Teitelman v. SAIF Corp.

Summarized by:

  • Court: Oregon Court of Appeals
  • Area(s) of Law: Civil Law
  • Date Filed: 04-17-2024
  • Case #: A176678
  • Judge(s)/Court Below: Ortega, PJ; Powers, J; Hellman, J.
  • Full Text Opinion

When an insurer submits an IME as evidence to support denial of a worker’s claim, the denial is “based” on an IME such that the worker is eligible for a WRME under the terms of ORS 656.325(1)(e).

Petitioner sought review of the Workers’ Compensation Board order denying a Worker Requested Medical Examination. Petitioner argued there was no distinction in ORS 656.325(1)(e) between an Independent Medical Examination filed before or after a denial of claim, therefore, the denial was “based” on the IME filed after and finding otherwise would allow insurers to deny all claims prior to an IME and frustrate the statute’s purpose. Respondent argues that because the denial occurred before the IME it was not possible for it to be “based” on the IME and contended that the text, context, and legislative history support the argument without accounting for a reviewing body finding the IME to support denial. When an insurer submits an IME as evidence to support denial of a worker’s claim, the denial is “based” on an IME such that the worker is eligible for a WRME under the terms of ORS 656.325(1)(e). The court observed the text did not require IME to be performed per-denial and requiring denials to be “based on one or more” IME suggested a legislative intent that does not limit eligibility to pre-denial IMEs. If this was the intent, precise language could have required it. Reversed and remanded.

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