- Court: Oregon Supreme Court
- Area(s) of Law: Workers Compensation
- Date Filed: 09-25-2025
- Case #: S071117
- Judge(s)/Court Below: Bushong, J., writing for the majority; Garrett, J., joined by DeHood, J., dissenting.
- Full Text Opinion
A worker suffered a back injury and filed a worker’s comp claim. The insurer denied this claim and the worker consequently requested a hearing. The insurer requested that the worker provide an independent medical exam (IME), which results ultimately supported the insurer’s finding of no compensability. The worker then requested a worker requested medical exam (WRME) pursuant to the worker’s comp statute and was denied. The Worker’s Compensation Board affirmed the insurer’ denial of the worker’s WRME; however, the Court of Appeals disagreed with the Board’s decision and now the insurer seeks judicial review.
ORS 656.325(1)(e) authorizes a WRME if the “claimant has requested ‘a hearing on a denial of compensability that is based on’ an IME report”...“a claimant’s right to a WRME is not limited to the grounds of denial at the time of the hearing request” because an insurer may rely on an IME after the claimant made the hearing request.
The Court conducted a statutory interpretation analysis, beginning first with the plain text of ORS 656.325(1)(e). The words “denial of compensability” were interpreted as the whole legal process of a claim, including hearings and appeals, not just the procedural written notice. The Court relied on case law interpreting this term, which indicated that a claim could change throughout the administration process; therefore concluding that the denial of compensability ends at the insurer’s written notice is improper. The insurer later used the IME to deny the WRME request, which constitutes a denial “based on [an IME report]”.
Lastly, the legislative intent of this statute was to provide more of a choice to workers for medical examinations during litigation of the claim. Limiting workers to exercise this option only if an IME was received before denial of compensability would be contrary to the purpose of the statute. before IME reports were completed, the policy behind the law would be ineffective.Therefore, the Worker’s Compensation Board erred in denying claimant’s request for a WRME. Court of Appeals decision AFFIRMED.
Justice Garrett, joined by Justice DeHoog, dissenting, opined that the majority misinterpreted the plain text of the statute and failed to properly address the legislative intent to include temporal language “is based on” as a basis for WRME.