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Flashcards in Settlement and Legal Management Deck (5)
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1

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

- 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.

2

What are two common settlement types in a denied claim?

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

3

What are the settlement options in an accepted claim?

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

4

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

Medical benefits

5

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

14 days from receipt of the approved order from WCB.