(A) Which of several subject employers is the true employer of a claimant worker;
(B) Which of more than one insurer of a certain employer is responsible for payment of compensation to a worker;
(C) Responsibility between two or more employers or their insurers involving payment of compensation for one or more accidental injuries; or
(D) Joint employment by two or more employers, the Director of the Department of Consumer and Business Services shall, by order, designate who shall pay the claim, if the employers and insurers admit that the claim is otherwise compensable. Payments shall begin in any event as provided in ORS 656.262 (4).
(b) At the time of claim closure, all parties to an order issued pursuant to paragraph (a) of this subsection shall have reconsideration and appeal rights.
(2) The director then shall request the Workers’ Compensation Board chairperson to appoint an Administrative Law Judge to determine the responsible paying party. The proceedings shall be conducted in the same manner as any other hearing and any further appeal shall be conducted pursuant to ORS 656.295 and 656.298.
(3) When a determination of the responsible paying party has been made, the director shall direct any necessary monetary adjustment between the parties involved. Any monetary adjustment not reimbursed by an insurer or self-insured employer shall be recovered from the Consumer and Business Services Fund. Any stipulation or agreement under subsection (6) of this section shall not obligate the Consumer and Business Services Fund for reimbursement without prior approval of the Director of the Department of Consumer and Business Services.
(4) No self-insured employer or an insurer shall be joined in any proceeding under this section regarding its responsibility for any claim subject to ORS 656.273 unless the issue is entitled to hearing on application of the worker.
(5) The claimant shall be joined in any proceeding under this section as a necessary party, but may elect to be treated as a nominal party. If the claimant appears at any such proceeding and actively and meaningfully participates through an attorney, the Administrative Law Judge may require that a reasonable fee for the claimant’s attorney be paid by the employer or insurer determined by the Administrative Law Judge to be the party responsible for paying the claim.
(6)(a) Notwithstanding subsection (2) of this section, parties to a responsibility proceeding under this section may agree to resolution of the dispute by mediation or arbitration by a private party. Any settlement stipulation, arbitration decision or other resolution of matters in dispute resulting from mediation or arbitration proceedings shall be filed with the Hearings Division and shall be given the same force and effect as an order of an Administrative Law Judge made pursuant to subsection (2) of this section. However, any such settlement stipulation, arbitration decision or other resolution is binding on the parties and is not subject to review by the director, an Administrative Law Judge, the board or any court or other administrative body, unless required pursuant to paragraph (d) of this subsection or subsection (3) of this section.
(b) For purposes of this subsection, mediation is a process of discussion and negotiation, with the mediator playing a central role in seeking a consensus among the parties. Such consensus may be reflected in a final mediation settlement stipulation, signed by all the parties and fully binding upon the parties with the same effect as a final order of an Administrative Law Judge, when the signed mediation settlement stipulation is filed with the Hearings Division of the Workers’ Compensation Board.
(c) For purposes of this subsection, arbitration is an agreement to submit the matter to a binding decision by an arbitrator, through a process mutually agreed upon in advance. Once all the parties have agreed in writing to proceed with arbitration, no party may withdraw from the arbitration process except as provided in the written arbitration agreement.
(d) A mediation settlement stipulation may include matters beyond the responsibility issues. If other matters are included, the settlement agreement shall be submitted to the Hearings Division of the Workers’ Compensation Board for review and approval, under this chapter, as to such additional matters beyond the responsibility issues.
(e) Any arbitration decision shall be limited to a decision as to responsibility and, where appropriate, the payment of associated costs and attorney fees. The arbitrator’s decision shall have the same effect as a final order of an Administrative Law Judge when the signed decision is filed with the Hearings Division.
(f) When the parties have reported to the Hearings Division that they have agreed upon a mediation or arbitration process, the hearing shall be deferred for 90 days to allow the mediation or arbitration process to occur. Once 90 days have passed, the matter shall again be docketed for hearing unless the parties advise the Hearings Division in writing that progress has been made and request an extension of time of up to 90 days, which extension of time shall be granted as a matter of right. Once the second 90 days have passed, the matter shall again be docketed for hearing, and the hearing shall proceed before an Administrative Law Judge as though there had been no mediation or arbitration process, unless the parties present a mediation settlement stipulation or signed arbitration decision before the hearing begins.
(g) All parties must agree in writing to pursue mediation or arbitration and must agree upon the selection of the mediator or arbitrator. The mediator or arbitrator shall not be an employee of any insurer or self-insured employer that is a party to the proceedings. The mediator or arbitrator must be an attorney admitted to practice law in the State of Oregon. The mediator or arbitrator may serve as a mediator or arbitrator, even if the mediator or arbitrator separately represents any insurer or self-insured employer in other proceedings, provided that all parties are advised of such representation and consent in writing that the mediator or arbitrator may so serve despite such other representation. Such written consent supersedes any legal ethics restrictions otherwise provided for in law or regulation.
(h) If the claimant is represented by an attorney, the other parties must arrange for payment of a reasonable attorney fee for the claimant’s attorney’s services during the mediation or arbitration. Any mediation or arbitration agreement shall specify the terms of the fee arrangement.
(i) If the claimant is not represented by an attorney, the mediation process cannot include any issue other than responsibility. A nonrepresented claimant must be advised in writing of the following before the mediation or arbitration proceeds:
(A) The claimant’s right to refuse to participate in mediation or arbitration proceedings and to, instead, proceed to a hearing before an Administrative Law Judge;
(B) The present rate of temporary total disability benefits for each alleged date of injury;
(C) The present rate of permanent partial disability benefits for each alleged date of injury;
(D) The estimated date of expiration of aggravation rights for each alleged date of injury; and
(E) The claimant’s right to be represented by counsel of the claimant’s choice at no expense to the claimant.
(j) Notwithstanding any other provision of law, any insurer or self-insured employer may be represented by a certified claims examiner rather than by an attorney in any mediation or arbitration hereunder. Any separate insured for the same insurer shall be represented by a separate claims examiner, if the insured has a continuing financial exposure as to the claim; where no continuing financial exposure exists, a single certified claims examiner may represent more than one insured for the same insurer in the mediation or arbitration proceeding.
(k) Any other procedures as to mediation or arbitration shall be subject to agreement among the parties. The Workers’ Compensation Board may adopt rules as to the process for deferral and docketing of hearings where mediation or arbitration occurs, the filing of arbitration decisions as orders of the Hearings Division, the filing of mediation settlement stipulations regarding responsibility as orders of the Hearings Division, and review and approval of mediation settlement stipulations that extend beyond the issues of responsibility and associated attorney fees and costs. The Workers’ Compensation Board shall not enact rules that restrict the mediation or arbitration process except to the extent provided within this section. [1965 c.285 §39; 1971 c.70 §1; 1979 c.839 §8; 1987 c.713 §5; 1995 c.332 §36; 1997 c.43 §1; 1999 c.313 §9; 1999 c.876 §3; 2003 c.657 §§9,10; 2007 c.274 §5]
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.