Liberty Northwest Ins. Corp. v. Vera-Chavez

Under ORS 656.268(1) and ORS 656.268(10), after a claimant has completed an authorized training program, a disability claim can only be closed when the worker is medically stationary and there is sufficient information to determine disability.

Liberty Northwest Insurance Corp. (Liberty) and Hallmark Inns and Resorts appealed the Workers Compensation Board’s (WCB) upholding of the administrative law judge’s (ALJ) determination. Vera-Chavez suffered an on-the-job injury and two years later a physician determined that the condition was medically stationary. This physician’s finding permitted Liberty to close the claim and issue a permanent disability finding. The claim was reopened so that Vera-Chavez could participate in an authorized training program (ATP). After the ATP was complete, Liberty reclosed the claim without any new physician findings. Liberty only awarded temporary disability for the period of time in which Vera-Chavez participated in the ATP. Vera-Chavez requested a hearing regarding the reclosing of the claim. The ALJ held that Liberty prematurely closed Vera-Chavez’s disability benefits because there was no physician finding that claimant was medically stationary and there was insufficient information (i.e. a closing medical examination) to determine the extent of permanent disability. The ALJ found, and the WCB affirmed, that Vera-Chavez is entitled to additional benefits and attorney fees. The Court held that upon closure of a claim after ATP, a redetermination of Vera-Chavez’s medically stationary status and closing medical examination are required pursuant ORS 656.268(1) and ORS 656.268(10). Affirmed on petition; remanded for redetermination of penalty under ORS 656.268(5)(d).