Daugherty v. SAIF

Under ORS 656.704, the Workers' Compensation Board is vested with exclusive authority to determine the causal relationship between a claimant's injury and medical services.

Daugherty sought judicial review of a final order of the Director of the Department of Consumer and Business Services (the Director) dismissing her request for administrative review of her medical services claim. Director refused to transfer the matter to the Workers' Compensation Board (the Board) for a hearing. Daugherty argued that under ORS 656.704, the Board has exclusive authority to determine the sufficiency of the evidence relating to causation, and that the Director was vested solely with the authority to determine whether medical services are excessive, inappropriate, ineffectual, or in violation of the rules regarding performance of medical services. Daugherty asserted that the Director therefore erred in determining that there was no factual dispute to be transferred to the Board concerning the causal relationship between Daugherty's requested medical services and her accepted lumbar strain. Under the transfer provision of ORS 656.704(5), SAIF argued that the Director was vested with discretion to review the evidence in a case in order to determine whether it should be transferred to the Board for causality review. However, the Court of Appeals held that the Director exceeded his authority under ORS 656.704, when making a dispositive decision concerning a potential causal relationship between requested medical services and an accepted claim. While the Director asserted that no factual issue was ever raised, it is the exclusive statutory responsibility of the Board to make such a determination. Accordingly, upon determining that the disposition of Daugherty's request for medical services pertained to a potential causal-relationship dispute, the Director was obligated to transfer the matter to the Board. Reversed and remanded.