Mantle v. SAIF

8 January 4, 2024 No. 2

IN THE COURT OF APPEALS OF THE

STATE OF OREGON

In the Medical Service Dispute of

Jacob E. Mantle, Worker.

Jacob E. MANTLE,

Petitioner,

v.

SAIF CORPORATION;

Whirlwind Services, Inc.; and

Department of Consumer and Business Services

Respondents.

Workers’ Compensation Division

DBV2359; A176516

Argued and submitted January 17, 2023.

Jodie Anne Phillips Polich argued the cause for peti-

tioner. Also on the briefs was Law Offices of Jodie Anne

Phillips Polich, P. C.

Daniel Edward Walker argued the cause and filed the

brief for respondents SAIF Corporation and Whirlwind

Clean & Green.

Denise G. Fjordbeck waived appearance for respondent

Department of Consumer and Business Services.

Before Shorr, Presiding Judge, and Mooney, Judge, and

Pagán, Judge.

SHORR, P. J.

Reversed and remanded.

Mooney, J., dissenting.

Cite as 330 Or App 8 (2024) 9

10 Mantle v. SAIF

SHORR, P. J.

Petitioner seeks judicial review of a final order of

the Director of the Department of Consumer and Business

Services (“the director”). In the administrative proceed-

ing, petitioner had requested that the director declare that

petitioner was not liable to pay two medical providers’ bills

because the providers had not followed the otherwise appli-

cable workers’ compensation treatment rules. The director

dismissed petitioner’s request. The director concluded that,

under ORS 656.704(3), it lacked authority to address the

medical billing issue because the medical services were not

causally related to the worker’s accepted claim. We disagree

that the director lacked such authority. We reverse and

remand for further proceedings.

The relevant facts are taken from the direc-

tor’s Final Order, which adopted the findings of the

Administrative Law Judge. Those findings are undisputed

on judicial review. Petitioner sustained a compensable

injury on April 4, 2016. That injury was ultimately accepted

for non-disabling thoracic and lumbar strains. Because the

claim was nondisabling, no notice of closure was required or

issued. Petitioner later sought medical treatment from April

to July 2018 at Columbia Medical Clinic (Columbia), which

resulted in a referral to Gateway Sports Medicine & Rehab

(Gateway) where petitioner participated in physical therapy.

Petitioner and respondent SAIF Corporation stipulated that

neither of those providers provided a treatment plan nor did

they obtain pre-authorization for the services they provided.

As we will discuss in more detail later, that is significant,

because the workers’ compensation statutes and rules pro-

vide that a worker is not obligated to pay for medical treat-

ment when the medical provider does not follow the applica-

ble rules. See, e.g., ORS 656.327(2) (stating that “the worker

is not obligated to pay for medical treatment determined not

to be compensable under this subsection.”); OAR 436-010-

0230(7)(a) (2015) (stating that certain providers “must pre-

pare a treatment plan before beginning treatment.”).

In March 2019, petitioner requested administrative

review by the “Medical Resolution Team” (MRT) regarding

Cite as 330 Or App 8 (2024) 11

the medical providers’ bills.1 ORS 656.327(3). The MRT

then transferred the matter to the Workers’ Compensation

Board (the board) for an initial determination of whether

a causal relationship existed between the disputed medical

services and the accepted conditions. In August 2019, an

Administrative Law Judge (ALJ) within the board’s Hearing

Division issued an Opinion and Order, concluding that there

was no causal relationship between the accepted April 2016

thoracic and lumbar strain claim and the medical treatment

provided to petitioner by Columbia and Gateway.2 The ALJ

then determined that the remaining dispute over the pro-

priety of the billing for medical services, which were pro-

vided by Columbia and Gateway without preauthorization

or an approved treatment plan, was within the director’s

authority. The ALJ concluded that “[l]acking jurisdiction to

address that dispute, that medical services dispute is trans-

ferred back to the Director. See ORS 656.704(3)(b)(B).”

The MRT, which acts under the director’s delegated

authority, reviewed the transferred matter. It noted that “[t]he

worker requests an order finding that he is not responsi-

ble for the medical services in question [those provided by

Columbia and Gateway] due to the provider[s’] failure to fol-

low the OARs and the statutes which control medical ser-

vices.” The MRT then reviewed those rules and stated:

“The MRT finds according to OAR 436-010-0230(7)(a-c),

ancillary medical service providers must send a treatment

plan to the prescribing provider within seven days of begin-

ning treatment. Further, if no treatment plan is sent, the

insurer is not required to pay for the services provided prior

to the date the treatment plan was sent. * * * SAIF and

[petitioner] stipulated that there was no request for preau-

thorization for the disputed 2018 medical services and that

no treatment plan was ever provided. As such, the MRT

could not order SAIF liable for medical services where no

treatment plan was provided, even if the medical services

were causally related to the worker’s accepted claim.”

1

The MRT is a physician or panel of physicians delegated by the authority

of the Director to review the propriety of medical treatments of injured workers

under ORS 656.327.

2

The board adopted that ALJ decision regarding lack of causation. Petitioner

did not seek further review of that decision.

12 Mantle v. SAIF

As a result, according to the MRT, SAIF was not liable to

pay the medical service providers Columbia and Gateway

even assuming that the medical services were causally

related to petitioner’s accepted claim. That left unanswered

petitioner’s potential liability for the providers’ bills when

those providers did not follow the rules for medical services

related to workers’ compensation claims in this particular

circumstance. The MRT then, at least in part, answered

that question:

“[I]n this case, the [ALJ Opinion and Order] address-

ing the causal relationship between the medical services

and the accepted claim found the medical services were

not causally related to [petitioner’s] accepted 2016 non-dis-

abling claim. As such, the medical services fall outside the

MRT’s jurisdiction.

“The worker requested an order finding him not respon-

sible for the treatment due to the provider[s’] failure to fol-

low OARs and the statutes which control medical services;

however, since the MRT has no jurisdiction over medical

services that are not related to an accepted claim, the MRT

is unable to find the worker not responsible for the disputed

medical services.”

Thus, at least as far as the workers’ compensation system

is concerned, petitioner was still responsible for paying the

medical bills despite the medical service providers not fol-

lowing the rules for providing medical services relating to

a workers’ compensation claim. Or, stated differently, the

MRT concluded that it at least did not have authority to

decide that the worker was not responsible to pay the dis-

puted medical bills.

Petitioner then sought review of that decision before

a new ALJ, one different from the one that had found there

was no causal relationship between the medical services

and the original April 2016 accepted back strain. That ALJ

reviewed the relevant statutes, particularly ORS 656.704

and ORS 656.327, which we will discuss further below. He

came to a different conclusion, that “even if disputed med-

ical treatment has been found not to be causally related to

the accepted injury and is consequently not compensable,

the director has jurisdiction to review issues concerning

provision of medical treatment in violation of the rules, and

Cite as 330 Or App 8 (2024) 13

may order that a worker is not obligated to pay for such ser-

vices.” The ALJ then did just that; it ordered that petitioner

was “not obligated to pay for medical services, if they were

performed in violation of the rules.” The ALJ then ordered

that the matter should be transferred back to the director

(or the MRT acting under the director’s delegated authority)

to determine precisely which medical services, and result-

ing bills, were provided in violation of the workers’ compen-

sation rules.

The MRT then filed exceptions to the ALJ’s order,

arguing to the director that the ALJ had erred in concluding

that the director, and by extension the MRT, had authority

to order that a worker was not obligated to pay for medical

services provided in violation of the workers’ compensation

rules in circumstances where the services were not causally

related to the worker’s accepted claim. The director, exam-

ining ORS 656.704 and ORS 656.327, but also heavily rely-

ing on historical practice, reversed the ALJ and concluded

that

“[b]ecause the treatment was ultimately determined not to

be related to the worker’s compensable claim, it falls out-

side of the workers’ compensation system; ORS 656.327

and the corresponding administrative rules do not apply;

and MRT was correct to dismiss the propriety issue.”

The director further stated:

“In holding that the director’s authority to review the

propriety aspect of a medical services dispute is contingent

upon the services being causally related to the worker’s

accepted claim – in other words, that ORS 656.327 applies

only to treatment that is causally related to the worker’s

accepted claim – it could be argued that MRT is insert-

ing into the workers’ compensation statute what has been

omitted. MRT’s interpretation, however, is consistent with

the way in which the statute and rules have historically

been applied, and it is not inconsistent with the wording or

context of the statute and rules themselves.”

That brings this matter up to the current moment.

Petitioner seeks our review of the director’s deci-

sion. The issue before us is solely one of law. We therefore

review the director’s decision for legal error. Zach v. Chartis

14 Mantle v. SAIF

Claims, Inc., 279 Or App 557, 560, 379 P3d 721, rev den, 360

Or 697 (2016); ORS 183.482(8). The legal issue before us is

primarily one of statutory construction. We apply our usual

method of statutory construction, considering the text and

context of the relevant statutes and any relevant legislative

history we find helpful. State v. Gaines, 346 Or 160, 171-72,

206 P3d 1042 (2009).

As noted, the relevant statutes include ORS 656.704

and ORS 656.327. Those statutes define and divide the

authority for resolving workers’ compensation related dis-

putes between the board and the director. ORS 656.704(3)(a)

provides:

“For the purpose of determining the respective author-

ity of the director and the board to conduct hearings, inves-

tigations and other proceedings under this chapter, and

for determining the procedure for the conduct and review

thereof, matters concerning a claim under this chapter

are those matters in which a worker’s right to receive com-

pensation, or the amount thereof, are directly at issue.

However, subject to paragraph (b) of this subsection, such

matters do not include any disputes arising under ORS * * *

656.327, any other provisions directly relating to the provi-

sion of medical services or any disputes arising under ORS

656.340 except as those provisions may otherwise provide.”

The parties agree with the basic division of authority

between the board and the director, and so do we. “Generally

speaking, under ORS 656.704, the board has review author-

ity over matters concerning a claim, and the director has

review authority over matters other than those concerning

a claim.” Martin v. SAIF, 247 Or App 377, 382, 270 P3d 296

(2011).

The disputed issue is whether the director has

authority to resolve certain disputes regarding the provi-

sion of medical services to petitioner after the board con-

cludes that the worker’s claim is not compensable under the

workers’ compensation system.

ORS 656.704(3)(b) provides:

“The respective authority of the board and the direc-

tor to resolve medical service disputes shall be determined

according to the following principles:

Cite as 330 Or App 8 (2024) 15

“(A) Any dispute that requires a determination of the

compensability of the medical condition for which medical

services are proposed is a matter concerning a claim.

“(B) Any dispute that requires a determination of

whether medical services are excessive, inappropriate,

ineffectual or in violation of the rules regarding the perfor-

mance of medical services, or a determination of whether

medical services for an accepted condition qualify as com-

pensable medical services among those listed in ORS

656.245 (1)(c), is not a matter concerning a claim.

“(C) Any dispute that requires a determination of

whether a sufficient causal relationship exists between

medical services and an accepted claim to establish com-

pensability is a matter concerning a claim.”

ORS 656.704(3)(b). ORS 656.704(3) certainly divides author-

ity between the board and director along the lines stated

above. See also OAR 436-010-0008 (similarly dividing

authority between the board and director).3 But nowhere

does it state that the director either loses or lacks author-

ity to resolve a pending dispute regarding “violation of the

rules regarding the performance of medical services,” which

is the issue here, when the board has concluded that the

claim is separately not compensable. We note, as we will dis-

cuss again later, that, at the time that petitioner sought ser-

vices from the medical providers for his condition and they

3

OAR 436-010-0008 provides:

“(1) General.

“(a) Except as otherwise provided in ORS 656.704, the director has

exclusive jurisdiction to resolve all disputes concerning medical fees, nonpay-

ment of compensable medical bills, and medical service and treatment dis-

putes arising under ORS 656.245, 656.247, 656.248, 656.260, 656.325, and

656.327. Disputes about whether a medical service provided after a worker is

medically stationary is compensable within the meaning of ORS 656.245(1)

(c), or whether a medical treatment is unscientific, unproven, outmoded, or

experimental under ORS 656.245(3), are subject to administrative review

before the director.

“(b) As provided in ORS 656.704(3)(b), the following disputes are in the

jurisdiction of the board and will be transferred:

“(A) A dispute that requires a determination of the compensability of the

medical condition for which medical services are proposed; and

“(B) A dispute that requires a determination of whether a sufficient

causal relationship exists between medical services and an accepted claim.”

16 Mantle v. SAIF

failed to follow the workers’ compensation treatment rules,

petitioner’s claim had not been denied.

We turn to ORS 656.327, which further discusses

the role of the director in considering disputes about whether

medical services are “excessive, inappropriate, ineffectual

or in violation of rules regarding the performance of med-

ical services.” ORS 656.327(1)(a). ORS 656.327 provides, in

relevant part:

“(1)(a) If an injured worker, an insurer or self-insured

employer or the Director of the Department of Consumer

and Business Services believes that the medical treatment

* * * that the injured worker has received, is receiving, will

receive or is proposed to receive is excessive, inappropri-

ate, ineffectual or in violation of rules regarding the per-

formance of medical services, the injured worker, insurer or

self-insured employer must request administrative review of

the treatment by the director prior to requesting a hearing

on the issue and so notify the parties.

“* * * * *

“(2) The director shall review medical information and

records regarding the treatment. The director may cause an

appropriate medical service provider to perform reasonable

and appropriate tests, other than invasive tests, upon the

worker and may examine the worker. Notwithstanding ORS

656.325(1), the worker may refuse a test without sanction.

Review of the medical treatment shall be completed and the

director shall issue an order within 60 days of the request

for review. The director shall create a documentary record

sufficient for purposes of judicial review. If the worker,

insurer, self-insured employer or medical service provider

is dissatisfied with that order, the dissatisfied party may

request review under ORS 656.704. The administrative

order may be modified at hearing only if it is not supported

by substantial evidence in the record or if it reflects an error

of law. No new medical evidence or issues shall be admit-

ted. The worker is not obligated to pay for medical treatment

determined not to be compensable under this subsection.”

(Emphases added.) Here again, the statute defines the direc-

tor’s authority to resolve disputes, including this one, regard-

ing whether medical treatment has been provided in viola-

tion of rules regarding the performance of medical services.

Cite as 330 Or App 8 (2024) 17

It does not, however, provide that the director’s authority

to resolve those disputes depends on the board first con-

cluding that the medical services are causally related to an

accepted claim. Indeed, the director’s authority under the

statute necessarily includes deciding, in response to a claim

that the medical provider has violated the rules regarding

performance of medical services, that “[t]he worker is not

obligated to pay for medical treatment determined not to be

compensable under this subsection.” ORS 656.327(2) (empha-

sis added). That is, the director has authority to conclude

that the worker is not obligated to pay for medical treatment

that is not compensable under that subsection because, hav-

ing reviewed the medical records under subsection (2), the

director has determined that the medical provider has been

“excessive, inappropriate, ineffectual” or, as claimed here,

acted in “violation of rules regarding the performance of

medical services” as required by ORS 656.327(1)(a).

Were we to conclude that the director’s authority is

as limited as the director concluded, we would have to add

to ORS 656.327(2) that the director’s authority to review for

violation of the rules regarding the performance of medical

services is further confined to reviewing only those disputes

regarding medical services where the medical treatment

is otherwise determined to be compensable. But the stat-

ute does not provide that limitation. We respectfully dis-

agree with the dissent’s construction of ORS 656.327 and

the director’s authority within the overall statutory scheme.

ORS 656.327(2) uses the word “compensable” but only in the

context of declaring that a worker is not obligated to pay for

medical treatment that is determined “not to be compensa-

ble under this subsection.” ORS 656.327(2). As noted above,

that subsection addresses the director’s review of the medical

treatment provided to the worker and not to the compensabil-

ity of the claim more generally. The legislature did not limit

the director’s authority to review medical treatment disputes

to just those that involve generally compensable claims.

Respondents SAIF and the employer contend that

the entire statutory scheme was designed to cover only those

medical services that are compensably related to a workers’

compensation claim. Thus, they contend, to the extent that

18 Mantle v. SAIF

a claim is not compensable because the medical treatment

is not causally related to a worker’s accepted claim, it falls

entirely outside Oregon’s workers’ compensation system,

and the director would not have authority to address it.

That argument has logical appeal. However, as noted, the

statute does not state that the director’s authority is limited

in that way. The argument also fails to grapple with the fact

that, at the time petitioner sought care from Columbia and

Gateway, he had had a previously nondisabling accepted

claim that had not been closed. At that juncture, petitioner

was seeing medical providers to follow up on care that he

understood to be related to his accepted workers’ compensa-

tion claim. Further, as stipulated by the parties at least, the

providers had not obtained pre-authorization from SAIF or

the employer for the medical services.

Respondents next contend that if a dispute arises

concerning both the causal relationship between medical

services and an accepted claim to establish compensability,

an issue for the board under ORS 656.704(3)(b)(C), and the

propriety of the medical services, an issue for the director

(or MRT) under ORS 656.704(3)(b)(B), the director must first

transfer the issue to the board to determine compensability.

That is, respondents contend that compensability must be

established by the board before the director (or MRT) may

decide whether the medical services are in violation of the

applicable rules. Respondents contend that, if the board

decides that the claim is not compensable, there is then no

need for the director or MRT to review the propriety of the

medical services. For that proposition, respondents rely on

a footnote from SAIF v. Martinez, 219 Or App 182, 182 P3d

873 (2008), which provides,

“The MRU[4] may, at its discretion, transfer cases to the

board via a Defer and Transfer Order if it believes that

there is a dispute about both the propriety of the proposed

treatment—which it may determine—and the compensa-

bility of the condition itself. ORS 656.704(3)(b). That allows

the board to determine whether the employer is liable for

any medical payment before the MRU decides precisely

what costs the employer must pay.”

4

The MRT was formerly known as the Medical Review Unit or “MRU.”

Cite as 330 Or App 8 (2024) 19

Id. at 186 n 4 (emphasis in original). That footnote is true

as far as it goes. There is discretion to transfer matters

between the board and director and either or both may have

authority over parts of the dispute. See id. at 186 n 3 (noting

that either the MRU, the board, or both may have authority

to resolve the dispute); cf. Daugherty v. SAIF, 258 Or App

512, 514 n 1, 310 P3d 713 (2013) (“ ‘If a request for hearing

or administrative review is filed with either the director or

the board and it is determined that the request should have

been filed with the other, the dispute shall be transferred.’ ”)

(quoting ORS 656.704(5)) (emphasis in Daugherty).5

Further, it is true that, if the claim is not compen-

sable, the employer has no liability for the medical payment.

But that does not mean that the director loses authority

to resolve a dispute about whether a medical provider vio-

lated the rules regarding the provision of medical services

to a worker when the board first determines that there is

a non-compensable claim. Although the employer may not

have liability, there is still a remaining issue whether the

provider violated the workers’ compensation rules when pro-

viding medical services and whether the worker is required

5

ORS 656.704(3)(c) describes the process when a dispute includes both a

matter concerning a claim and a matter not concerning a claim:

“Notwithstanding ORS 656.283(3), if parties to a hearing scheduled

before an Administrative Law Judge are involved in a dispute regarding

both matters concerning a claim and matters not concerning a claim, the

Administrative Law Judge may defer any action on the matter concerning a

claim until the director has completed an administrative review of the mat-

ters other than those concerning a claim. The director shall mail a copy of

the administrative order to the parties and to the Administrative Law Judge.

A party may request a hearing on the order of the director. At the request of

a party or by the own motion of the Administrative Law Judge, the hearings

on the separate matters may be consolidated. The Administrative Law Judge

shall issue an order for those matters concerning a claim and a separate

order for matters other than those concerning a claim.”

Here, the opposite occurred: The MRT determined that petitioner’s request

included a matter concerning a claim and transferred the matter to the board to

address first the relationship of the disputed services to the 2016 claim. That is a

process permitted by ORS 656.704(5):

“If a request for hearing or administrative review is filed with either the

director or the board and it is determined that the request should have been

filed with the other, the dispute shall be transferred. Filing a request will be

timely filed if the original filing was completed within the prescribed time.”

As noted, the board ultimately determined that the disputed services were not

related to the 2016 claim and returned the case to the MRT.

20 Mantle v. SAIF

to pay. The workers’ compensation statutes provide that the

director has authority over those issues, and none of the rel-

evant statutes provide that the director loses that authority

if the board first concludes that the claim is not compensable.

We therefore conclude that the director still had

authority under ORS 656.704(3)(b)(B) to determine whether

Columbia and Gateway provided medical services to peti-

tioner “in violation of [the] rules regarding the performance

of medical services.” ORS 656.327(1)(a).6

Reversed and remanded.

MOONEY, J., dissenting.

I respectfully disagree with the majority’s conclu-

sion that the Director of the Department of Consumer and

Business Services erred in dismissing petitioner’s request to

resolve petitioner’s dispute with a medical service provider

over payment for physical therapy services, and therefore

dissent.

As the majority notes, it has been conclusively

determined that the symptoms for which petitioner sought

medical services are not compensable. Petitioner nonethe-

less sought a determination by the director that he did not

have to pay for those services, because the provider had vio-

lated an administrative rule by failing to provide a treat-

ment plan. The director’s Medical Resolution Team (MRT)

dismissed the request based on its conclusion that the direc-

tor lacked authority to consider it, because the disputed

services had been determined to be not compensable. The

director upheld the MRT’s order.

A complete understanding of the statutory con-

text persuades me that the director was correct. The direc-

tor’s authority is derived from ORS chapter 656. See ORS

656.726(4) (“The director hereby is charged with duties of

6

We note the limited nature of that conclusion. We conclude that the direc-

tor has authority to decide whether the medical providers provided medical ser-

vices to petitioner in violation of the applicable workers’ compensation rules and

the effect of that violation within the workers’ compensation system. We do not

decide, as it is not before us, what effect that decision may have in any further

private or court dispute directly between the medical providers and petitioner

regarding liability for payment for medical services that may have been provided

in violation of the workers’ compensation rules.

Cite as 330 Or App 8 (2024) 21

administration, regulation and enforcement of ORS 654.001

to 654.295, 654.412 to 654.423, 654.750 to 654.780 and this

chapter.”). OAR 436-010-0001(1) (2021) provides:

“The purpose of these rules is to establish uniform stan-

dards for administering the delivery of and payment for

medical services to workers within the workers’ compensa-

tion system.”

(Emphasis added.) Medical services that are not compensa-

ble under the Workers’ Compensation Act are not within the

workers’ compensation system and are not subject to OAR

chapter 436 or to the director’s administrative authority.

Thus, once the determination had been made that the dis-

puted services were not compensable, the procedures set out

in ORS 656.327 for the director’s review of medical service

disputes were not applicable.

The majority focuses its analysis on ORS 656.327,

particularly ORS 656.327(1)(a), providing that

“[i]f an injured worker * * * believes that the medical treat-

ment * * * that the injured worker has received, is receiv-

ing, will receive * * * is excessive, inappropriate, ineffec-

tual or in violation of rules regarding the performance of

medical services, the injured worker, insurer or self-insured

employer must request administrative review of the treat-

ment by the director prior to requesting a hearing on the

issue and so notify the parties.”

(Emphasis added.) Although that provision does unequivo-

cally give an injured worker the right to seek administrative

review of violations of rules relating to the provision of med-

ical treatment, the statutory context makes clear that the

right to request administrative review is limited to medical

treatment disputes relating to compensable claims.

Additionally, unlike the majority, I do not think that

petitioner’s position is strengthened by the last sentence

of ORS 656.327(2) (“The worker is not obligated to pay for

medical treatment determined not to be compensable under

this subsection.”). As that subparagraph states, it applies to

“medical treatment determined not to be compensable under

this subsection.” (Emphasis added.) The director’s authority

under ORS 656.327 is circumscribed by ORS 656.704(3)(b),

22 Mantle v. SAIF

which limits the director’s authority to matters other than

matters concerning a claim. A matter concerning a claim is

a dispute concerning the compensability of a condition for

which medical treatment is sought or a dispute whether

there is a sufficient causal relationship between the services

and an accepted claim. Both such disputes are within the

exclusive authority of the board. ORS 656.704(3)(b)(A) (“Any

dispute that requires a determination of the compensability

of the medical condition for which medical services are pro-

posed is a matter concerning a claim.”); ORS 656.704(3)(b)(C)

(“Any dispute that requires a determination of whether a suf-

ficient causal relationship exists between medical services

and an accepted claim to establish compensability is a mat-

ter concerning a claim.”). A dispute relating to the propriety

of the treatment, i.e., whether it is “excessive, inappropriate,

ineffectual or in violation of the rules” is not a matter con-

cerning a claim and is within the exclusive authority of the

director. ORS 656.704(3)(b)(B). That latter determination

of “compensability” is the one made by the director under

ORS 656.327(2) and to which the last sentence of that sub-

paragraph refers. A worker will not be required to pay for

treatment of a compensable condition on an accepted claim

that bears a sufficient causal relationship to the accepted

claim if the director determines that the services are “exces-

sive, inappropriate, ineffectual or in violation of the rules.”

ORS 656.704(3)(b)(B). Here, the condition for which peti-

tioner sought treatment was not compensable, and the med-

ical services have been determined not to bear a sufficient

causal relationship to the accepted claim. Thus, contrary

to the majority’s view, the last sentence of ORS 656.327(2)

could not absolve petitioner of the obligation to pay for the

medical treatment.

My final qualm with the majority’s analysis is that

it would seem to permit private persons not subject to the

Workers’ Compensation Act to turn to the MRT to resolve

their medical bills with a medical service provider also not

subject to the Act. I have not found within ORS chapter 656

a statute that provides a worker with a remedy of relief from

payment of medical bills for noncompensable medical ser-

vices that fall outside of the workers’ compensation system,

even when the service provider did not comply with OAR

Cite as 330 Or App 8 (2024) 23

chapter 436. SAIF’s unchallenged denial of compensabil-

ity and the board’s final determination that the disputed

services were not for a condition related to the 2016 claim

meant that the services were not within the Act. I would

conclude, therefore, that the director did not err in deter-

mining that it did not have authority to address petitioner’s

request for relief from payment of the bills and did not err in

dismissing petitioner’s request. I therefore dissent.