In this case, the Oregon Workers' Compensation board awarded penalties and attorney fees because an insurance carrier was unreasonable in refusing to close a claim for new/omitted medical conditions. The Board explained that the attending physician provided in opinion that the injured worker was medically stationary and permanently and totally disabled. Nonetheless, the insurance company did not take any actions for several months.
Even several months later, a vocational counselor advised the insurance company that the injured worker would not even be able to perform sedentary work. Another request to close the claim was made. After the second request, the insurance company refused closure, arguing that there was not enough information to determine the level of impairment.
Three months after that, the attending physician again provided in opinion that the injured worker was permanently and totally disabled. When the insurance company refused to act in response to this request, the injured worker then sought relief with the Board, seeking penalties and attorney fees.
Looking at the facts of the case, the Board found that the insurance company lacked "legitimate doubt" that the injured worker was medically stable, and was permanently and totally disabled. Because of this, the Board agreed with the injured worker, and awarded attorney fees and penalties.
Some injured workers have great difficulty getting the insurance company to close a claim regardless of their level of disability. If you are having trouble moving on from your Oregon Workers' Compensation claim, call us at 503-325-8600. We can review your file, and determine whether or not penalties are available for unreasonable behavior.