How does a claimant meet the criteria necessary for reopening a “post-aggravation rights” new/omitted medical condition claim?
ORS 656.267(1) provides that to initiate a “post-aggravation rights” new or omitted medical condition claim, the worker must clearly request formal written acceptance of a new or omitted medical condition from the carrier. The worker may initiate a new or omitted medical condition claim at any time. A claimant’s attorney may make such a claim on the claimant’s behalf. Andria D. Costello, 55 Van Natta 498, 501 fn 4 (2003). However, such claims are not made by medical billings or by requests for authorization to provide (or actual provision of) medical services. The carrier is not required to accept every diagnosis, provided that the carrier’s acceptance reasonably apprises the claimant and medical providers of the nature of the compensable conditions. NOTE: The requirements to pay benefits on an open claim are different from the requirements to reopen a claim. A claim may meet the requirements for reopening and not meet the requirements for payment of benefits. See section regarding “Be
ORS 656.267(1) provides that to initiate a “post-aggravation rights” new or omitted medical condition claim, the worker must clearly request formal written acceptance of a new or omitted medical condition from the carrier. The worker may initiate a new or omitted medical condition claim at any time. A claimant’s attorney may make such a claim on the claimant’s behalf. Andria D. Costello, 55 Van Natta 498, 501 fn 4 (2003). However, such claims are not made by medical billings or by requests for authorization to provide (or actual provision of) medical services. The carrier is not required to accept every diagnosis, provided that the carrier’s acceptance reasonably apprises the claimant and medical providers of the nature of the compensable conditions. NOTE: The requirements to pay benefits on an open claim are different from the requirements to reopen a claim. A claim may meet the requirements for reopening and not meet the requirements for payment of benefits.
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