The Oregon Workers' Compensation Board found that an insurance company was acting unreasonably in refusing to close a claim because it did nothing for several months after it had sufficient evidence to issue a Notice of Closure.
A Notice of Closure is issued when the injured worker is determined to be "medically stationary," and there sufficient information to determine the level of permanent impairment that resulted from the on-the-job injury. In many cases, insurance carriers will have the injured worker attend a physical capacities evaluation, also known as an "PCE." Physical therapists that are specially trained conduct these examinations to measure an injured worker's ability to do certain work activity after an injury.
In this particular case, the Board walked through all of the facts showing that the attending physician had declared the injured worker medically stationary. The term "medically stationary" means that additional treatment or time will not likely improve an injured worker's condition, and that the injured worker stable. When this occurs, the insurance company is required to gather information that it needs in order to calculate permanent partial disability.
The Board scolded the carrier because the information required to close the claim (a physician's opinion that the worker was medically stationary and impairment findings) had been determined for several months, but no action was taken. The Board pointed out that the injured worker may more than one request to close the claim.
If you have an open Oregon Workers' Compensation claim, and wonder whether the insurance company's holding up your claim closure, call us at 503-325-8600. We can determine whether not your claim is ready to close, and if so, do it needs to be done to get the benefits you deserve. We are only paid if we are successful in obtaining additional benefits on your behalf.
