Settlement and Legal Management

Question 1

When a claim denial is appealed, what are the four levels of litigation (appeal) that can occur?

Answer 1

• An in-person administrative hearing before an Administrative Law Judge (ALJ) at the WCB Hearings Division.
• Board review of the ALJ’s opinion by the Workers’ Compensation Board.
• Review by the Oregon Court of Appeals.
• Review by the Oregon Supreme Court.

Question 2

What are two common settlement types in a denied claim?

Answer 2

• Disputed claim settlement (DCS): settles all benefits in the claim,
• Stipulation and Order (Stip): an agreement to rescind the denial and accept the claim.

Question 3

What are the settlement options in an accepted claim?

Answer 3

• Claims Disposition Agreement (CDA),
• Disputed Claim Settlement (DCS) (if there is a partial denial in the claim),
• Stipulation and Order (Stip).

Question 4

What is the only benefit a worker cannot settle when agreeing to a CDA?

Answer 4

Medical benefits

Question 5

How many days do insurers have to pay a CDA once it has been approved?

Answer 5

14 days from receipt of the approved order from WCB.