2019 Analysis of Workers' Compensation Laws - 105

Chart XI-Administration: Notice to Employer and Claims, cont.
Administration

Oregon

Department
of Consumer
and Business
Services; Workers'
Compensation
Division

Pennsylvania

Bureau of
Workers'
Compensation

Notice to
Employer

Claim Filing

How Claims Are Settled

Award Effect

Review by Agency

Modifications

Attorney's Fees

In writing within
90 days

Injury-within
90 days from
the accident or
a denial from a
health benefit
plan (one year
under specific
circumstances).
Occupational
disease-the
later of: (a)
one year from
date worker
discovered or
should have
discovered the
disease; or (b)
one year from
date of disability
or date informed
of disability by a
physician.

Accepted claims-closed by
insurer or claims disposition
agreement (claims disposition
agreement cannot release right to
medical benefits or eligibility for
the Preferred Worker Program).
Denied claims may be appealed
to Workers' Compensation Board
or resolved by a disputed claim
settlement. Disputes-settled by
agreement, Workers' Compensation
Division, ALJ, Workers'
Compensation Board, Court of
Appeals, or Supreme Court (matters
of law only).

Payment by insurer
within 30 days or
after order except
where appeal stays
payment.

Appeal of claim denial is to
the Workers' Compensation
Board within 60 days.
Worker's appeal of claim
closure is to the Workers'
Compensation Division
within 60 days of insurer
notice of closure. Insurer
appeal of claim closure is
to the division within seven
days of notice of closure and
is limited to findings used to
rate impairment. Division's
appellate unit issues Orders
on Reconsideration of
disability awards within
18 days of request (60
additional days if a medical
arbiter exam or additional
information required). Appeal
on Order on Reconsideration
is to the Workers'
Compensation Board's
Hearings Division within 30
days; further appeal to board
within 30 days.

By Workers'
Compensation Division,
Board on application
or by stipulation of
parties, Court of
Appeals, or Supreme
Court (matters of law
only)

Subject to approval of
Workers' Compensation
Division, Workers'
Compensation Board,
or court, attorney fee
awards include: 25%
of increased PPD;
25% of increased PTD
($20,000 maximum).
10% of any increased
compensation due to
reconsideration of claim
closure. Up to $4,418
(more if extraordinary
circumstances) for
prevailing in a dispute
about medical services or
vocational rehabilitation,
or unreasonable
delay in, or refusal to
pay, compensation,
attorney fees, or
costs. Reasonable
fees if attorney is
instrumental in obtaining
reclassification of a claim
from nondisabling to
disabling. $275 per hour
for time spent during
mandatory interviews and
depositions.

If notice not given
within 21 days,
no compensation
due until given.
If not given
within 120 days,
compensation
disallowed.

Within three
years after injury,
death, or last
payment32

By agreement after seven days
from injury, subject to department
approval. Disputed cases heard
by Workers' Compensation Judge
(WCJ); appeals from a WCJ
decision may be taken within 20
days to the Worker's Compensation
Appeal Board (WCAB); appeals
from the WCAB decision may
be taken within 30 days to the
Commonwealth Court; finally, a
Petition for Allowance of Appeal
may be filed with the Supreme
Court within 30 days of the
Commonwealth Court decision.

Payment within
30 days, unless
order is appealed
and supersedes is
granted.

By Workers' Compensation
Appeal Board, within 20 days
of Workers' Compensation
Judge's decision

By department on
application within
statutory limits

Subject to approval of
Workers' Compensation
judge, Appeal Board,
or court. Attorney's
fees are limited to 20%
of the award to the
injured employee and
are generally paid out of
the employee's award.
However, in certain
instances, such as an
unreasonable contest,
attorneys may be granted
a quantum merit award or
their fee may be ordered
to be paid in addition
to the award to the
employee.

2019 Analysis of Workers' Compensation Laws | 105

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2019 Analysis of Workers' Compensation Laws

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