SBH Legal
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SBH Legal is a litigation firm emphasizing representation of employers, insurers, and claims administrators in all matters relating to employment including workers' compensation, Longshore, OSHA, wage and hour, discrimination, and related litigation.
SBH Legal
7h ago
On April 10, 2024, the Oregon Court of Appeals issued a ruling reiterating the importance of the exclusive remedy clause under ORS 656.018. The case, Pierce v. Best Western Int., was litigated by Rebecca Watkins of SBH Legal.
ORS 656.018 is the “exclusive remedy” clause for workers’ compensation claims in the civil arena. Under the “exclusive remedy” statute, a worker who is injured in the course and scope of their employment is entitled to receive (from their employer) only the remedies provided for in the Workers’ Compensation Act. The rights provided for under the Act are in lieu of any rem ..read more
SBH Legal
5d ago
Oregon Governor Tina Kotek recently signed new legislation aimed at simplifying Oregon’s leave laws. Senate Bill 1515 eliminates many types of leave previously covered under the Oregon Family Leave Act (OFLA). The goal is to decrease overlap between the types of leave that qualify for OFLA and Paid Leave Oregon (PLO).
Effective July 1, 2024, OFLA will only cover:
Leave for home care of a child due to a health condition (but expanded to include minor illness and injury as well as serious health condition), or because of school/childcare closures in public health emergency
Bereavement l ..read more
SBH Legal
1w ago
A recent Oregon Workers’ Compensation Board case, In re Cambria Souza, 76 Van Natta 130 (2024), found a workers’ injury compensable where they were hurt crossing a public street to retrieve work clothing from their car.
Cambria involved an Oregon restaurant server who parker her car in a public lot across the street from the restaurant where she worked. After entering the restaurant and clocking in, claimant realized she’d left her required apron in her car. Black aprons were provided/required by the employer, and employees were expected to take their aprons home to be washed. Unable to find a ..read more
SBH Legal
3w ago
It is not uncommon for an overpayment of benefits to occur during the administration a workers’ compensation claim. An overpayment may arise due to clerical error, innocent misrepresentation or willful misrepresentation (RCW 51.32.240). Often overpayments arise when a worker is paid provisional time loss benefits and the claim is later denied by the Department.
Within five days of knowledge of the overpayment, a self-insured employer must notify the worker using the Assessment of Overpayment template (WAC 296-15-425). Generally the worker must be notified in writing within one year of the date ..read more
SBH Legal
3w ago
We are all familiar with the idea of a “compensable injury” in Oregon workers’ compensation law. A compensable injury is any injury sustained while performing work-related duties that results in a disability or the requirement for medical attention. However, this broad concept of an injury may be somewhat limited when processing an injury under a combined condition. A combined condition analysis necessitating a major contributing cause standard is an essential armor in an employer/insurer/administrator’s arsenal.
Recent Oregon case law has limited the scope of what constitutes an injury ..read more
SBH Legal
1M ago
The Department of Consumer and Business Services Workers’ Compensation Division amended several provisions of the OAR that will directly impact MCO enrolled claims in Oregon. The net effect of the amended OAR is essentially more claim processing, and in the worst-case scenario, potential exposure for increased claim costs, litigation costs, attorney fees and penalty for non-compliance.
SBH attorney Kevin J. Anderson and SAIF submitted argumentative testimony against the changes, which the Agency considered when formalizing the final Rule changes.
Changes Effective April 1, 2024
OAR 436-010-022 ..read more
SBH Legal
1M ago
Two significant decisions regarding the vocational process were recently determined by the Board of Industrial Insurance Appeals. In re Michael Killpatrick BIIA Dec., 21 13384 (2023) clarified what qualifies as good cause for an interruption of a vocational plan. Mr. Killpatrick was in the process of going through vocational retraining when he was diagnosed with prostate cancer, a condition unrelated to his industrial injury. He withdrew from his vocational retraining due to undergoing prostate cancer treatment and feeling overwhelmed with his cancer diagnosis. Claimant was unable to complete ..read more
SBH Legal
1M ago
On January 9, 2024, the Workers’ Compensation Board ruled in Maria F. Opferman, 76 Van Natta 10 (2024), that the employer’s post-litigation acceptance of a concussion combined with a preexisting condition was valid. Through prior litigation, an administrative law judge (ALJ) ordered the employer to accept a concussion. In lieu of accepting a concussion as a standalone condition, the employer generated medical evidence to support combined condition processing. It then accepted the claim for a concussion combined with underlying depression and, thereafter, it issued a combined condition “ceases ..read more
SBH Legal
1M ago
The Washington Department of Labor & Industries lifted its COVID coverage presumption on April 11, 2023. Under the presumption, frontline workers who tested positive for COVID-19 between February 29, 2020 and April 11, 2023 were automatically considered to have contracted the disease at work and the burden was placed on employers to rebut the presumption by showing that the worker more likely contracted the disease from nonemployment activities. Since the presumption has lifted, workers are still entitled to file COVID-19 claims, but they are evaluated under the usual occupational disease ..read more
SBH Legal
1M ago
Insurers or self-insured employers are required to conduct a reasonable investigation based on all available information” in order to decide whether to accept or deny a claim. See OAR 436-060-0140(1). Additionally, workers also have an obligation to cooperate with and assist the insurer’s or self-insured employer’s investigation into their claim. See ORS 656.262(14). A workers’ failure to reasonably cooperate with an investigation can result in suspension of benefits and denial of the claim.
Specifically, during an initial claim investigation to establish a compensable injury or an aggravation ..read more