General Definitions

Question 1

Aggravation(Agg)

Answer 1

An aggravation is actual worsening of the compensable condition or conditions after the last award or arrangement of compensation, which is established by medical evidence supported by objective findings.
ORS 656.273,
OAR 436-060-0005(1)

Question 2

Attending physician (AP)

Answer 2

The attending physician in a claim is the doctor or physician who is primarily responsible for the treatment of a worker’s compensable injury or illness.
OAR 436-010-0005(2),
ORS 656.005(12)

Question 3

Type A medical provider

Answer 3

A medical doctor, Doctor of Osteopathic Medicine, a podiatric physician and surgeon, or an oral and maxillofacial surgeon;
ORS 656.005(12)(b)(A)

Question 4

Type B medical provider

Answer 4

Chiropractic physician, physician assistant, naturopathic physician;
ORS 656.005(12)(b)(B)

Question 5

Claim

Answer 5

This means a written request for compensation from a subject worker or someone on the worker’s behalf, or any compensable injury of which a subject employer has notice or knowledge.
ORS 656.005(6)

Question 6

Combined condition

Answer 6

This is when an otherwise compensable injury combines with a qualified preexisting condition to cause or prolong disability or a need for treatment.
ORS 656.005(7)(a)(B)

Question 7

Come-along provider

Answer 7

A primary care physician, chirpractic physician, or an authorized nurse practitioner who is not a managed care organization (MCO) panel provider and who continues to treat the worker when the worker becomes enrolled in an MCO.
OAR 436-010-005(7)

Question 8

Compensable injury

Answer 8

A compensable injury is an accidental injury, or accidental injury to prosthetic appliances, arising out of and in the course of employment requiring medical services or resulting in disability or death.An injury is accidental if the result is an accident, whether or not due to accidental means, if it is established by medical evidence supported by objective findings.
ORS 656.005(7)

Question 9

Compensation

Answer 9

This includes all benefits, including medical services, provided for a compensable injury to a subject worker or the worker’s beneficiaries by an insurer.
ORS 656.005(8)

Question 10

Consequential condition

Answer 10

This type of condition occurs as a consequence of a compensable injury.
ORS 656.005(7)(a)(A)

Question 11

Curative care

Answer 11

This is care provided to a worker to stabilize a temporary and acute waxing and waning of symptoms. ORS 656.245(1)(c)(L)

Question 12

Director

Answer 12

This refers to theDirector of the Department of Consumer and Business Services
ORS 656.005(11)
OAR 436-060-0005(4)

Question 13

Disabling injury

Answer 13

A disabling injury entitles the worker to compensation for disability or death.An injury is not disabling if no temporary benefits are due and payable, unless there is a reasonable expectation that permanent disability will result from the injury.
ORS 656.005(7)(c)

Question 14

Elective surgery

Answer 14

Elective surgery is a surgery which may be required in the process of recovery from an injury or illness, but does not need to be done as an emergency to preserve life, function, or health.
OAR 436-010-0250(1)

Question 15

Impairment

Answer 15

A permanent loss of use or function of a body part or system related to the compensable condition.
OAR 436-035-0005(8)

Question 16

Incarceration

Answer 16

A worker is considered incarceratedwhen in pretrial detention or imprisoned following conviction for a crime.
OAR 436-060-0045(1)(a)(A)(B)

Question 17

Initial Claim

Answer 17

The first open period on the claim immediately following the original filing of the occupational injury or disease claim until the worker is first declared medically stationary by an attending physician or authorized nurse practitioner.
OAR 436-010-0005(19)

Question 18

Inpatient

Answer 18

Admitted to a hospital prior to and extending past midnight for treatment and lodging.
OAR 436-010-0005(20)
OAR 436-060-0005(9)

Question 19

Managed Care Organization (MCO)

Answer 19

An organization formed to provide medical services. OAR 436-010-0005(24)

Question 20

Medical services

Answer 20

Any medical treatment or any medical, surgical, diagnostic, chiropractic, dental, hospital, nursing, ambulances, and other related services, and drugs, medicine, crutches and prosthetic appliances, braces and supports and where necessary, physical restorative services.
OAR 436-010-0005(25)

Question 21

Medically stationary(Med Stat)

Answer 21

No further material improvement is expected with either treatment or the passage of time.
ORS 656.005(17)

Question 22

Nondisabling injury(MO claim)

Answer 22

A nondisabling injury only requires medical services.

ORS 656.005(7)(d)

Question 23

Objective findings

Answer 23

These are verifiable indications of injury or disease that may include, but are not limited to, range of motion, atrophy, muscle strength,and palpable muscle spasm. “Objective findings” does not include physical findings or subjective responses to physical examinations that are not reproducible, measurable,or observable.
ORS 656.005(19)

Question 24

Occupational disease (OD)

Answer 24

This includes any disease or infection arising out of and in the course of employment caused by substances or activities to which an employee is not ordinarily subjected or exposed other than during a period of regular actual employment therein, and which requires medical services or results in disability or death.
ORS 656.802

Question 25

Palliative care

Answer 25

This is medical service rendered to reduce or moderate temporarily the intensity of an otherwise stable medical condition, but does not include those medical services rendered to diagnose, heal,or permanently alleviate or eliminate a medical condition.
ORS 656.005(20)

Question 26

Permanent partial disability (PPD)

Answer 26

PPD is the permanent loss of use or function of a body part or system resulting from the compensable injury or occupational disease or permanent impairment and work disability resulting from the compensable injury or occupational disease.

Question 27

Permanent total disability(PTD)

Answer 27

A worker is permanently and totally disabled if permanently incapacitated from regularly performing work in a suitableand gainful occupation.
OAR 436-030-0055(1)

Question 28

Preexisting condition

Answer 28

A preexisting condition is any injury, disease, congenital abnormality, personality disorder,or similar condition that contributes to disability or need for treatment.ORS 656.005(24)(a)

Question 29

Qualifying preexisting condition

Answer 29

A qualifying preexisting condition is one where the worker has received prior medical treatment for the condition, was diagnosed with the condition prior to the injury, or is diagnosed as arthritis or an arthritic condition.

Question 30

Subject employer

Answer 30

This is an employer who is subject to the workers’ compensation laws found in ORS 656.
ORS 656.005(27)

Question 31

Subject worker

Answer 31

This is a worker who is subject to the workers’ compensation law found ORS 656.
ORS 656.005(28)
See ORS 656.027 for a complete list of workers who are NOT considered subject workers.

Question 32

Temporary partial disability (TPD)

Answer 32

This is when the worker is capable of returning to some form of work, but may be limited in the number of hours or the type of work performed.
ORS 656.212

Question 33

Temporary total disability(TTD)

Answer 33

This is when the worker istemporarily unable to return to any employment. ORS 656.210

Question 34

Three-day wait (3DW)

Answer 34

This refers to the three consecutive calendar days beginning with the first day the worker loses time or wages from work as a result of the compensable injury. OAR 436-060-0019(1)

Question 35

Work disability

Answer 35

This means the separate factoring of impairment as modified by age, education, and adaptabilityto perform the job at which the worker was injured.OAR 436-035-0005(20)

Question 36

Authorized Nurse Practitioner

Answer 36

An authorized nurse practitioner is a nurse practitioner authorized to provide compensable medical services.