reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0160 - Second through Fifth Toes

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 No rating is given for loss of motion in the distal interphalangeal joint of
			 the second through fifth toes (to be referred to as toes), except in the case
			 of ankylosis.
(2) Ankylosis in the
			 distal interphalangeal joint of the toes is rated as follows: [Rating not
			 included. See ED. NOTE]
(3) No
			 rating is given for loss of motion in the proximal interphalangeal joint of the
			 toes, except in the case of ankylosis.
(4) Ankylosis in the proximal interphalangeal
			 joint of the toes is rated as follows: [Rating not included. See ED.
			 NOTE]
(5) The following ratings are
			 for loss of dorsiflexion (extension) in the metatarsophalangeal joints of the
			 toes: [Rating not included. See ED. NOTE]
(6) The following ratings are for
			 dorsiflexion (extension) ankylosis in the metatarsophalangeal joints of the
			 toes: [Rating not included. See ED. NOTE]
(7) The following ratings are for loss of
			 (plantar) flexion in the metatarsophalangeal joints of the toes: [Rating not
			 included. See ED. NOTE]
(8)
			 Plantarflexion ankylosis in the metatarsophalangeal joints of the toes is rated
			 as follows: [Rating not included. See ED. NOTE]
Ratings referenced are available from the
				  agency.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0180 - Conversion of Toe Values to Foot Value

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If the only findings are in the toes, it
			 is not possible to convert the toe findings to a loss in the foot unless there
			 are impairment findings in the foot. Each toe must be converted to the foot
			 separately. After converting to the foot, each converted value is
			 added.
(2) If there are impairment
			 findings in the foot and impairment findings in the great toe, the following
			 table is used to convert losses in the great toe to losses in the foot: [Table
			 not included. See ED. NOTE.]
(3) If
			 there are impairment findings in the foot and impairment findings in the second
			 through the fifth toes, the following table is used to convert losses in the
			 toes to losses in the foot: [Table not included. See ED. NOTE.]
The Tables referenced are not printed in the OARCompilation.
				  Copies are available from the agency.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268 & ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0190 - Foot

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Ankylosis at
			 the tarsometatarsal joints receives a rating of 10% of the foot for each of the
			 tarsometatarsal joints ankylosed.
(2) The following ratings are for loss of
			 subtalar inversion in the foot: [Rating not included. See ED. NOTE.]
(3) The following ratings are for subtalar
			 inversion (varus) ankylosis in the foot: [Rating not included. See ED.
			 NOTE.]
(4) The following ratings
			 are for loss of subtalar eversion in the foot: [Rating not included. See ED.
			 NOTE.]
(5) The following ratings
			 are for subtalar eversion (valgus) ankylosis in the foot: [Rating not included.
			 See ED. NOTE.]
(6) The following
			 ratings are for loss of dorsiflexion (extension) in the ankle joint: [Rating
			 not included. See ED. NOTE.]
(7)
			 The following ratings are for dorsiflexion (extension) ankylosis in the ankle
			 joint: [Rating not included. See ED. NOTE.]
(8) The following ratings are for loss of
			 plantar flexion in the ankle joint: [Rating not included. See ED.
			 NOTE.]
(9) The following ratings
			 are for plantar flexion ankylosis in the ankle joint: [Rating not included. See
			 ED. NOTE.]
(10) The following
			 applies when determining impairment for loss of motion or ankylosis in the
			 ankle or subtalar joint:
(a) If there is loss
			 of motion only (no ankylosis in either joint) in the subtalar joint or the
			 ankle joint, the following applies:
(A) the
			 values for loss of motion in the subtalar joint are added;
(B) the values for loss of motion in the
			 ankle joint are added;
(C) the
			 value for loss of motion in the subtalar joint is added to the value for loss
			 of motion in the ankle joint.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0210 - Conversion of Foot Value to Leg Value

Current through Register Vol. 63, No. 7, July 1, 2024
The following ratings are for converting losses in the foot to
				losses in the leg:
Impairment ofImpairment ofImpairment ofImpairment of
Foot - LegFoot - LegFoot - LegFoot - Leg
1% = 1%27% = 24%52% = 47% 77% = 69%
2% = 2%28% = 25%53% = 48% 78% = 70%
3% = 3%29% = 26%54% = 49% 79% = 71%
4% = 4%30% = 27%55-56% = 50% 80% = 72%
5-6% = 5%31% = 28%57% = 51% 81% = 73%
7% = 6%32% = 29%58% = 52% 82% = 74%
8% = 7%33% = 30%59% = 53% 83% = 75%
9% = 8%34% = 31%60% = 54% 84% = 76%
10% = 9%35-36% = 32%61% = 55% 85-86% = 77%
11% = 10%37% = 33%62% = 56% 87% = 78%
12% = 11%38% = 34%63% = 57% 88% = 79%
13% = 12%39% = 35%64% = 58% 89% = 80%
14% = 13%40% = 36%65-66% = 59% 90% = 81%
15-16% = 14%41% = 37%67 = 60% 91% = 82%
17% = 15%42% = 38%68% = 61% 92% = 83%
18% = 16%43% = 39%69% = 62% 93% = 84%
19% = 17%44% = 40%70% = 63% 94% = 85%
20% = 18%45-46% = 41%71% = 64% 95-96% = 86%
21% = 19%47% = 42%72% = 65% 97% = 87%
22% = 20%48% = 43%73% = 66% 98% = 88%
23% = 21%49% = 44%74% = 67% 99% = 89%
24% = 22%50% = 45%75-76% = 68%100% = 90%
25-26% = 23%51% = 46%
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268 & ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0220 - Leg

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following
			 ratings are for loss of flexion in the knee (150° describes the knee in
			 full flexion): [Rating not included. See ED. NOTE]
(2) The following ratings are for loss of
			 extension in the knee (0° describes the knee in full extension): [Rating
			 not included. See ED. NOTE]
(3)
			 Ankylosis of the knee in flexion or extension shall be rated as follows:
			 [Rating not included. See ED. NOTE]
(4) The determination of loss of range of
			 motion in the hip is valued in this section when there is no pelvic bone
			 involvement. Loss associated with pelvic bone involvement is determined
			 pursuant to OAR 436-035-0340.
(5) The following ratings are for loss of
			 forward flexion in the hip: [Rating not included. See ED. NOTE]
(6) The following ratings are for loss of
			 backward extension in the hip joint: [Rating not included. See ED.
			 NOTE]
(7) The following ratings are
			 for loss of abduction in the hip joint: [Rating not included. See ED.
			 NOTE]
(8) The following ratings are
			 for loss of adduction in the hip joint: [Rating not included. See ED.
			 NOTE]
(9) The following ratings are
			 for loss of internal rotation in the hip joint: [Rating not included. See ED.
			 NOTE]
(10) The following ratings
			 are for loss of external rotation in the hip joint: [Rating not included. See
			 ED. NOTE]
(11) Ankylosis in the hip
			 joint is rated under OAR
			 436-035-0340.
Ratings referenced are available from the
				  agency.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0230 - Other Lower Extremity Findings

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Loss of sensation or hypersensitivity in
			 the leg is not considered disabling except for the plantar surface of the foot
			 and toes, including the great toe, where it is rated as follows:
(a) Toe (in any toe) Foot partial loss of
			 sensation or hypersensitivity 5%5% total loss of sensation or
			 hypersensitivity10%10%
(b) Partial
			 is part of the toe or foot. Total means the entire toe or foot.
(c) Loss of sensation or hypersensitivity in
			 the toes in addition to loss of sensation or hypersensitivity in the foot is
			 rated for the foot only. No additional value is allowed for loss of sensation
			 or hypersensitivity in the toes.
(d) When there are hypersensitivity and
			 sensation loss, both conditions are rated.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0235 - Conversion of Lower Extremity Values to Whole Person Values

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The tables in
			 this rule are used to convert losses in the lower extremity to a whole person
			 (WP) value for claims with a date of injury on or after January 1,
			 2005.
(2) The following table is
			 used to convert losses in the great toe to a whole person (WP) value.
			 Impairment in any of the other toes receives a whole person value of 1% for
			 each toe that is injured. [Values not included. See ED. NOTE.]
(3) The following table is used to convert a
			 loss in the foot to a whole person (WP) value. [Values not included. See ED.
			 NOTE.]
(4) The following table is
			 used to convert a loss in the leg to a whole person (WP) value. [Values not
			 included. See ED. NOTE.]
Ratings & Values referenced are not included in rule
				  text.
Click here for
				  PDF copy of rating(s) &
				  value(s)
.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0250 - Hearing Loss

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following
			 information is provided by the attending physician or reviewed and commented on
			 by the attending physician, under OAR
			 436-035-0007(5) and
			 (6), to value work-related hearing loss:
(a) A written record, history, examination,
			 diagnosis, opinion, interpretation and a statement noting if further material
			 improvement would reasonably be expected from medical treatment or the passage
			 of time by a medical provider with specialty training or experience in
			 evaluating hearing loss.
(b) The
			 complete audiometric testing.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0255 - Conversion of Hearing Loss Values to Whole Person Values

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following table is used to convert a
			 loss of hearing in one ear to a whole person (WP) value for claims with a date
			 of injury on or after January 1, 2005: [Table not included. See ED.
			 NOTE.]
(2) The following table is
			 used to convert a loss of hearing in two ears to a whole person (WP) value for
			 claims with a date of injury on or after January 1, 2005: [Table not included.
			 See ED. NOTE.]
Tables referenced are not included in rule text.
Click here for PDF
				  copy of table(s)
.
Stat. Auth.: ORS
				  656.726
Stats.Implemented: ORS
				  656
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0260 - Visual Loss

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Visual loss due
			 to a work-related illness or injury is rated for central visual acuity,
			 integrity of the peripheral visual fields, and ocular motility. For ocular
			 disturbances that cause visual impairment that is not reflected in visual
			 acuity, visual fields or ocular motility refer to section (5) of this rule.
			 Visual loss is measured with best correction, using the lenses recommended by
			 the worker's physician. For lacrimal system disturbances refer to OAR
			 436-035-0440.
(2) Ratings for loss in central visual acuity
			 are calculated for each eye as follows:
(a)
			 Reports for central visual acuity must be for distance and near
			 acuity.
(b) The ratings for loss of
			 distance acuity are as follows, reported in standard increments of Snellen
			 notation for English and Metric 6: [Ratings not included. See ED.
			 NOTE.]
(c) The ratings for loss of
			 near acuity are as follows: reported in standard increments of Snellen 14/14
			 notation, Revised Jaeger Standard, or American Point-type notation: [Ratings
			 not included. See ED. NOTE.]
(d)
			 Once the ratings for near and distance acuity are found, add them and divide by
			 two. The value which results is the rating for lost central visual
			 acuity.
(e) If a lens has been
			 removed and a prosthetic lens implanted, an additional 25%, is to be combined
			 (not added) with the percent loss for central visual acuity to determine total
			 central visual acuity, as shown in table (g).
(f) If a lens has been removed and there is
			 no prosthetic lens implanted, an additional 50% is to be combined (not added)
			 with the percent loss for central visual acuity to determine total central
			 visual acuity, as shown in table (g).
(g) The table below may be substituted for
			 combining central visual acuity and the loss of a lens for a total central
			 visual acuity. The table displays the percent loss of central vision for the
			 range of near and distance acuity combined with lens removal for a total
			 central visual acuity. The upper figure is to be used when the lens is present
			 (as found in (d)), the middle figure is to be used when the lens is absent and
			 a prosthetic lens has been implanted (as found in (e)), and the lower figure is
			 to be used when the lens is absent with no implant (as found in (f)). If near
			 acuity is reported in Revised Jaeger Standard or American Point-type, convert
			 these findings to Near Snellen for rating purposes under (2)(c) of this rule
			 when using this table.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0265 - Conversion of Vision Loss Values to Whole Person Values

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following table is used to convert
			 vision loss in one eye to a whole person (WP) value for claims with a date of
			 injury on or after January 1, 2005: [Table not included. See ED.
			 NOTE.]
(2) The following table is
			 used to convert vision loss in both eyes to a whole person (WP) value for
			 claims with a date of injury on or after January 1, 2005: [Table not included.
			 See ED. NOTE.]
Tables referenced are not included in rule text.
Click here for PDF
				  copy of table(s)
.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0350 - General Spinal Findings

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 following ratings are for fractured vertebrae:
(a) For a compression fracture of a single
			 vertebral body: [Tables not included. See ED. NOTE.]
(b) A fracture of one or more of the
			 posterior elements of a vertebra (spinous process, pedicles, laminae, articular
			 processes, or transverse processes) is valued per vertebra as follows: [Tables
			 not included. See ED. NOTE.]
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0360 - Spinal Ranges of Motion

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For
			 the purpose of determining impairment due to loss of spinal range of motion,
			 sections (2) through (12) of this rule apply when the physician uses an
			 inclinometer to measure impairment.
(2) The following ratings are for loss of
			 flexion in the cervical region: [Ratings not included. See ED. NOTE.]
(3) The following ratings are for loss of
			 extension in the cervical region: [Ratings not included. See ED.
			 NOTE.]
(4) The following ratings
			 are for loss of right or left lateral flexion in the cervical region: [Ratings
			 not included. See ED. NOTE.]
(5)
			 The following ratings are for loss of right or left rotation in the cervical
			 region: [Ratings not included. See ED. NOTE.]
(6) The following ratings are for loss of
			 flexion in the thoracic region: [Ratings not included. See ED. NOTE.]
(7) The following ratings are for loss of
			 right or left rotation in the thoracic region: [Ratings not included. See ED.
			 NOTE.]
(8) The following ratings
			 are for loss of flexion in the lumbosacral region: [Ratings not included. See
			 ED. NOTE.]
(9) The following
			 ratings are for loss of extension in the lumbosacral region: [Ratings not
			 included. See ED. NOTE.]
(10) The
			 following ratings are for loss of right or left lateral flexion of the
			 lumbosacral region: [Ratings not included. See ED. NOTE.]
(11) For a total impairment value due to loss
			 of motion, as measured by inclinometer, in any of the cervical, thoracic or
			 lumbosacral regions, add (do not combine) values for loss of motion for each
			 region.
(12) In order to rate range
			 of motion loss and surgery in one region, combine (do not add) the total range
			 of motion loss in that region with the appropriate total surgical impairment
			 value of the corresponding region. Combine the value from each region to find
			 the total impairment of the spine.
Ratings referenced are available from the
				  agency.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0370 - Pelvis

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following
			 ratings are for a fractured pelvis which heals with displacement and deformity:
			 [Tables not included. See ED. NOTE.] In the acetabulum - Rate only loss of hip
			 motion as in OAR 436-035-0340
(2) A hemipelvectomy receives 25% for the
			 pelvis, and the accompanying loss of the leg is determined under OAR
			 436-035-0140(1).
Ratings referenced are not included in rule text.
Click here for PDF
				  copy of rating(s)
.
Stat. Auth.: ORS
				  656.726
Stats.Implemented: ORS
				  656.005,
				  656.214,
				  656.268 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0375 - Abdomen

Current through Register Vol. 63, No. 7, July 1, 2024
Use the following classifications when impairment has resulted
				from a permanent and palpable defect in the supporting structures of the
				abdominal wall:
(1) Class 1: 5% for a
			 slight protrusion at the site of the defect with increased abdominal pressure
			 that is readily reducible; or occasional mild discomfort at the site of the
			 defect, which limits the worker in one or more activities of daily living
			 (ADL).
(2) Class 2: 15% for
			 frequent or persistent protrusion at the site of the defect with increased
			 pressure that is manually reducible; or frequent discomfort, which limits the
			 worker from heavy lifting, but does not hamper some ADL.
(3) Class 3: 25% for persistent, irreducible,
			 or irreparable protrusion at the site of the defect and there is a limitation
			 in the worker's ADL.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0385 - Respiratory System

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For the
			 purpose of this rule, the following definitions apply:
(a) FVC is forced vital capacity.
(b) FEV1 is forced expiratory volume in the
			 first second.
(c) Dco refers to
			 diffusing capacity of carbon monoxide.
(d) VO2 Max is measured exercise
			 capacity.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0390 - Cranial Nerves/Brain

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Impairment of the first cranial nerve (olfactory) resulting in either complete
			 inability to detect odors or alteration of the sense of smell is 3%
			 impairment.
(2) Ratings given for
			 impairment of the second cranial nerve (optic) are rated based on their effects
			 on vision under OAR 436-035-0260.
(3) Ratings given for impairment in the third
			 cranial nerve (oculomotor), fourth cranial nerve (trochlear), and sixth cranial
			 nerve (abducens) are rated based on their effects on ocular motility under OAR
			 436-035-0260.
(4) Ratings given for impairment of the fifth
			 cranial nerve (trigeminal) are as follows:
(a) For loss or alteration of sensation in
			 the trigeminal distribution on one side: 10%; on both sides: 35%.
(b) The rating given for loss of motor
			 function for each trigeminal Nerve is 5%.
(c) The rating given for loss of motor
			 function of both trigeminal Nerves is determined under OAR
			 436-035-0385 and
			 436-035-0420.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0395 - Spinal Cord

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The spinal cord
			 is concerned with sensory, motor, and visceral functions. Permanent impairment
			 can result from various disorders affecting these functions. Spinal cord
			 impairment is determined under the following classes:
(a) Class 1: 15% when the worker has spinal
			 cord damage but is able to carry out the activities of daily living
			 independently.
(b) Class 2: 35%
			 when the worker is a paraplegic and requires assistive measures or devices for
			 any of the activities of daily living.
(c) Class 3: 50% when the worker is a
			 quadriplegic and requires assistive measures or devices for any of the
			 activities of daily living.
(d)
			 Class 4: 75% when the worker is a paraplegic or quadriplegic and requires the
			 assistance of another person for any of the activities of daily
			 living.
(e) Class 5: 95% when the
			 worker is a paraplegic or quadriplegic and is dependent in all of the
			 activities of daily living.
(f)
			 When a value is granted under section (1) of this rule, no additional
			 impairment value is allowed for reduced range of motion in the spine because it
			 is included in the impairment values shown in this section.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0400 - Mental Illness

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Accepted
			 mental disorders resulting in impairment must be diagnosed by a psychiatrist or
			 other mental health professional as provided for in a managed care organization
			 certified under OAR chapter 436, Division 015.
(2) Diagnoses of mental disorders for the
			 purposes of these rules follow the guidelines of the Diagnostic and Statistical
			 Manual of Mental Disorders DSM-IV (1994), published by the American Psychiatric
			 Association. A copy of the standards referenced in this rule is available for
			 review during regular business hours at the Workers' Compensation Division, 350
			 Winter Street NE, Salem OR 97301, 503-947-7810.
(3) The physician describes permanent changes
			 in mental function in terms of their affect on the worker's activities of daily
			 living (ADLs), as defined in OAR
			 436-035-0005(1).
			 Additionally, the physician describes the affect on social functioning and
			 deterioration or decompensation in work or work-like settings.
(a) Social functioning refers to an
			 individual's capacity to interact appropriately, communicate effectively, and
			 get along with other individuals.
(b) Deterioration or decompensation in work
			 or work-like settings refers to repeated failure to adapt to stressful
			 circumstances, which causes the individual either to withdraw from that
			 situation or to experience exacerbations with accompanying difficulty in
			 maintaining ADL, social relationships, concentration, persistence, pace, or
			 adaptive behaviors.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0410 - Hematopoietic System

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Anemia can
			 be impairing when the cardiovascular system cannot compensate for the effects
			 of the anemia. The following values are given for workers who become anemic:
(a) Class 1: 0% when there are no complaints
			 or evidence of disease and the usual activities of daily living can be
			 performed; no blood transfusion is required; and the hemoglobin level is
			 10-12gm/100ml.
(b) Class 2: 30%
			 when there are complaints or evidence of disease and the usual activities of
			 daily living can be performed with some difficulty; no blood transfusion is
			 required; and the hemoglobin level is 8-10gm/100ml.
(c) Class 3: 70% when there are signs and
			 symptoms of disease and the usual activities of daily living can be performed
			 with difficulty and with varying amounts of assistance from others; blood
			 transfusion of 2 to 3 units is required every 4 to 6 weeks; and the hemoglobin
			 level is 5-8gm/100ml before transfusion.
(d) Class 4: 85% when there are signs and
			 symptoms of disease and the usual activities of daily living cannot be
			 performed without assistance from others; blood transfusion of 2 to 3 units is
			 required every 2 weeks, implying hemolysis of transfused blood; and the
			 hemoglobin level is 5-8gm/100ml before transfusion.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0420 - Gastrointestinal and Genitourinary Systems

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Impairments in mastication (chewing) and
			 deglutition (swallowing) are determined based on the following criteria:
(a) Diet limited to semi-solid or soft foods
			 - 8%
(b) Diet limited to liquid
			 foods - 25%
(c) Eating requires
			 tube feeding or gastrostomy - 50%
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0430 - Endocrine System

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 assessment of permanent impairment from disorders of the hypothalamic-pituitary
			 axis requires evaluation of (1) primary abnormalities related to growth
			 hormone, prolactin, or ADH; (2) secondary abnormalities in other endocrine
			 glands, such as thyroid, adrenal, and gonads, and; (3) structural and
			 functional disorders of the central nervous system caused by anatomic
			 abnormalities of the pituitary. Each disorder must be evaluated separately,
			 using the standards for rating the nervous system, visual system, and mental
			 and behavioral disorders, and the impairments combined. Impairment of the
			 hypothalamic-pituitary axis is determined under the following classes:
(a) Class 1: 5% when controlled effectively
			 with continuous treatment.
(b)
			 Class 2: 18% when inadequately controlled by treatment.
(c) Class 3: 38% when there are severe
			 symptoms and signs despite treatment.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0440 - Integument and Lacrimal System

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 If the worker has developed an immunologic reaction to physical, chemical or
			 biological agents, impairment will also be valued under OAR
			 436-035-0450.
(2) Impairments of the integumentary system
			 may or may not show signs or symptoms of skin disorder upon examination but are
			 rated under the following classes:
(a) Class
			 1: 3% when with treatment, there is no limitation, or minimal limitation, in
			 the performance of work related activities, although exposure to certain
			 physical or chemical agents might increase limitation temporarily.
(b) Class 2: 15% when intermittent treatment
			 is required and there is mild limitation in the performance of some work
			 related activities.
(c) Class 3:
			 38% when continuous treatment is required and there is moderate limitation in
			 the performance of many work related activities.
(d) Class 4: 68% when continuous treatment is
			 required, which may include periodic confinement at home or other domicile; and
			 there is moderate to severe limitation in the performance of many work related
			 activities.
(e) Class 5: 90% when
			 continuous treatment is required, which necessitates confinement at home or
			 other domicile; and there is severe limitation in the performance of work
			 related activities.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0450 - Immune System

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When
			 exposure to physical, chemical, or biological agents has resulted in the
			 development of an immunological response, impairment of the immune system is
			 valued as follows:
(a) Class 1: 3% when the
			 reaction is a nuisance but does not prevent most regular work related
			 activities.
(b) Class 2: 8% when
			 the reaction prevents some regular work related activities.
(c) Class 3: 13% when the reaction prevents
			 most regular work related activities.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 35 - DISABILITY RATING STANDARDS › Section 436-035-0500 - Rating Standard for Individual Claims

Current through Register Vol. 63, No. 7, July 1, 2024
(1) This rule applies to the rating of
			 permanent disability under ORS chapter 656 in individual cases under ORS
			 656.726(4)(f)
			 which requires the director to determine the rating standard in cases where the
			 director finds that the worker's impairment is not addressed in the disability
			 standards.
(2) Rating standards
			 determined under ORS 656.726(4)(f)
			 will be written into the director's order on reconsideration and will apply
			 solely to the rating of that claim.
Stat. Auth.: ORS
				  656.726(4)
Stats. Implemented: ORS
				  656.005,
				  656.214,
				  656.268,
				  656.726 & 2007 OL Ch. 270
				  ¦ 7
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0001 - Authority for Rules

Current through Register Vol. 63, No. 7, July 1, 2024
These rules are promulgated under the Director's authority
				contained in ORS 656.726 and
				656.628.
Stat. Auth.: ORS 656
Stats. Implemented: ORS
				  656.628 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0002 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of these rules is to establish guidelines for the
				administration of the Workers with Disabilities Program established to
				encourage the employment or reemployment of workers with
				disabilities.
Stat. Auth.: ORS 656
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0003 - Applicability of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
(1) These rules
			 are effective July 1, 2008, and apply to all applications for relief submitted
			 prior to May 1, 1990 and all requests for reimbursement from the Workers with
			 Disabilities Program filed with the director on or after July 1, 2008 for
			 injuries occurring on or after November 1, 1981.
(2) These rules carry out the provisions of
			 ORS 656.628.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.236, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
Except where the context requires otherwise, these rules are
				governed by the following definitions:
(1) "Compensation" means all benefits,
			 including medical services and attorney fees, provided for a compensable injury
			 to a subject worker or the worker's beneficiaries. However, it does not include
			 expenses as defined by the National Council on Compensation Insurance, in its
			 Workers' Compensation Statistical Plan, Part IV.
(2) "Deductible" means the initial $1,000 of
			 cumulative compensation paid on qualifying claim(s) applied once per worker
			 with a disability.
(3) "Director"
			 means the director of the Department of Consumer and Business Services or the
			 director's delegate for the matter.
(4) "Division" means the Workers'
			 Compensation Division of the Department of Consumer and Business
			 Services.
(5) "Employer" means an
			 employer who qualifies pursuant to the provisions of ORS
			 656.017, either as a
			 carrier-insured employer or as a self-insured employer under ORS
			 656.407.
(6) "Worker with a disability" means a worker
			 who is afflicted with, or subject to, any permanent physical or mental
			 impairment, whether congenital or due to an injury or disease, including
			 periodic impairment of consciousness or muscular control of such character that
			 the impairment would prevent the worker from obtaining or retaining
			 employment.
(7) "Workers with
			 Disabilities Claim Reserve" means the total anticipated liability (paid plus
			 future reimbursable costs) regardless of any relief granted under the Workers
			 with Disabilities Program.
(8)
			 "Workers with Disabilities Program" means the program established under ORS
			 656.628.
(9) "Paying Agency" means the insurer,
			 self-insured employer, or designated representative of the self-insured
			 employer, responsible for paying compensation for a compensable injury.
(10) "Settlement" means any
			 agreement produced as a result of the act or process of settling differences
			 between a paying agent and a worker with a disability, or disposition of a
			 claim pursuant to ORS
			 656.236 or
			 656.289.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0006 - Administration of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
For the purpose of administration of the Workers with
				Disabilities Program, orders of the division are deemed orders of the
				director.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0008 - Administrative Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If a paying
			 agency or employer is aggrieved by a decision of the division, the director may
			 be petitioned for reconsideration.
(2) The director shall examine the
			 application and such further evidence filed, and enter an order. Copies of the
			 order will be sent to the paying agency, the division, and employer, if
			 applicable. Granting or denying reimbursement from the Workers with
			 Disabilities Program is at the sole discretion of the director. Pursuant to ORS
			 656.628(7), the
			 director's order is final and not subject to review by any court or other
			 administrative body.
(3) In
			 adopting these rules, the director reserves the right to reexamine any
			 liability created against the Workers' Benefit Fund and to modify or terminate
			 such liability, where such action is justified.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0010 - Criteria for Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 criteria used to determine eligibility for relief from the Workers with
			 Disabilities Program are:
(a) Without regard
			 to employer knowledge, a worker must have a permanent physical or mental
			 impairment, whether congenital or due to an injury or disease which would
			 prevent the worker from obtaining or retaining employment. For the purpose of
			 this section, a worker has a preexisting permanent impairment if it is equal to
			 or greater than twenty five percent (25%) of the whole person.
(b) There must be a subsequent compensable
			 injury or injuries:
(A) To the worker with a
			 disability resulting in cumulative claim(s) costs in excess of $1,000;
			 or
(B) To other workers employed by
			 the disabled worker's employer resulting in cumulative claim(s) costs in excess
			 of $1,000.
(c) The
			 insurer or employer must demonstrate that the subsequent injury or injuries:
(A) Would not have been sustained except for
			 the disabled worker's impairment; or
(B) Would not have occurred, to workers of
			 the same employer, except for the act or omission of a worker with a disability
			 which resulted from the disabled worker's impairment; or
(C) Resulted in disability which is at least
			 one-fourth greater by reason of the worker's preexisting impairment, as
			 determined by the division.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0020 - Limitation of Program

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Reimbursement is limited to the monies available in the Workers' Benefit
			 Fund.
(2) In the event of
			 insufficient reserves in the Workers' Benefit Fund, the director shall have
			 final authority to determine an equitable distribution which will
			 proportionately distribute the available funds among the claims which have
			 qualified for reimbursement from the Workers with Disabilities
			 Program.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0030 - Application for Determination of Relief From the Workers with Disabilities Program

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The paying
			 agency must provide the director adequate evidence to establish eligibility for
			 determination of relief from the Workers with Disabilities Program.
(2) When the deductible has been met and
			 possible eligibility for relief becomes known, the paying agency shall make
			 prompt application to the division requesting determination of relief from the
			 Workers with Disabilities Program in a form prescribed by the
			 director.
(3) The application shall
			 be submitted prior to the date of the last valuation affecting an employer's
			 experience rating, prior to the last valuation for retrospective rating,
			 whichever is the last to occur and prior to the employer ceasing to do
			 business. The application shall be supported by sufficient evidence
			 establishing eligibility for reimbursement under the general provisions herein
			 and in accordance with OAR
			 436-040-0010. For employers that
			 are not experience rated, application shall be submitted prior to the date
			 there would have been a last valuation, had the employer been so rated, and
			 prior to the employer ceasing to do business. The preceding application time
			 frames do not apply to self-insured employers or their paying
			 agencies.
(4) To meet the
			 requirements of OAR 436-040-0030(3),
			 the paying agency shall:
(a) Specify the
			 condition which caused permanent impairment and which constituted a
			 handicap;
(b) Specify whether this
			 request is based on a causal or contributory relationship pursuant to OAR
			 436-040-0010(1)(c);
(c) Provide documentation describing prior
			 impairment: such as medical reports, direct information from the worker,
			 employer documentation, prior Determination Orders, Opinion and Orders, and
			 Orders on Review;
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0040 - Eligibility Determination

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 division shall determine whether a claim qualifies for reimbursement, and the
			 percentage of the reimbursement.
(2) The division shall issue a determination
			 order accepting or denying the application within 30 calendar days after
			 receipt of the application and supporting documentation.
(3) The reimbursement percentage shown on the
			 determination order will be:
(a) 100% after
			 the $1,000 deductible in those cases qualifying under OAR
			 436-040-0010(1)(c)(A) and
			 (B); or
(b) In direct proportion to the percentage
			 the resulting disability was increased as a result of the preexisting
			 impairment in those cases qualifying under OAR
			 436-040-0010(1)(c)(C).
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0050 - Reimbursement

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Reimbursement
			 will be made to the paying agency based on the percentage of reimbursement
			 ordered by the division.
(2)
			 Request for reimbursement shall not be made until the deductible has been
			 met.
(3) Requests for reimbursement
			 are not to include: costs incurred for conditions unrelated to the compensable
			 claim; costs incurred due to inaccurate, untimely, or improper processing;
			 expenses; and settlement amounts not approved by the division, to which the
			 parties agreed after relief was granted.
(4) The division will authorize reimbursement
			 to the paying agency quarterly after receipt and approval of documentation of
			 compensation paid from the paying agency. Documentation shall include, but not
			 be limited to:
(a) Net amounts paid separated
			 into disability benefits by type, and medical benefits for corresponding
			 quarterly time periods;
(b) The
			 current Worker with a Disability Claim Reserve as defined in these
			 rules;
(c) Payment certification
			 statement; and
(d) Any other
			 information deemed necessary by the director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0060 - Effects on Rates; Reporting

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Where an order of acceptance has established the percentage of reimbursement to
			 an insured, the incurred claim cost above $1,000, prior to reimbursement, shall
			 be reduced by that percentage. The net incurred cost after such reduction shall
			 be used in any dividend calculation, retrospective rating evaluation or
			 experience rating computation, retroactively if necessary, and shall be
			 reported at that net incurred cost to the rating organization. Any subsequent
			 reevaluation of the claims reserve requirements under the rules of the Unit
			 Statistical Plan Manual shall be similarly reduced by the percentage of
			 reimbursement.
(2) The paying
			 agency "eligible for" or receiving reimbursement from the Workers with
			 Disabilities Program, shall report the subject claims in such method and manner
			 as the insurance commissioner shall require. Notwithstanding the reporting
			 requirements of the Insurance Commissioner and an authorized rating
			 organization, the paying agency must be able to document that such reimbursed
			 costs are not and will not be included in data reported that will affect the
			 rates and/or dividend eligibility.
(3) If compensation reported to the
			 appropriate rating organization subsequently becomes eligible for reimbursement
			 from the Workers with Disabilities Program, the insured paying agency shall
			 immediately file a "reevaluation of losses" report, pursuant to the Insurance
			 Commissioner's rules, with a rating organization licensed by the Insurance
			 Commissioner.
(4) If compensation
			 used by the division for experience rating purposes becomes eligible for
			 reimbursement from the Workers with Disabilities Program, the self-insured
			 paying agency may file a request for reevaluation of experience rating
			 modification(s) with the division. Any necessary calculation(s) will be made,
			 retroactively if necessary, when the annual experience rating modification is
			 calculated.
Publications: Publications referenced are available from the
				  agency.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0070 - Settlements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any settlement
			 of the claim by the parties is not eligible for reimbursement from the Workers
			 with Disabilities Program unless made with the prior written approval of the
			 division.
(2) Requests for written
			 approval of proposed settlements should include:
(a) A copy of the proposed
			 settlement;
(b) Correspondence
			 between the paying agency and the claimant or claimant's representative which
			 establishes the basis for settlement or a statement from the paying agency of
			 how the amount of the settlement was calculated;
(c) Additional medical reports not available
			 at the time of the determination; and
(d) Other material which would support the
			 proposed settlement as an appropriate manner to handle the claim.