical record to advise the attending physician or nurse practitioner authorized to provide compensable medical services under ORS 656.245 regarding treatment of a worker’s compensable injury.
(13)(a) "Employer" means any person, including receiver, administrator, executor or trustee, and the state, state agencies, counties, municipal corporations, school districts and other public corporations or political subdivisions, that contracts to pay a remuneration for the services of any worker.
(b) Notwithstanding paragraph (a) of this subsection, for purposes of this chapter, the client of a temporary service provider is not the employer of temporary workers provided by the temporary service provider.
(c) As used in paragraph (b) of this subsection, "temporary service provider" has the meaning for that term provided in ORS 656.850.
(d) For the purposes of this chapter, "subject employer" means an employer that is subject to this chapter as provided in ORS 656.023.
(14) "Insurer" means the State Accident Insurance Fund Corporation or an insurer authorized under ORS chapter 731 to transact workers’ compensation insurance in this state or an assigned claims agent selected by the director under ORS 656.054.
(15) "Consumer and Business Services Fund" means the fund created by ORS 705.145.
(16) "Invalid" means one who is physically or mentally incapacitated from earning a livelihood.
(17) "Medically stationary" means that no further material improvement would reasonably be expected from medical treatment or the passage of time.
(18) "Noncomplying employer" means a subject employer that has failed to comply with ORS 656.017.
(19) "Objective findings" in support of medical evidence are verifiable indications of injury or disease that may include, but are not limited to, range of motion, atrophy, muscle strength and palpable muscle spasm. "Objective findings" does not include physical findings or subjective responses to physical examinations that are not reproducible, measurable or observable.
(20) "Palliative care" means medical service rendered to reduce or moderate temporarily the intensity of an otherwise stable medical condition, but does not include those medical services rendered to diagnose, heal or permanently alleviate or eliminate a medical condition.
(21) "Party" means a claimant for compensation, the employer of the injured worker at the time of injury and the insurer, if any, of the employer.
(22) "Payroll" means a record of wages payable to workers for their services and includes commissions, value of exchange labor and the reasonable value of board, rent, housing, lodging or similar advantage received from the employer. However, "payroll" does not include overtime pay, vacation pay, bonus pay, tips, amounts payable under profit-sharing agreements or bonus payments to reward workers for safe working practices. Bonus pay is limited to payments that are not anticipated under the contract of employment and that are paid at the sole discretion of the employer. The exclusion from payroll of bonus payments to reward workers for safe working practices is only for the purpose of calculations based on payroll to determine premium for workers’ compensation insurance, and does not affect any other calculation or determination based on payroll for the purposes of this chapter.
(23) "Person" includes a partnership, joint venture, association, limited liability company and corporation.
(24)(a) "Preexisting condition" means, for all industrial injury claims, any injury, disease, congenital abnormality, personality disorder or similar condition that contributes to disability or need for treatment, provided that:
(A) Except for claims in which a preexisting condition is arthritis or an arthritic condition, the worker has been diagnosed with the condition, or has obtained medical services for the symptoms of the condition regardless of diagnosis; and
(B)(i) In claims for an initial injury or omitted condition, the diagnosis or treatment precedes the initial injury;
(ii) In claims for a new medical condition, the diagnosis or treatment precedes the onset of the new medical condition; or
(iii) In claims for a worsening pursuant to ORS 656.273 or 656.278, the diagnosis or treatment precedes the onset of the worsened condition.
(b) "Preexisting condition" means, for all occupational disease claims, any injury, disease, congenital abnormality, personality disorder or similar condition that contributes to disability or need for treatment and that precedes the onset of the claimed occupational disease, or precedes a claim for worsening in such claims pursuant to ORS 656.273 or 656.278.
(c) For the purposes of industrial injury claims, a condition does not contribute to disability or need for treatment if the condition merely renders the worker more susceptible to the injury.
(25) "Self-insured employer" means an employer or group of employers certified under ORS 656.430 as meeting the qualifications set out by ORS 656.407.
(26) "State Accident Insurance Fund Corporation" and "corporation" mean the State Accident Insurance Fund Corporation created under ORS 656.752.
(27) "Wages" means the money rate at which the service rendered is recompensed under the contract of hiring in force at the time of the accident, including reasonable value of board, rent, housing, lodging or similar advantage received from the employer, and includes the amount of tips required to be reported by the employer pursuant to section 6053 of the Internal Revenue Code of 1954, as amended, and the regulations promulgated pursuant thereto, or the amount of actual tips reported, whichever amount is greater. The State Accident Insurance Fund Corporation may establish assumed minimum and maximum wages, in conformity with recognized insurance principles, at which any worker shall be carried upon the payroll of the employer for the purpose of determining the premium of the employer.
(28)(a) "Worker" means any person, other than an independent contractor, who engages to furnish services for a remuneration, including a minor whether lawfully or unlawfully employed and salaried, elected and appointed officials of the state, state agencies, counties, cities, school districts and other public corporations, but does not include any person whose services are performed as an adult in custody or ward of a state institution or as part of the eligibility requirements for a general or public assistance grant.
(b) For the purpose of determining entitlement to temporary disability benefits or permanent total disability benefits under this chapter, "worker" does not include a person who has withdrawn from the workforce during the period for which such benefits are sought.
(c) For the purposes of this chapter, "subject worker" means a worker who is subject to this chapter as provided in ORS 656.027.
(29) "Independent contractor" has the meaning for that term provided in ORS 670.600. [1975 c.556 §§3 to 19 (enacted in lieu of 656.002); 1977 c.109 §2; 1977 c.804 §1; 1979 c.839 §26; 1981 c.535 §30; 1981 c.723 §3; 1981 c.854 §2; 1983 c.740 §242; 1985 c.212 §1; 1985 c.507 §1; 1985 c.770 §1; 1987 c.373 §31; 1987 c.457 §1; 1987 c.713 §3; 1987 c.884 §25; 1989 c.762 §3; 1990 c.2 §3; 1993 c.739 §23; 1993 c.744 §18; 1995 c.93 §31; 1995 c.332 §1; 1997 c.491 §5; 2001 c.865 §1; 2003 c.811 §§1,2; 2007 c.241 §§6,7; 2007 c.252 §§1,2; 2007 c.365 §1; 2007 c.505 §§1,2; 2009 c.43 §§6,7; 2011 c.117 §1; 2015 c.629 §53; 2017 c.21 §64; 2017 c.71 §1; 2017 c.409 §19; 2019 c.13 §62; 2019 c.213 §113; 2021 c.257 §1]
Structure 2021 Oregon Revised Statutes
Volume : 16 - Trade Practices, Labor and Employment
Chapter 656 - Workers’ Compensation
Section 656.005 - Definitions.
Section 656.012 - Findings and policy.
Section 656.018 - Effect of providing coverage; exclusive remedy.
Section 656.020 - Damage actions by workers against noncomplying employers; defenses outlawed.
Section 656.025 - Individuals engaged in commuter ridesharing not subject workers; conditions.
Section 656.027 - Who are subject workers.
Section 656.031 - Coverage for municipal volunteer personnel.
Section 656.041 - City or county may elect to provide coverage for adults in custody.
Section 656.056 - Subject employers must post notice of manner of compliance.
Section 656.070 - Definitions for ORS 656.027, 656.070 and 656.075.
Section 656.132 - Coverage of minors.
Section 656.135 - Coverage of deaf school work experience trainees.
Section 656.138 - Coverage of apprentices, trainees participating in related instruction classes.
Section 656.140 - Coverage of persons operating equipment for hire.
Section 656.156 - Intentional injuries.
Section 656.160 - Effect of incarceration on receipt of compensation.
Section 656.172 - Applicability of and criteria for establishing program under ORS 656.170.
Section 656.206 - Permanent total disability.
Section 656.209 - Offsetting permanent total disability benefits against Social Security benefits.
Section 656.210 - Temporary total disability; payment during medical treatment; election; rules.
Section 656.212 - Temporary partial disability.
Section 656.214 - Permanent partial disability.
Section 656.225 - Compensability of certain preexisting conditions.
Section 656.228 - Payments directly to beneficiary or custodian.
Section 656.230 - Lump sum award payments.
Section 656.232 - Payments to aliens residing outside of United States.
Section 656.264 - Compensable injury, denied claim and other reports.
Section 656.265 - Notice of accident from worker.
Section 656.266 - Burden of proving compensability and nature and extent of disability.
Section 656.267 - Claims for new and omitted medical conditions.
Section 656.278 - Board has continuing authority to alter earlier action on claim; limitations.
Section 656.291 - Expedited Claim Service; jurisdiction; procedure; representation; rules.
Section 656.319 - Time within which hearing must be requested.
Section 656.327 - Review of medical treatment of worker; findings; review; costs.
Section 656.360 - Confidentiality of worker medical and vocational claim records.
Section 656.362 - Liability for disclosure of worker medical and vocational claim records.
Section 656.382 - Penalties and attorney fees payable by insurer or employer in processing claim.
Section 656.383 - Attorney fees in cases prior to decision or after request for hearing.
Section 656.390 - Frivolous appeals, hearing requests or motions; expenses and attorney fee.
Section 656.403 - Obligations of self-insured employer.
Section 656.407 - Qualifications of insured employers.
Section 656.419 - Workers’ compensation insurance contracts.
Section 656.423 - Cancellation of coverage by employer; notice required.
Section 656.434 - Certification effective until canceled or revoked; revocation of certificate.
Section 656.440 - Notice of certificate revocation; appeal; effective date.
Section 656.443 - Procedure upon default by employer or self-insured employer group; rules.
Section 656.447 - Sanctions against insurer for failure to comply with contracts, orders or rules.
Section 656.508 - Authority to fix premium rates for employers.
Section 656.526 - Distribution of dividends from surplus in Industrial Accident Fund.
Section 656.554 - Injunction against employer failing to comply with deposit requirements.
Section 656.560 - Default in payment of premiums, fees, assessments or deposit; remedies.
Section 656.566 - Lien on property of employer for amounts due.
Section 656.583 - Paying agency may compel election and prompt action.
Section 656.595 - Precedence of cause of action; compensation paid or payable not to be an issue.
Section 656.605 - Workers’ Benefit Fund; uses and limitations.
Section 656.612 - Assessments for department activities; amount; collection procedure.
Section 656.625 - Reopened Claims Program; rules.
Section 656.630 - Oregon Institute of Occupational Health Sciences funding; report of activities.
Section 656.632 - Industrial Accident Fund.
Section 656.634 - Trust fund status of Industrial Accident Fund.
Section 656.635 - Reserve accounts in Industrial Accident Fund.
Section 656.642 - Emergency Fund.
Section 656.702 - Disclosure of records of corporation, department and insurers.
Section 656.709 - Ombudsman for injured workers; ombudsman for small business; duties.
Section 656.714 - Removal of board member.
Section 656.718 - Chairperson; quorum; panels.
Section 656.725 - Duties and status of Administrative Law Judges.
Section 656.727 - Rules for administration of benefit offset.
Section 656.730 - Assigned risk plan.
Section 656.752 - State Accident Insurance Fund Corporation; purpose and functions.
Section 656.754 - Manager; appointment; functions.
Section 656.795 - Informational materials for nurse practitioners.
Section 656.797 - Certification by nurse practitioner of review of required materials.
Section 656.802 - Occupational disease; mental disorder; presumptions as to stress disorders; proof.
Section 656.807 - Time for filing of claims for occupational disease; procedure.
Section 656.850 - License; compliance with workers’ compensation and safety laws.