In this case, the injured worker suffered a severe reaction to wood dust as a result of her on the job activities. When the claim was closed, the attending physician endorsed a mild impairment involving the respiratory condition, and permanent partial disability benefits were based on that opinion. However, when the Notice of Closure was appealed through a Request for Reconsideration, the attending physician endorsed a greater level of permanent impairment.
The injured worker then sought a penalty and attorney fees, arguing that the insurance company was "unreasonable" in awarding a lower level of permanent impairment. The Board eventually ruled that the insurance company's behavior was reasonable, because the attending doctor had endorsed the lesser level of permanent impairment prior to claim closure. One Board Member issued a "concurring" opinion, taking some issue with how the Oregon Workers' Compensation law deals with penalties on claim closure. A "concurring" opinion is an opinion where a decision maker agrees with the ultimate outcome, but has a different view on how the law should be applied to get to the outcome.
Another Board Member filed a dissenting opinion. This is an opinion that disagrees with the majority of the Board Members. Examining the medical opinions, this Board Member felt that the insurance company had enough information to award the higher level of disability at the time the claim was closed, and should have gotten more information when putting together the Notice of Closure.
Every injured worker's entitled to a permanent partial disability benefit if the on-the-job injury affects their ability to perform work activity. Sometimes, this can be a complex issue. If you have an accepted claim, and wonder if it makes sense to appeal a Notice of Closure, call us at 503-325-8600. We can review your file, and let you know whether an appeal makes sense. If we do appeal, there is no attorney fee unless we are successful.