Teitelman v. SAIF

No. 38 September 25, 2025 271

IN THE SUPREME COURT OF THE

STATE OF OREGON

In the Matter of the Compensation of

Thomas K. Cardoza, Claimant.

Andrew TEITELMAN,

Personal Representative of the Estate of

Thomas K. Cardoza, Deceased,

Respondent on Review,

v.

SAIF CORPORATION

and Werner Gourmet Meat Snacks, Inc.,

Petitioners on Review.

(WCB 1906431; 2003506) (CA A176678) (SC S071117)

En Banc

On review from the Court of Appeals.*

Argued and submitted April 17, 2025.

Daniel Walker, Appellate Counsel, SAIF Corporation,

Salem, argued the cause and filed the briefs for petitioners

on review.

Bennett Dalton, The Dalton Law Firm, Portland, argued

the cause and filed the brief for respondent on review.

Theodore P. Heus, Quinn & Heus, LLC, Beaverton, filed

the brief for amicus curiae Oregon Trial Lawyers Association.

BUSHONG, J.

The decision of the Court of Appeals is affirmed. The

order of the Workers’ Compensation Board is reversed, and

the case is remanded to the board for further proceedings.

Garrett, J., dissented and filed an opinion, in which

DeHoog, J., joined.

______________

* On judicial review of an order of the Workers’ Compensation Board. 332 Or

App 72, 548 P3d 140 (2024).

272 Teitelman v. SAIF

Cite as 374 Or 271 (2025) 273

BUSHONG, J.

This workers’ compensation case presents a statu-

tory interpretation issue regarding a worker’s request for a

medical examination in connection with a disputed benefits

claim. Claimant sought workers’ compensation benefits, con-

tending that he had injured his back at work. His employ-

er’s insurer, SAIF Corporation (SAIF), investigated and sent

claimant a written notice of denial, concluding that claim-

ant’s back condition had not been caused by a work-related

injury. After claimant requested a hearing, SAIF required

claimant to submit to an independent medical examination

(IME).1 The resulting IME report supported SAIF’s decision

to deny the claim. Claimant then sought a worker requested

medical examination (WRME) under ORS 656.325(1)(e).

That statute authorizes a WRME if, among other things, a

claimant has requested “a hearing on a denial of compensa-

bility * * * that is based on” an IME report.

The question in this case is whether the Workers’

Compensation Board (board) erred in denying claimant’s

request because it determined that claimant had not

requested “a hearing on a denial of compensability * * * that

is based on” an IME report. In particular, the question is

whether we determine if a denial of compensability “is based

on” an IME report by looking at the grounds for denial when

claimant requested a hearing or when claimant’s request for

a WRME was decided. At the time of the hearing request,

the denial was not based on an IME report because no IME

had been requested or performed. But, at the time of the

decision on claimant’s WRME request, SAIF’s continuing

denial was based on an IME report because the IME had

been conducted, the resulting report supported SAIF’s

denial, and SAIF had confirmed that it intended to rely on

the report to defend its denial at the upcoming hearing.

1

Although the term “independent medical examination” (IME) is often used

in workers’ compensation cases, we have referred to the examination required

by ORS 656.325(1)(a) as a “compelled medical examination” (CME), Robinson v.

Nabisco, Inc., 331 Or 178, 181, 11 P3d 1286 (2000), and the Court of Appeals has

referred to the examination as an “insurer medical examination” (IME), Darling

v. Johnson Controls Battery Group, 188 Or App 190, 192 n 1, 70 P3d 894 (2003),

rev den, 336 Or 376 (2004). The administrative rules use the terms “indepen-

dent medical examination” (IME) and “worker requested medical examination”

(WRME). See OAR 436-010-0265. We use the terms “IME” and “WRME” in this

opinion without attaching any significance to those labels.

274 Teitelman v. SAIF

We hold that, to determine whether a claimant

has requested “a hearing on a denial of compensability * * *

that is based on” an IME report, we look at the grounds for

denial at the time that a claimant’s request for a WRME

was decided. The legislature intended the WRME to pro-

vide workers with evidence that they could use to counter

an IME report that the insurer uses in litigating the denial

of a disputed claim. Because an insurer may request, and

begin to rely on, an IME after a claimant has requested

a hearing, as occurred in this case, a claimant’s right to a

WRME is not limited to the grounds for denial at the time

of the hearing request. We therefore conclude that the board

erred in denying claimant’s request for a WRME.

I. BACKGROUND

The facts are procedural, undisputed, and taken

from the agency record. The original claimant, Thomas K.

Cardoza, filed a workers’ compensation claim, alleging that

he injured his back on the job at Werner Gourmet Meat

Snacks, Inc. (Werner). SAIF—Werner’s workers’ compen-

sation insurer—investigated and sent Cardoza a notice of

denial, stating that he had not sustained a compensable

injury arising out of, or in the course of, his employment.

Cardoza filed a timely request for a hearing before an admin-

istrative law judge (ALJ) to challenge that decision.2 At

that point, SAIF requested that Cardoza submit to an IME

conducted by a physician that SAIF selected, Dr. Ballard.

Cardoza complied with that request.

Ballard’s IME report supported SAIF’s denial deci-

sion, concluding that Cardoza’s preexisting back condition—

not an injury suffered at work—was the major cause of any

disability or need for treatment. Cardoza’s treating physi-

cian, Dr. Mitchell, then signed a letter indicating that he

disagreed with Ballard’s opinion. In Mitchell’s opinion, the

major cause of Cardoza’s need for treatment was a work

injury. Cardoza then submitted a request pursuant to

ORS 656.325(1)(e) to the Workers’ Compensation Division

for authorization of a WRME, citing the conflict between

Ballard’s IME report and Mitchell’s opinion. The division’s

2

The hearing was originally scheduled for February 24, 2020. It was then

rescheduled for June 11, 2020, and then rescheduled again for October 2, 2020.

Cite as 374 Or 271 (2025) 275

Medical Resolution Team (MRT) denied Cardoza’s request.

The MRT’s written order indicated that, although it had

“received no insurer objection to the WRME request,” it was

denying Cardoza’s request because Ballard’s IME had been

conducted after SAIF’s written notice of denial.

Cardoza’s attorney requested a hearing on the

WRME denial and asked that the hearing be consolidated

with the hearing on SAIF’s denial of compensability. SAIF

was required by rule to file and serve its hearing exhibits 28

days before the hearing. OAR 438-007-0018(1).3 After SAIF

had filed its hearing exhibits, Cardoza’s attorney sent a let-

ter request to the ALJ, asking him to order SAIF to either

amend its denial of the claim to reflect that the denial was

now “based on” an IME report or withdraw the IME report

as a hearing exhibit. In a letter to the ALJ, SAIF opposed

both requests, stating that its defense of the denial “includes

the post-denial IME” and that “[i]ssuance of the denial, and

defense of the denial, are two different things.”

The ALJ then issued an “Interim Order” denying

Cardoza’s request for a WRME and denying his request for an

order requiring SAIF to either amend its denial to state that

it is based on Ballard’s IME report or withdraw the report

as a proposed exhibit. After the hearing, the ALJ upheld the

denial of Cardoza’s claim, citing Ballard’s IME report as “per-

suasive” evidence that Cardoza’s claim was not compensable.

Cardoza filed a timely appeal to the board, challenging both

the denial of compensability and the denial of his request for

WRME authorization. The board affirmed the ALJ’s orders

on both issues. Cardoza filed a timely petition for judicial

review of the board’s decisions in the Court of Appeals.

Cardoza died while his petition was pending in the

Court of Appeals. The court granted a motion filed by the

personal representative of Cardoza’s estate to be substituted

3

The agency record does not reflect exactly when SAIF filed its exhibits. SAIF’s

initial exhibit list described Exhibits 1-9; its supplemental exhibit list described

chart notes from 2013-14 marked as Exhibits A through E, and Ballard’s IME

report, which was marked as Exhibit 10. As noted, OAR 438-007-0018(1) required

SAIF to submit its exhibits no later than 28 days before the hearing. It is unclear

whether SAIF filed its exhibits and exhibit lists at least 28 days before the hearing

scheduled for June 11, 2020, that was subsequently rescheduled, or whether those

materials were first filed at least 28 days in advance of the October 2, 2020, hearing.

276 Teitelman v. SAIF

as the petitioner and the appeal proceeded. On the merits,

the Court of Appeals agreed with petitioner that the board

had erred in denying Cardoza’s request for WRME autho-

rization and remanded the claim to the board for further

proceedings. The court saw nothing in the text, context, or

legislative history of ORS 656.325(1)(e), or in the implement-

ing administrative rule, OAR 436-060-0147, that required

an IME report to be requested and completed before SAIF

issued its written notice for the “denial of compensability” to

be “based on” an IME report. Thus, the court concluded that

“SAIF’s denial was based on an IME.” Teitelman v. SAIF,

332 Or App 72, 78, 548 P3d 140 (2024).4

We allowed review on SAIF’s petition to address the

statutory interpretation issue.

II. DISCUSSION

The issue on review hinges on the interpretation

of ORS 656.325(1)(e), which is part of Oregon’s Workers’

Compensation Law. See ORS 656.001 (“This chapter may be

cited as the Workers’ Compensation Law.”). We review the

interpretation of a statute for legal error, applying our usual

statutory interpretation framework to ascertain the legis-

lature’s intent by examining the text, context, and any leg-

islative history of the statute that is useful to our analysis.

State v. Gaines, 346 Or 160, 171-72, 206 P3d 1042 (2009). We

begin with an overview of the Workers’ Compensation Law

before turning to the specific provision in dispute.

A. Overview of Workers’ Compensation Law

Oregon’s Workers’ Compensation Law was designed

to provide an exclusive statutory system that results in “the

best societal measure” of compensation for work-related

injuries. ORS 656.012(1)(c). One objective of the law is to

provide “a fair and just administrative system for delivery

of medical and financial benefits to injured workers[.]” ORS

656.012(2)(b). The legislature has declared, “[i]n recognition

that the goals and objectives of this Workers’ Compensation

4

The Court of Appeals noted in a footnote that neither party had suggested

the Cardoza’s death rendered the petition for judicial review proceeding moot,

leaving it to the board on remand to address the effect, if any, Cardoza’s death

had on the claim. Teitelman, 332 Or App at 78 n 1.

Cite as 374 Or 271 (2025) 277

Law are intended to benefit all citizens, * * * that the provi-

sions of this law shall be interpreted and understood in an

impartial and balanced manner.” ORS 656.012(3).

Under the Workers’ Compensation Law, except

where the right to compensation is denied by the insurer or

self-insured employer, a worker is entitled to receive benefits

to compensate for a work-related injury “upon the employer’s

receiving notice or knowledge of a claim[.]” ORS 656.262(2).

A worker suffering a work-related injury is required to give

notice to the employer no later than 90 days after the accident

that caused the injury. ORS 656.265(1)(a). That starts the

process for resolving the worker’s claim for benefits. A “claim”

is “a written request for compensation * * * or any compensa-

ble injury[.]” ORS 656.005(6).5 Injured workers have a duty to

“cooperate and assist the insurer * * * in the investigation of

claims for compensation.” ORS 656.262(14)(a).

A “compensable injury” is an accidental injury

“arising out of and in the course of employment requiring

medical services or resulting in disability or death.” ORS

656.005(7)(a). An employer receiving notice of any claim or

accident that may result in a compensable injury must notify

its insurer not later than five days after receiving notice.

ORS 656.262(3). When a worker is injured at work, the

injury is considered a compensable injury “from the moment

of its occurrence, even if the insurer denies that the injury

is compensable, and even if the administrative and judicial

systems take months or years to determine the validity” of

that denial. Armstrong v. Rogue Federal Credit Union, 328

Or 154, 159-60, 969 P2d 382 (1998).

An insurer that receives notice that a worker may

have suffered a compensable injury is responsible for pro-

cessing the worker’s claim and providing compensation.

ORS 656.262(1). Some benefits are payable immediately,

even before the insurer has decided whether to accept or

deny the claim. See ORS 656.262(4) (temporary disability

benefits authorized by the worker’s attending physician).

5

We have recognized that the “disjunctive” definition of “claim” reflects a

“distinction between a dispute over the compensability of an injury and a dispute

over the amount of a claimant’s benefits[.]” SAIF Corp. v. Allen, 320 Or 192, 201-

02, 881 P2d 773 (1994).

278 Teitelman v. SAIF

The insurer is required to send the claimant a “[w]ritten

notice of acceptance or denial of the claim” within 60 days

after the employer has notice or knowledge of the claim.

ORS 656.262(6)(a).6

If an insurer provides written notice of acceptance

and later obtains evidence that the claim was not compen-

sable, it may under some circumstances “revoke the claim

acceptance and issue a formal notice of claim denial” no later

than two years after the date of the initial acceptance. ORS

656.262(6). A worker can add claims for new or omitted med-

ical conditions after the initial acceptance. ORS 656.262(6);

ORS 656.267. If the insurer sends a written notice of denial,

a worker seeking to contest that decision must file a request

for hearing not later than the 60th day after the insurer

mailed the notice of denial to the worker. ORS 656.319

(1)(a). A written notice of a denial is considered “a key pro-

cedural component of the claim adjudication system.” Allen,

320 Or at 213. The notice “furnishes important information”

to the affected parties, the board, and others, and it is used

to “guide the dispute to the proper decision-making body

within the compensation system[.]” Id. at 214.

The IME process is described in ORS 656.325(1)

(a), which states that “[a]ny worker entitled to receive com-

pensation under this chapter” is required upon request of

the insurer to submit to an IME. The insurer may request

“[n]o more than three” IMEs without prior authorization

of the director. ORS 656.325(1)(a). The insurer chooses the

physician from a list of qualified physicians approved by the

director. ORS 656.325(1)(b); see also OAR 436-010-0265(1)(d)

(stating that the insurer “must choose the medical service

provider from the director’s list of authorized IME providers”

and that “the insurer may not use the IME report” if the

provider is not on the approved list at the time of the IME).

The worker “must comply with a request for [an IME]

or face suspension of the right to compensation.” Robinson v.

6

An insurer’s failure to provide notice of acceptance or denial of a claim

within 60 days as required by ORS 656.262(6) may be treated as a denial of

the claim. See Allen, 320 Or at 216 (holding that the board’s conclusion that an

insurer had denied a claim when the insurer did not provide written notice of

acceptance or denial of a claim within the time specified by ORS 656.262(6) was

supported by the text, context, and legislative policy of the statute).

Cite as 374 Or 271 (2025) 279

Nabisco, Inc., 331 Or 178, 187, 11 P3d 1286 (2000). Although

the statute “does not state explicitly the purpose” of an IME,

in context, “the purpose is clear.” Id. An IME is designed to

provide the insurer and others involved in the claim process

“with information about [the] claimant’s condition from a

doctor who has no fiduciary relationship with [the] claim-

ant, such as that of an attending physician.” Id. An insurer

requesting an IME “might use the examining doctor’s infor-

mation” in resolving the claim, for example, “by challenging

the continuing compensability of the injury[.]” Id.; see also

Darling v. Johnson Controls Battery Group, 188 Or App 190,

204, 70 P3d 894 (2003) (stating that Robinson, “in broad

terms,” had “recognized the purpose of IMEs to be to pro-

tect [a self-ensured employer or insurer’s] legal position on

the claim, a purpose that readily encompasses [defense of] a

denied claim that is being challenged via further review”).

The statutory requirement to submit to an IME

applies to “[a]ny worker entitled to receive compensation

under this chapter.” ORS 656.325(1)(a). The board and

the Court of Appeals have broadly interpreted that pro-

vision as applying not only to a worker who has had their

claim accepted but to any open claim, including one that

the insurer denied.7 See Darling, 188 Or App at 202 (noting

that ORS 656.325(1)(a) authorizes IMEs “throughout the

open period of a claim, not just the period before the denial

and following acceptance”); OAR 436-010-0265(1)(b) (“The

insurer may obtain three IMEs for each opening of the claim

without authorization by the director. These IMEs may be

obtained before or after claim closure.”). Under that inter-

pretation, an insurer may require a worker to submit to an

IME after the insurer has sent a written notice of denial of

the claim, as happened in this case.

ORS 656.325(1)(e) is the provision in the Workers’

Compensation Law that governs a WRME and the resolution

7

Generally, a claim is considered “open” until the claim is “closed” pursu-

ant to ORS 656.268, though a closed claim can be reopened under ORS 656.265.

See OAR 436-030-003 - 436-030-0580 (describing procedures for claim closure

and reconsideration). When a worker makes a timely request for a hearing on an

insurer’s decision to deny the claim, the claim remains “open” until it is finally

resolved through the hearing and appeals process. See ORS 656.283 (describing

hearing rights and procedures); ORS 656.295 (board review of ALJ orders); ORS

656.295 (judicial review of board orders).

280 Teitelman v. SAIF

of this case hinges on our interpretation of that provision.

Accordingly, we now examine its text and context in detail.

B. Text and Context of ORS 656.325(1)(e)

ORS 656.325(1)(e) provides:

“If the worker has made a timely request for a hearing

on a denial of compensability as required by ORS 656.319

(1)(a) that is based on one or more reports of examinations

conducted pursuant to paragraph (a) of this subsection and

the worker’s attending physician or nurse practitioner

authorized to provide compensable medical services under

ORS 656.245 does not concur with the report or reports,

the worker may request an examination to be conducted by

a physician selected by the director from the list described

in ORS 656.328. The cost of the examination and the exam-

ination report shall be paid by the insurer or self-insured

employer.”

(Emphases added.) In this case, the parties agree that

(1) Cardoza made a timely request for a hearing; (2) he then

complied with SAIF’s request for an IME; (3) the IME report

supported SAIF’s denial and became part of SAIF’s “defense”

of its denial decision, which it maintained throughout the

claim process and at the hearing; (4) Cardoza’s attending

physician did not concur with the conclusion in the IME

report; and (5) Cardoza then requested authorization for a

WRME.

Thus, the only textual issue in dispute is whether

Cardoza made a “request for a hearing” on a “denial of

compensability” that was “based on” an IME report within

the intended meaning of the statute. SAIF contends that

the statute requires us to look at the grounds for denial

at the time claimant requested a hearing. Because claim-

ant requested a hearing on the “denial of compensability”

in SAIF’s written notice, SAIF contends that Cardoza was

not entitled to a WRME because its written notice of denial

and Cardoza’s request for a hearing both occurred before

SAIF requested an IME. Thus, according to SAIF, its denial

was not and could not have been “based on” an IME report

because the report did not exist when SAIF made its deci-

sion to deny the claim and when Cardoza requested a hear-

ing on that denial. We disagree.

Cite as 374 Or 271 (2025) 281

SAIF’s interpretation is a plausible reading of the

text of ORS 656.325(1)(e), but it is not the only plausible

interpretation of that provision. An insurer’s written notice

of denial is a one-time event, while its “denial of compensa-

bility” decision continues throughout the time the claim is

in dispute. As we have explained, an insurer’s notice “is a

key procedural component of the claim adjudication system.”

Allen, 320 Or at 213 (emphasis added). That notice “fur-

nishes important information” that helps the parties “guide

the dispute to the proper decision-making body within the

compensation system, narrows the issues on which the par-

ties must prepare for litigation, and expedites disposition of

the claim through hearing or settlement.” Id. at 214.

By contrast, a “denial of compensability” has sub-

stantive legal consequences that continue—and could

change—until the claim is finally resolved. For example, we

have indicated that an insurer’s denial of compensability

under the Workers’ Compensation Law “expressly relieve[s]

the insurer of the duty to pay most workers’ compensation

benefits.” Armstrong, 328 Or at 161 (emphasis in original);

see also Darling, 188 Or App at 198-99 (explaining that,

under Armstrong, a denial of compensability relieves the

insurer or self-insured employer “of the present duty to pay

most workers’ compensation benefits”). But that can change

at any point in the claim administration process, as this

court and the Court of Appeals have recognized.

In Darling, the Court of Appeals explained that a

denial of compensability “does not extinguish the worker’s

legal entitlement to receive benefits; it instead suspends the

actual receipt of most benefits and places the worker’s enti-

tlement in dispute.” Id. (emphases in original). The denial

thus “relieves the [self-insured employer or insurer] only of

the present duty to pay most workers’ compensation benefits.”

Id. (citing Armstrong, 328 Or at 161 (emphasis added)). The

court further explained that, “until a worker’s challenge to

the denial is resolved, we cannot know as a general prop-

osition whether the worker is entitled to those suspended

benefits.” Id. at 199.

Treating the benefits as “suspended” pending reso-

lution of a disputed claim is consistent with our observation

282 Teitelman v. SAIF

in Armstrong that an injury is compensable “from the

moment of its occurrence, even if the insurer denies that the

injury is compensable[.]” 328 Or at 159. As we explained,

“[i]f the insurer denies the employee’s right to compensa-

tion, the statutes expressly relieve the insurer of the duty to

pay most workers’ compensation benefits. ORS 656.262(2).

If the injury is determined to be compensable in the hear-

ing and appeal process, the insurer is liable for all back

benefits, interest, penalties, and attorney fees.”

Id. at 161 (emphasis in original).

Thus, under the Workers’ Compensation Law, an

insurer’s written notice of denial suspends the worker’s

receipt of benefits that the worker may eventually receive.

When a worker requests a hearing after receiving that

notice, those suspended benefits are in dispute and the

claim remains open. The insurer can resolve the dispute

by accepting the claim voluntarily or in a settlement, as

we noted in Allen, 320 Or at 214. See also OAR 438-009-

0005 (settlement stipulations); OAR 438-009-0010 (disputed

claim settlements). If the insurer does not resolve the dis-

pute by voluntarily accepting the claim or through settle-

ment, and the injury is later determined to be compensable,

then the insurer will be liable for all benefits that had been

suspended, plus interest, penalties, and attorney fees, as we

observed in Armstrong, 328 Or at 161.

Thus, an insurer’s “denial of compensability” on an

open claim continues as long as the claim remains open, and

the denial decision can change at any point in the hearing

and appeal process. The insurer’s initial written notice is the

procedural event that triggers that process and suspends the

benefits that are in dispute, but the legal consequences of a

denial of compensability that is in dispute are not resolved

until the dispute is resolved. That suggests that an insurer’s

“denial of compensability” on an open claim continues and

may be “based on” an IME report if an IME has been con-

ducted and the insurer uses the resulting report to support

its continued decision to deny that the claim is compensable.

SAIF contends that the statute’s use of the pres-

ent tense—a denial of compensability that “is based on” an

Cite as 374 Or 271 (2025) 283

IME report—means that the statute was not intended to

apply if the IME report did not exist when the insurer sent

its notice of denial or when the worker requested a hear-

ing challenging that denial. See Brownstone Homes Condo.

Assn. v. Brownstone Forest Hts., 358 Or 223, 232, 363 P3d

467 (2015) (citing several cases for the proposition that “the

use of a particular verb tense in a statute can be a signif-

icant indicator of the legislature’s intention” (internal quo-

tation marks and brackets omitted)). However, as petitioner

points out, the statute’s use of “is” in the present tense can

plausibly be understood to mean that a denial “is based on”

an IME report whenever the insurer uses an IME report to

defend its continued denial of an open claim at any point in

the claim resolution process, not just when the insurer mails

notice of its initial decision.

SAIF further contends that the statutory scheme

and its implementing administrative rules reflect a “tem-

poral relationship” between the existence of an IME report

and the insurer’s notice of denial that compels SAIF’s inter-

pretation. But that “temporal relationship” is not as clearly

defined as SAIF suggests.

Under ORS 656.325(1)(e), a worker “may request”

a WRME if the worker has made a timely “request for a

hearing” on an insurer’s “denial of compensability” that “is

based on” on IME report. One way to read that provision is

to connect the grounds for an insurer’s “denial of compensa-

bility” temporally to the worker’s “request for a hearing,” as

SAIF contends.8 But the statute’s text can plausibly be read

to require a WRME if all three conditions exist, regardless

of the order in which they come into existence. That read-

ing is consistent with the context that shows how a worker’s

request for a WRME fits within the process for resolving a

disputed claim.

8

The dissenting opinion connects the “denial of compensability” in ORS

656.325(1)(e) to the “mailing of the denial” in ORS 656.319(1)(a) because ORS

656.325(1)(e) expressly refers to ORS 656.319(1)(a). 374 Or at 292-93 (Garrett, J.,

dissenting). That is one way to read those provisions, but not the only way. ORS

656.319(1) specifies the time limitations that apply to a request for a hearing.

Thus, the reference in ORS 656.325(1)(e) to a worker’s “timely request for a hear-

ing on a denial of compensability as required by ORS 656.319(1)(a)” could just be

a reference to the statute that specifies when the request for a hearing must be

filed to be considered timely. (Emphases added.)

284 Teitelman v. SAIF

As explained above, an insurer’s “denial of com-

pensability” of an open claim can change as the claim pro-

gresses through the appeal and hearing process, potentially

affecting whether the insurer’s decision remains a denial

or whether a WRME—or a hearing—is needed at all. For

example, an insurer that requested an IME after sending a

notice of denial could decide to accept the claim based on the

IME report. If that occurred, there would be no reason for a

WRME because there would not be a denial at all, nor would

there be a hearing on the worker’s claim.

Another possibility is that the basis for denying the

claim could be sufficiently strengthened by the IME report

that the worker decides to withdraw the request for a hear-

ing. If that occurred, there would be no reason for a WRME

even though the denial decision has not changed because

there would be no pending request for a hearing. And if the

insurer decided after receiving the IME report and the work-

er’s request for a WRME that it did not need the IME report

to support its denial decision or did not want to pay for a

WRME, the insurer could disclaim any intent to use the IME

report to support its continued denial of the claim. If that

occurred, there would still be a hearing, but the worker would

not be entitled to a WRME because the insurer’s denial deci-

sion at that point would not be “based on” the IME report.

Those possibilities suggest that a worker is entitled

to a WRME on an open claim if there is a temporal coin-

ciding of a pending hearing request, an IME report that is

disputed by the worker’s attending physician, the insurer’s

use of that report to support its continued denial of compen-

sability, and the worker’s request for a WRME.9 In this case,

it is undisputed that, at the time of Cardoza’s request for a

WRME, Cardoza’s request for a hearing was pending, there

was an IME report that was disputed by Cardoza’s attend-

ing physician, and the IME report supported SAIF’s contin-

ued denial of the claim. SAIF confirmed, when it opposed

9

We note that the text of ORS 656.325(1)(e) says that the worker “may

request” a WRME; it says nothing about whether that request must be granted.

However, the text also requires the insurer to pay for the WRME and the exam-

ination report. That certainly implies that, if the worker satisfied the conditions

in ORS 656.325(1)(e) for requesting a WRME, the worker is entitled to a WRME

and a report of that examination, and SAIF does not contend otherwise.

Cite as 374 Or 271 (2025) 285

Cardoza’s request, that it intended to use that report at the

hearing to support its continued denial of the claim. It fol-

lows that, when Cardoza’s request was denied, SAIF’s denial

of compensability was “based on” an IME report within the

intended meaning of ORS 656.325(1)(e).

SAIF’s contrary interpretation would mean that a

“denial of compensability” could be supported by an IME

report written by a physician selected by the insurer, and a

worker’s right to access a WRME to contest the IME report

would depend entirely upon whether the IME request came

before or after the insurer’s notice of denial. That interpre-

tation would be inconsistent with the policies underlying

Oregon’s Workers’ Compensation Law. See ORS 656.012

(2)(b) (stating that one objective of the law was to provide “a

fair and just administrative system for delivery of medical

and financial benefits to injured workers”); ORS 656.012(3)

(declaring that the provisions of the Workers’ Compensation

Law “shall be interpreted and understood in an impartial

and balanced manner”).

Denying a worker the opportunity to get a medical

examination that the worker could use to contest the insurer’s

IME report based solely on the timing of the insurer’s IME

request seems to favor the insurer. And a decision-making

process that relies on an IME report prepared by a doctor

selected by the insurer, and disputed by the worker’s doctor,

without allowing another medical examination at the work-

er’s request by a doctor approved by the board, does not seem

to be very impartial and balanced. And, as we explain next,

the legislative history demonstrates that making the process

fairer and more balanced and impartial is exactly what the

legislature intended when it enacted ORS 656.325(1)(e).

C. Legislative History of ORS 656.325(1)(e)

ORS 656.325(1)(e), formerly ORS 656.325(1)(b), was

enacted in 2001 through a provision in Senate Bill (SB)

485 with the support of a Management Labor Advisory

Committee (MLAC). Or Laws 2001, ch 865, § 13.10 John Shilts,

10

As originally enacted, ORS 656.325(1)(b) (2001) provided:

“If the worker has made a timely request for a hearing on a denial of

compensability as required by ORS 656.319(1)(a) that is based on one or

more reports of examinations conducted pursuant to paragraph (a) of this

286 Teitelman v. SAIF

then-administrator of the Workers’ Compensation Division of

the Department of Consumer and Business Services (DCBS),

explained that the purpose of that provision in SB 485 was

“to provide for more worker input regarding the choice of

IME providers” and “introduce[ ] a level of choice for the

worker that ha[d] not existed previously.” Exhibit A, Senate

Committee on Business, Labor and Economic Development,

SB 485, Jan 31, 2001 (written testimony of John Shilts).

Consistent with that goal, under SB 485 as orig-

inally proposed, if an insurer or self-insured employer

required a worker to submit to an IME, the worker—not

the insurer—would choose the IME provider from a group of

three physicians that had been qualified by DCBS. SB 485,

A-Engrossed (Jan 25, 2001); see also Tape Recording, Senate

Committee on Business, Labor and Economic Development,

SB 485, Jan 31, 2001, Tape 14, Side A (testimony of John

Shilts). Several witnesses criticized that proposal as add-

ing unnecessary administrative complications.11 Some

witnesses who opposed the bill as originally proposed

subsection and the worker’s attending physician does not concur with the

report or reports, the worker may request an examination to be conducted by

a physician selected by the director from the list described in 656.268 (7)(d).

The cost of the examination and the examination report shall be paid by the

insurer or self-insured employer.”

That paragraph was renumbered as ORS 656.325(1)(e) in 2005. The only sub-

stantive change that is reflected in the current version of ORS 656.325(1)(e) is

the inclusion of nurse practitioners among those professionals whose opinion a

worker can rely upon to establish a lack of concurrence with an IME.

11

For example, James Johnson, then-city manager for the City of Eugene,

testified that the provision would cause “an increased administrative burden” for

insurers and employers without creating tangible benefits for workers. Exhibit B,

Senate Committee on Business, Labor and Economic Development, SB 485, Feb 2,

2001 (written testimony of James Johnson). Joe Gilliam of the Oregon Grocery

Industry Association asserted that the change would not improve the workers’

compensation system and instead would “complicate it for all parties.” Exhibit H,

Senate Committee on Business, Labor and Economic Development, SB 485, Feb 2,

2001 (written testimony of Joe Gilliam). Hasina Squires of the Special Districts

Association of Oregon described it as “a solution looking for a problem,” consid-

ering that “[n]o one benefits from biased medical opinions[.]” Exhibit J, Senate

Committee on Business, Labor and Economic Development, SB 485, Feb 2, 2001

(written testimony of Hasina Squires). Ken Hector, the supervisor of workers’

compensation for a local company, discounted the presumed concern about anti-

worker bias among physicians who conduct IMEs. He explained that the IME

physician often concurs with the treating physician; that the ALJ typically gives

the treating physician’s opinion more weight; and that the ALJ is likely to give

“zero credibility” to an IME physician that makes the same medical findings

regardless of the case. Tape Recording, Senate Committee on Business, Labor

Cite as 374 Or 271 (2025) 287

nevertheless acknowledged worker concerns about bias in

the existing IME process. For example, Mike Crew of the

Oregon Medical Association acknowledged the concern that

“insurance companies were somehow using physicians that

had some preconceived notion or bias toward the party who’s

paying the bill.” Tape Recording, Senate Committee on

Business, Labor and Economic Development, SB 485, Feb 2,

2001, Tape 18, Side A (testimony of Mike Crew).

In response to those concerns, Representative Kevin

Mannix—testifying in his personal capacity—proposed an

alternative that the legislature ultimately adopted. Mannix

acknowledged that “workers want to see a little more bal-

ance” in the IME process and that “they feel that the IME

process is kind of loaded against them and is used against

them in litigation.” Tape Recording, Senate Committee on

Business, Labor and Economic Development, SB 485, Feb 2,

2001, Tape 17, Side A (testimony of Kevin Mannix).12 Mannix

then proposed this solution:

“Where there is an IME, and there is a denial, and the

worker requests a hearing on the denial, allow the worker

to have access to the very same medical arbiter panel that

we have right now, and allow the worker an exam with a

panel equivalent to whatever that IME panel was, at the

cost of the employer insurer. In other words, you take the

current medical arbitration process and expand it and say,

‘If the worker’s at risk in litigation and there’s an IME, give

the worker a medical arbiter exam.’ You no longer have to

get into the whole issue of relationships between employers

and insurers and IME providers and all of that. You use an

existing system, and still, the employer insurer pays for it.”

Id. (emphases added). As so described, Mannix’s proposal was

not intended to give a worker access to an additional medical

examination to contest an IME report only if the IME report

existed before an insurer’s written notice of denial. Rather,

all that was required was the existence of an IME report

and Economic Development, SB 485, Feb 2, 2001, Tape 18, Side B (testimony of

Ken Hector).

12

Mannix did not agree with the perception that the IME process was “kind

of loaded” against workers, stating that “85 percent of claims are accepted,” and

that, “in many of those cases, you had an IME that agreed with the attending

physician.” Tape Recording, Senate Committee on Business, Labor and Economic

Development, SB 485, Feb 2, 2001, Tape 17, Side A (testimony of Kevin Mannix).

288 Teitelman v. SAIF

supporting the insurer’s decision when the worker was “at

risk in litigation.” The wording of Mannix’s proposed amend-

ment was one of many proposed amendments that was con-

sidered by the MLAC and one of the amendments that was

eventually approved by the MLAC and the legislature, but

there is no clear evidence in the legislative history about how

that amendment was intended to work, other than Mannix’s

testimony when he initially proposed it to the legislature.13

A summary of Mannix’s proposed amendment, as

presented to the Senate committee, articulated the approach

as follows:

“Amend the statute as follows: retain the insurer’s

authority to select IMEs, as they currently do, but allow

a worker to request examination by a medical arbiter

selected by the director if:

“the worker has timely requested a hearing on a denial[;]

“where that denial is based upon one or more IME reports

obtained by an insurer or self-insured employer[;] and

“the worker’s attending physician does not concur with

those reports.”

13

On February 2, 2001, Mannix stated that he had “just presented” his pro-

posed amendment to the MLAC. Tape Recording, Senate Committee on Business,

Labor and Economic Development, SB 485, Feb 2, 2001, Tape 17, Side A (testimony

of Kevin Mannix). During a subsequent work session on SB 485 on February 14,

2001, Shilts provided an update on the MLAC’s deliberations. He explained that

the MLAC had been provided with “dozens of amendment suggestions on the bill”

and had “gone through an initial analysis of the amendments, many of which

were brought forward in front of the committee during the last public hearing

[held on February 2].” Tape Recording, Senate Committee on Business, Labor and

Economic Development, SB 485, Feb 14, 2001, Tape 26, Side A (testimony of John

Shilts). The committee chair, Senator Roger Beyer, informed the rest of the com-

mittee that they would return to SB 485 a week later with the hope that “MLAC

[would] be done with [the amendments] by then.” Id. The committee did not dis-

cuss any of the proposed amendments to SB 485 at the February 14 work session.

At the next work session on February 21, Senator Beyer began by describ-

ing “a rough draft of amendments accepted by MLAC.” Tape Recording, Senate

Committee on Business, Labor and Economic Development, SB 485, Feb 21, 2001,

Tape 33, Side B (statements of Senator Beyer). That “rough draft” was a document

titled “Amendments Accepted by the Management-Labor Advisory Committee.”

Exhibit B, Senate Committee on Business, Labor and Economic Development, SB

485, Feb 21, 2001. Senator Steve Harper referred to that document as the MLAC’s

“proposed solutions” to the issues that had been presented to both committees. Tape

Recording, Senate Committee on Business, Labor and Economic Development, SB

485, Feb 21, 2001, Tape 32, Side B (statements of Senator Harper). One of those

“proposed solutions” was the amendment that Mannix had proposed on February 2.

Cite as 374 Or 271 (2025) 289

Exhibit B, Senate Committee on Business, Labor and

Economic Development, SB 485, Feb 21, 2001 (written tes-

timony of John Shilts). Shilts described the proposal as “a

three-level test that’ll allow a worker to get examined by

an impartial examiner, which was the point of the original

proposal, without interfering with insurers’ rights to select

independent medical examiners.” Tape Recording, Senate

Committee on Business, Labor and Economic Development,

SB 485, Feb 21, 2001, Tape 32, Side B (testimony of John

Shilts). Nothing in the legislative history suggests that the

legislature changed its fundamental objective—to address

workers’ concerns that the existing IME process was

biased—when it adopted Mannix’s amendment.

When SB 485 reached the House, Shilts again

explained the function and purpose of that provision in the

bill.14 In describing what that provision would do, he stated

that it “allows workers who are litigating a denial that is

based on an IME to request an examination from the arbi-

ter list.” Exhibit L, House Committee on Business, Labor

and Consumer Affairs, SB 485, May 15, 2001 (written tes-

timony of John Shilts). He explained that the provision was

intended to “provide for an impartial examination for work-

ers in litigation.” Id.

Jim Egan—testifying in his capacity as the

President of the Workers’ Compensation section of the

Oregon Trial Lawyers Association in support of SB 485, as

amended—stated that the provision “allows an exam by a

physician appointed by the department when a compelled

medical examination and attending physician’s report do

not agree.” Tape Recording, House Committee on Rules,

Redistricting, and Public Affairs, SB 485A, June 15, 2001,

Tape 150, Side B (testimony of Jim Egan). Tim Nesbitt,

then-President of the Oregon AFL-CIO, testified that the

14

The provision in SB 485 that gave workers a right to request a WRME

was only one of many changes to the Workers’ Compensation Law made when

the legislature enacted the bill. The Legislative Fiscal Office’s fiscal analysis of

SB 485 estimated that the bill would impact the Workers’ Benefit Fund in seven

major ways, resulting in an estimated $2.6 million to $8.6 million in increased

payments from the fund. The fiscal analysis did not identify the cost of additional

IMEs or WRMEs as one of the seven major fiscal impacts of the bill, nor did it

give any specific estimate of the fiscal impact of the provision that gave workers

a right to request a WRME.

290 Teitelman v. SAIF

bill would “provide new oversight over the use of compelled

medical exams by insurance companies” by “giving workers

the right to refer adverse determinations by insurance med-

ical examiners (IMEs) to an independent medical arbiter for

a second opinion.” Exhibit E, House Committee on Business,

Labor and Consumer Affairs, SB 485A, June 15, 2001 (writ-

ten testimony of Tim Nesbitt, President, Oregon AFL-CIO).

No witness or legislator indicated that a worker’s requested

medical examination would be allowed only if the insurer

had received the disputed IME report before sending the

worker a written notice of denial.15

In sum, the legislative history demonstrates that,

from the outset of the legislative process, the intended pur-

pose of the provision in SB 485 that authorized a medical

examination requested by the worker was to reduce per-

ceived or actual bias in the existing IME process. Although

the mechanism for doing so changed as the bill progressed,

the intended purpose never changed. The bill as enacted

was intended to meet that purpose by allowing workers to

get “a second opinion” when the claim is “in litigation.” Thus,

the legislative history supports the conclusion that a worker

is entitled to a WRME when the denial of the worker’s claim

is in litigation, the insurer uses one or more IME reports to

support its denial, and the worker’s attending physician or

nurse practitioner does not concur with the IME reports.

Nothing in the legislative history suggests that

the legislature specifically intended that a worker would be

entitled to a WRME only if the insurer had received the dis-

puted IME report before sending the worker a written notice

denying that the claim was compensable.16 To the contrary,

15

Petitioner contends that legislative testimony demonstrates that SB 485 was

intended to give “equal dignity” to the worker-requested and insurer-requested

examination reports. But we understand that testimony to refer to giving “equal

dignity” to the number and types of physicians involved in each examination, not

to the worker’s right to request a medical examination in the first place. See Tape

Recording, Senate Committee on Business, Labor and Economic Development,

SB 485, Mar 14, 2001, Tape 50, Side A (testimony of Jerry Keene) (stating that,

“if the insurer obtained a panel exam involving two or three different doctors, the

worker is entitled to have an examination of equal dignity, of equal type”).

16

The dissenting opinion suggests that the lack of any statement in the leg-

islative history that the initial denial must be based on an IME for a worker to

qualify for a WRME is understandable, because the wording of the bill was devel-

oped by MLAC, and “everyone involved in the development of the bill” understood

Cite as 374 Or 271 (2025) 291

by the time the bill reached the House, late in the legisla-

tive process, the legislative history indicates that the bill

as amended was intended to address perceived bias in the

IME process by giving the worker the right to an “impar-

tial” examination whenever the insurer’s continued denial

of the worker’s claim was in litigation.

III. CONCLUSION

We conclude from the text, context, and legislative

history of ORS 656.325(1)(e) that we must look to the claim

status at the time that a worker’s request for a WRME is

decided to determine whether the insurer’s denial of compen-

sability was “based on” an IME report. Here, SAIF required

Cardoza to submit to an IME and obtained a report, claim-

ant had requested a hearing to contest SAIF’s continuing

denial of the claim, and SAIF used the IME report to support

its continued denial that Cardoza’s claim was compensable.

Thus, the board erred in concluding that SAIF’s “denial

of compensability” was not “based on” an IME report, and

accordingly erred in holding that Cardoza was not entitled

under ORS 656.325(1)(e) to a WRME to contest that denial.

The decision of the Court of Appeals is affirmed. The

order of the Workers’ Compensation Board is reversed, and

the case is remanded to the board for further proceedings.

GARRETT, J., dissenting.

When an insurer or self-insured employer has denied

compensability based on a medical examination of the

claimant (IME), ORS 656.325(1)(e) entitles the claimant to

that that was the intent. 374 Or at 296-97 (Garrett, J., dissenting). But, as noted

above, 374 Or at 288 n 13, the precise wording of the Mannix amendment to

the bill was one of “dozens of amendments” that MLAC addressed between

February 2—when the amendment was first proposed—and February 21, when

the wording was presented to the legislative committee. There is no evidence

that “everyone” understood the intent behind all the amendments under con-

sideration during that stage of the legislative process. The dissent also suggests

that “it would hardly be surprising” if the wording was a “compromise” that was

intended to give workers a right to a WRME in more limited circumstances. Id.

at 296-97 (Garrett, J., dissenting). That is speculation; there is no evidence in the

legislative history that such a compromise was specifically intended. Moreover,

statements by Mannix and others during the legislative process show that the

intent was to give the worker a right to a WRME to contest an IME whenever

the worker’s physician disagreed with the IME report, and the dispute would be

resolved “in litigation.”

292 Teitelman v. SAIF

request her own examination (referred to here as a “worker

requested medical exam,” or “WRME”) at the insurer’s or

employer’s expense. In this case, SAIF denied compensabil-

ity without conducting any medical exam. Claimant made

a timely request for a hearing. Before the hearing, SAIF

required claimant to submit to an IME, which SAIF then

used as evidence to support its denial decision. The major-

ity concludes that, once SAIF obtained an IME and stated

its intention to rely on it at the hearing, the denial became

“based on” that IME for purposes of ORS 656.325(1)(e), so

that claimant was then entitled to a WRME, regardless of

why the claim was denied in the first place. 374 Or at 291.

In my view, the majority’s conclusion is contrary to

the statute. ORS 656.325(1)(e) provides:

“If the worker has made a timely request for a hearing

on a denial of compensability as required by ORS 656.319

(1)(a) that is based on one or more reports of examinations

conducted pursuant to paragraph (a) of this subsection

and the worker’s attending physician or nurse practitioner

authorized to provide compensable medical services under

ORS 656.245 does not concur with the report or reports,

the worker may request an examination to be conducted by

a physician selected by the director from the list described

in ORS 656.328. The cost of the examination and the exam-

ination report shall be paid by the insurer or self-insured

employer.”

The question is whether, under that provision, a denial of

compensability “is based on” an IME that occurs after the

insurer or employer informs the claimant that the claim has

been denied. The majority reasons that “denial” is a status

that exists throughout the claim resolution process, and

that a denial consequently may be “based on” different evi-

dence at different times. 374 Or at 282. Therefore, a denial

that was initially “based on” nonmedical reasons may later

come to be based on an IME if it lends support to the denial.

Although the majority may be correct that “denial”

can, in some contexts, be understood as a status that exists

over time, that does not appear to be how the legislature

used the word in ORS 656.325(1)(e). That statute contem-

plates that a “denial” means the decision to deny the claim,

Cite as 374 Or 271 (2025) 293

with the corresponding notice to the claimant stating the

basis for that decision.

That interpretation is evident from other textual

clues in the statute. First, for the entitlement to an WRME

to be triggered, the worker must have “made a timely

request for a hearing on a denial of compensability.” The

reference to requesting “a hearing on” a denial suggests that

a denial is an event; something must have occurred that

causes a claimant to request a hearing. Second, the statute

expressly refers to ORS 656.319(1)(a), which, as pertinent

here, provides:

“(1) With respect to objection by a claimant to denial

of a claim for compensation under ORS 656.262 [processing

of claims and payment of compensation], a hearing thereon

shall not be granted and the claim shall not be enforceable

unless:

“(a) A request for hearing is filed not later than the

60th day after the mailing of the denial to the claimant; or

“(b) The request is filed not later than the 180th day

after mailing of the denial and the claimant establishes at

a hearing that there was good cause for failure to file the

request by the 60th day after mailing of the denial.”

ORS 656.319(1). What is notable about that statute, for pres-

ent purposes, is that it refers three different times to “mail-

ing of the denial.” Thus, regardless of the majority’s point

that “denial” may, in some other contexts, describe a status

that exists over time, that is not the way the legislature has

used the word in ORS 656.319(1). In that statute, “denial”

obviously refers to the notice sent to the claimant that the

claim has been denied.

Accordingly, reading the two statutes together, I

would conclude that the legislature intended for “denial of

compensability” in ORS 656.325(1)(e) to mean the action

taken by the insurer or self-insured employer to notify the

claimant that the claim has been denied, which triggers

the claimant’s statutory obligation in ORS 656.319(1) to

request a hearing within a specified time period. It follows

that that action—the initial denial decision—is the subject

of the statute’s requirement that the denial must be “based

294 Teitelman v. SAIF

on” the IME in order for the claimant to have a statutory

entitlement to a WRME.

The majority contends that, as a matter of syn-

tax, the phrase “is based on” can be understood to refer to

evidence that post-dates the initial denial. 374 Or at 283.

Perhaps, but that does not explain why the legislature chose

to qualify the WRME entitlement by linking it to a claim-

ant’s request for a hearing on a denial of compensability—

and by expressly referring to ORS 656.319(1)(a), which

refers to the notice of denial as the event that starts the

clock for requesting that hearing. If the legislature had

intended for the initial basis for a denial to be irrelevant to

the entitlement to a WRME—that is, if the legislature had

intended that a claimant could obtain a WRME whenever an

insurer or employer obtains an IME, regardless of timing—

the legislature could easily have said so. For example, ORS

656.325(1)(e) could instead have provided:

“If, at any point, the insurer or self-insured employer

requires the claimant to submit to a medical examina-

tion conducted pursuant to paragraph (a) of this subsection

and the worker’s attending physician or nurse practitioner

authorized to provide compensable medical services under

ORS 656.245 does not concur with the report or reports,

the worker may request an examination to be conducted by

a physician selected by the director from the list described

in ORS 656.328.”

Or, the legislature could have provided that, whenever an

insurer or self-insured employer “relies on” or “intends to

rely on” an IME to support a denial, then the claimant is

entitled to a WRME. In their simplicity, those various alter-

natives stand in marked contrast to the wording the legisla-

ture actually chose: “If the worker has made a timely request

for a hearing on a denial of compensability as required by

ORS 656.319(1)(a) that is based on one or more reports of

examinations conducted pursuant to paragraph (a) of this

subsection * * *[.]” The reference to ORS 656.319(1)(a), which

explains that a hearing must be requested after a “denial” is

“mailed” to the claimant, must be presumed to have signifi-

cance. It is a clear indication that, in linking the entitlement

to a WRME to the basis for a “denial of compensability,” the

Cite as 374 Or 271 (2025) 295

legislature was contemplating the basis for the denial when

issued.1

Nothing in the legislative history cited by the

majority leads to a different conclusion. And the legislative

history includes additional evidence not cited by the major-

ity that is consistent with the natural reading of the text.

The majority points to statements by legislators and

witnesses to the effect that the purpose of the WRME provi-

sion was to “reduce perceived or actual bias in the existing

IME process. * * * The bill as enacted was intended to meet

that purpose by allowing workers to get ‘a second opinion’

when the claim is ‘in litigation.’ 374 Or at 290. But that gen-

eral statement of purpose sheds no real light on the inter-

pretive question here. It is undisputed that the legislature

created an entitlement to a WRME in ORS 656.325(1)(e) to

advance the policy objective described by the majority. At

issue is the scope of that entitlement. Claimant’s interpre-

tation and SAIF’s interpretation both are consistent with

the majority’s description of the statute’s purpose; SAIF’s

interpretation simply furthers the policy in a more limited

way by tying the entitlement to a WRME to the basis for

the initial denial. The majority appears to assume that,

because of that limitation, SAIF’s interpretation is less con-

sistent with the legislature’s purpose. But that assumption

is unjustified.

The legislature frequently chooses to pursue an

identified purpose without pursuing it to the maximum pos-

sible extent. As this court has observed, bills often result

from “ ‘the accommodation of competing and mutually incon-

sistent values.’ Many bills contain both provisions that

advance their principal purposes and provisions that may

limit their pursuit of those goals to protect other interests.”

State v. Uroza-Zuniga, 364 Or 682, 692-93, 439 P3d 973

1

It is worth noting that, under ORS 656.262(11)(a), insurers are subject to

penalties as well as attorney fees for unreasonably denying claims. The Court of

Appeals has held that the reasonableness of a denial is evaluated in light of the

evidence available when the initial denial decision is made. Brown v. Argonaut

Insurance Company, 93 Or App 588, 591, 763 P2d 408 (1988). The effect is that

insurers have an incentive to request an IME before making a decision on the

claim if they have reason to think that medical evidence would be needed to jus-

tify a denial. An insurer who acted otherwise in the hope of avoiding the expense

of a WRME would be acting at its peril.

296 Teitelman v. SAIF

(2019) (quoting Hans A. Linde, Due Process of Lawmaking,

55 Neb L Rev 197, 212 (1976)). Thus, the text of a statute may

reflect an accommodation of competing interests, and that

compromise may be a political prerequisite for—or even the

driving political reason behind—the bill’s passage. In such

a case, a court should be particularly mindful that the most

natural reading of the text likely also reflects the considered

understanding of those who drafted the bill and the intent

of legislators who wished to effectuate the compromise.

As the majority recounts, Senate Bill (SB) 485, the

2001 bill that led to the enactment of ORS 656.325(1)(e),

developed through the Management Labor Advisory

Committee (MLAC). 374 Or at 285. MLAC was created by

the 1990 legislation that substantially overhauled Oregon’s

workers’ compensation system. See, e.g., Brown v. SAIF, 361

Or 241, 391 P3d 773 (2017) (discussing enactment history).

Since 1990, MLAC, which comprises representatives from

management and labor, has exercised what is effectively a

gatekeeping role concerning legislative concepts that would

affect the workers’ compensation system, ensuring that ade-

quate consideration is given to stakeholder interests. In that

capacity, MLAC proposes legislation of its own and advises

on legislative concepts proposed by others.2

Because SB 485 was proposed through MLAC, we

may presume that people with expertise representing both

labor and management interests were involved in its devel-

opment. That matters for two reasons. First, accepting as a

premise that the goal of the proposal was to benefit one set of

MLAC stakeholders—workers—by giving them more access

to employer-paid medical exams, everyone involved would

have understood that the proposal would come at a cost to

the other MLAC stakeholders—insurers and employers. In

light of that, it would hardly be surprising if the product of

discussions within MLAC was a compromise—an “accom-

modation” of those competing interests, Uroza-Zuniga, 364

Or at 692—that provided for WRMEs in some but not all

cases.

2

For background, see https://www.oregon.gov/dcbs/mlac/pages/index.aspx

(accessed Sept 17, 2025).

Cite as 374 Or 271 (2025) 297

Second, the fact that the bill was developed through

MLAC helps explain what the majority sees as a puzzling

omission: During the legislative process, no one apparently

made it clear that the initial denial must be based on an

IME. 374 Or at 290. But, if everyone involved in the develop-

ment of the bill had a shared understanding of what the text

meant, the silence on that point is much less surprising; they

may just have taken it for granted that the text means what

it appears to say. Those well versed in the workers’ com-

pensation system would have understood that, by expressly

connecting the WRME entitlement in ORS 656.325(1)(e) to

the notice of denial referenced in ORS 656.319(1), the bill

contemplated that the initial denial must have been based

on an IME. Nor is there any basis in the legislative history

for supposing that legislators had a different understand-

ing or intended to do anything different than what MLAC

proposed.

The legislative history includes several pieces of

evidence that support that understanding. As the majority

notes, the entitlement to a WRME was not in the original

version of SB 485, and was proposed later by Kevin Mannix.

374 Or at 287. Mannix presented his idea to a legislative

committee, explaining:

“I think the solution is simple. Where there is an IME and

there is a denial and the worker requests a hearing on the

denial, [the amendment would] allow the worker to have

access to the very same medical arbiter panels that we

have right now and allow the worker an exam with a panel

equivalent to whatever that IME panel was at the cost of

the employer or insurer.”

Tape Recording, Senate Committee on Business, Labor and

Economic Development, SB 485, Feb 2, 2001, Tape 17, Side A

(statement of Kevin Mannix). Mannix’s testimony reflects

an understanding that events would occur in a particular

sequence: an IME would be conducted, followed by a denial,

followed by a request for hearing.

A few days later, the Mannix proposal was pre-

sented to MLAC with the following description:

“Kevin Mannix, Attorney: proposes amending the bill to

provide for a WCD-arranged, insurer-paid exam for injured

298 Teitelman v. SAIF

workers when an insurer or self-insured employer denies a

claim based on the findings of an insurer-arranged IME

which becomes the issue in a compensability suit.”

Minutes, Workers’ Compensation MLAC Committee, SB

485—Workers’ Comp Reform, Feb 5, 2001 (statement of WCD

Administrator John Shilts). MLAC proposed its own amend-

ments to the Mannix proposal, which then came back before

the Senate committee for consideration. That committee

heard testimony from appellate lawyer and workers’ com-

pensation specialist Jerry Keene, who testified as follows:

“Section 13, worker arbiter exams. The statute premises

a request on the timely filing of a request for hearing of a

compensability denial that was based on the IME. * * *

“And also it was discussed that one of the conditions is

that the attending physician of the worker not have con-

curred with the insurer’s IME. That isn’t fleshed out. There

was a sense that what that meant was that if the doctor

disagreed in part or with all of it, that it didn’t have to be

a total disagreement before the worker is entitled. It could

be a partial disagreement, but that the disagreement by

the attending physician had to be on the medical reason

that was offered by the IME doctor that was the basis for the

denial.”

Tape Recording, Senate Committee on Business, Labor and

Economic Development, SB 485, Mar 14, 2001, Tape 50, Side A

(statement of Jerry Keene) (emphases added). Keene’s testi-

mony is notable in that it refers to a denial that “was” based

on an IME, even though the statutory text used the phrase

“is based on.” That indicates that, to practitioners familiar

with the subject matter, there may have been no meaningful

difference in referring to a “denial that is based on” an IME

and a “denial that was based on” an IME.

To be sure, none of those excerpts is definitive. But

they are certainly consistent with an interpretation that, in

the view of MLAC and legislators, the WRME entitlement

would be triggered by an initial denial of compensability

based on an IME, as a straightforward reading of the text

of ORS 656.325(1)(e) would suggest. The majority does not

identify any legislative history that clearly suggests a dif-

ferent understanding.

Cite as 374 Or 271 (2025) 299

The best evidence of how the legislature chose to give

effect to its stated purpose is, of course, the text that it chose

to enact. As discussed above, the text of ORS 656.325(1)(e)

directs the reader’s focus to the “denial” that triggers the

claimant’s deadline for requesting a “hearing” under ORS

656.319(1), to which ORS 656.325(1)(e) expressly refers. In

that context, “denial” means the notice that informs the

claimant of the basis for denial of compensability. Because

the majority concludes otherwise, I respectfully dissent.

DeHoog, J., joins in this dissenting opinion.