ORS 656.267: Claims for new and omitted medical conditions.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
(1) To initiate omitted medical condition claims under ORS 656.262 (6)(d) or new medical condition claims under this section, the worker must clearly request formal written acceptance of a new medical condition or an omitted medical condition from the insurer or self-insured employer. A claim for a new medical condition or an omitted condition is not made by the receipt of medical billings, nor by requests for authorization to provide medical services for the new or omitted condition, nor by actually providing such medical services. The insurer or self-insured employer is not required to accept each and every diagnosis or medical condition with particularity, as long as the acceptance tendered reasonably apprises the claimant and the medical providers of the nature of the compensable conditions. Notwithstanding any other provision of this chapter, the worker may initiate a new medical or omitted condition claim at any time. (2)(a) Claims properly initiated for new medical conditions and omitted medical conditions related to an initially accepted claim shall be processed pursuant to ORS 656.262. (b) If an insurer or self-insured employer denies a claim for a new medical or omitted medical condition, the claimant may request a hearing on the denial pursuant to ORS 656.283. (3) Notwithstanding subsection (2) of this section, claims for new medical or omitted medical conditions related to an initially accepted claim that have been determined to be compensable and that were initiated after the rights under ORS 656.273 expired shall be processed as requests for relief under the Workers’ Compensation Board’s own motion jurisdiction pursuant to ORS 656.278 (1)(b). [2001 c.865 §10; 2005 c.188 §1]
Administrative rules citing this section
- OAR 436-035-0007: Temporary rule language in effect until 10/04/2026. General Principles — implements
- OAR 438-012-0001: Definitions — implements
- OAR 438-012-0110: Penalty for Unreasonable Failure to Comply or Untimely Compliance with Board Own Motion Rules — implements
- OAR 438-015-0080: Attorney Fees in Own Motion Cases — implements
- OAR 603-082-0010: Purpose — implements
- OAR 603-082-0020: Definitions — implements
This rule cites
- ORS 656.262 — resolved
- ORS 656.283 — resolved
- ORS 656.273 — resolved
- ORS 656.278 — resolved
Cited by
- ORS 656.262: Processing of claims and payment of compensation; payment by employer; acceptance and denial of claim; penalties and attorney fees; cooperation by worker and attorney in claim investigation; rules.
- ORS 656.278: Board has continuing authority to alter earlier action on claim; limitations.
- ORS 656.386: Recovery of attorney fees, expenses and costs in appeal on denied claim; attorney fees in other cases.
- OAR 436-035-0005: Temporary rule language in effect until 10/04/2026. Definitions
- OAR 436-060-0020: Temporary rule language in effect until 10/04/2026. Payment of Temporary Total Disability Compensation
- OAR 436-060-0140: Acceptance or Denial of a Claim
- OAR 438-012-0020: Insurer to Process Own Motion Claim: Notice and Contents of Claim; Worsened Condition Claim; "Post-aggravation Rights" New Medical Condition or Omitted Medical Condition Claim; Pre-1966 Injury Claim
Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors656.html