Oregon Administrative Code

436-050-0165 Security Deposit Requirements (1) Adoption of standards. The director adopts, by reference, the International Standby Practices 1998 (ISP98), ICC Publication No. 590. (a) This publication may be purchased from the International Chamber of Commerce website at https://…

436-050-0170 Excess Insurance Requirements (1) Excess insurance requirements. A self-insured employer must have excess workers’ compensation insurance coverage appropriate for the employer’s potential liability under ORS chapter 656 with an insurer authorized to do business in th…

436-050-0175 Annual Reporting Requirements (1) Annual Financial Report. Every self-insured employer must file an annual financial report with the director, subject to the following: (a) The report must include the employer’s audited financial statements or annual report with audi…

436-050-0180 Determination of Amount of Self-Insured Employer’s Deposit; Effective Date of Order to Increase Deposit (1) Minimum security deposit. Except for self-insured cities, counties, school districts, or qualified self-insured employer groups that are exempt under ORS 656.4…

436-050-0185 Qualifications for Deposit Exemption for Self-Insured Cities, Counties, School Districts, and Qualified Self-Insured Employer Groups, Application Procedures, Conditions and Requirements, Revocation and Requalification (1) Requirements to qualify for deposit exemption…

436-050-0190 Using Self-Insured Employers' Security Deposit/Self-Insured Employer Adjustment Reserve/Self-Insured Employer Group Adjustment Reserve/Director-Ordered Assessments of Private Employer Members of Self-Insured Employer Groups (1) Default, decertification, or cancellati…

436-050-0195 Requirements for Changes in Self-Insured Employer Entity (1) Notification of deletion of entity or changes in entity, contact information, or ownership. If there is any change in the entity, changes in addresses, telephone numbers, and points of contact, or ownership…

436-050-0200 Self-Insured Certification Cancellation; Revocation (1) Effective period of self-insurance certification. A self-insured employer’s certification remains in effect until: (a) Revoked as provided under OAR 436-050-0150 to 436-050-0195, ORS 656.434, and ORS 656.440; or…

436-050-0205 Notice of Self-Insurer’s Personal Elections When a self-insured employer elects to provide coverage for a nonsubject worker under ORS 656.039, the employer must notify the director in writing of the election and of any cancellation of the election within 30 days of t…

436-050-0210 Notice of Self-Insurer’s or Service Company's Place of Business in State; Records Self-Insured Must Maintain (1) Oregon claims processing location required. Except as described in section (4) of this rule and OAR 436-050-0230, every self-insured employer must establi…

436-050-0220 Records Self-Insured Employer Must Maintain; Period to be Retained, Removal and Disposition (1) Records self-insured employers must maintain. Each self-insured employer is required to maintain the following records in Oregon, to make the records available at an Orego…

436-050-0230 Out-of-State Recordkeeping and Claims Processing by Self-Insured Employer; Conditions and Procedure for Permit; Revocation (1) Permission to keep records and process claims outside of Oregon. Notwithstanding OAR 436-050-0210 and 436-050-0220, with the prior approval …

436-050-0260 Qualifications of a Self-Insured Employer Group The director may certify five or more employers as a self-insured employer group if the employers, as a group, meet all the requirements of this rule. (1) Organization. The employer group must be organized as: (a) A cor…

436-050-0270 Applying for Certification as a Self-Insured Employer Group: Private Employers (1) Employers applying for certification as a self-insured employer group must submit: (a) A completed Form 1867, “Application to Become a Self-Insured Employer Group: Private Employers;” …

436-050-0280 Applying for Certification as a Self-Insured Employer Group: Governmental Subdivisions (1) Required information. Governmental subdivisions applying for certification as a self-insured employer group must submit: (a) A completed Form 1867, “Application for Self-Insure…

436-050-0290 Commencement/Termination/Cancellation of Employers with a Self-Insured Employer Group; Effect on Net Worth; Extension of Coverage; Change in Entity; Change of Address; Recordkeeping (1) Addition of new members. Prospective new members of a self-insured employer group…

436-050-0300 Self-Insured Employer Group, Common Claims Fund (1) Except for qualified self-insured employer groups approved by the director as exempt from security deposit requirements under OAR 436-050-0185, a self-insured employer group must establish and maintain, under the di…

436-050-0340 Group Self-Insurance Revocation (1) The director may revoke the certification of a self-insured employer group after giving 10 days written notice if: (a) The employer group does not comply with ORS 656.430(7) or (8), OAR 436-050-0170 to 436-050-0190, 436-050-0260, o…

436-050-0500 Assessment of Civil Penalties The director may assess a civil penalty under ORS 656.745(2) against an employer or insurer that violates ORS chapter 656, OAR 436-050, or an order of the director. Statutory/Other Authority: ORS 656.726(4) Statutes/Other Implemented: OR…

436-055-0003 Applicability and Purpose (1) Applicability. These rules apply to the certification of all workers’ compensation claims examiners on or after the effective date of these rules. (2) Purpose. The purpose of these rules is to establish standards for the certification of…

436-055-0005 Definitions Except where the context requires otherwise, the definitions under ORS 656.005 and the following apply to OAR 436-055-0008 to 436-055-0110: (1) “Claims examiner” means anyone who has primary responsibility for decision making or benefit determination in a…

436-055-0008 Administrative Review and Contested Cases (1) Requests for hearings on sanctions and civil penalties. Any party that disagrees with a proposed order, or proposed assessment of civil penalty issued by the director under these rules, may request a hearing by the Hearin…

436-055-0070 Certification of Claims Examiners (1) Claims examiner test. To become an Oregon certified claims examiner, an individual must complete a test that demonstrates the individual’s competency in claims processing activities, subject to the following: (a) The test must in…

436-055-0085 Training for Interactions with Independent Medical Examination Providers (1) Director approval of training curricula. Any training relating to interactions with independent medical examination (IME) providers must follow a curriculum that has been approved by the dir…

436-055-0100 Insurer Duties (1) Insurer’s responsibility to employ certified or qualified examiners. An insurer may only employ Oregon certified claims examiners to process claims. An Oregon certified claims examiner must have primary responsibility for all activities related to …

436-055-0110 Assessment of Civil Penalties (1) Penalties for failure to comply with statutes, rules, and orders. The director may assess a civil penalty under ORS 656.745(2) against an insurer that violates ORS chapter 656, OAR 436-055, or an order of the director. (2) Penalties …

436-060-0003 Purpose, Applicability, Forms, and Bulletins (1) Purpose. The purpose of the rules in OAR 436-060 is to prescribe uniform standards for insurers to process workers’ compensation claims under ORS chapter 656. (2) Applicability. (a) The rules are subject to the applica…

436-060-0005 Definitions Unless a term is specifically defined elsewhere in these rules or the context otherwise requires, the definitions of ORS chapter 656 are hereby incorporated by reference and made a part of these rules. For the purpose of these rules unless the context req…

436-060-0008 Administrative Review and Contested Cases (1) Request for hearing on an action concerning a worker’s right to compensation. Any party, or assigned claims agent, that disagrees with an action taken under these rules that concerns a worker’s right to compensation, or t…

436-060-0010 Employer Responsibilities (1) General. A subject employer must accept notice of a claim for workers’ compensation benefits from a worker or the worker’s attorney under ORS 656.265. (a) Form 801, "Report of Job Injury or Illness," must be readily available for workers…

436-060-0011 Insurer Reporting Requirements (1) General. The insurer must process and file claims and reports required by the director in compliance with ORS chapter 656, OAR chapter 436, and orders of the director. (a) All forms must be legible and include all information requir…

436-060-0012 Notices and Correspondence Following the Death of a Worker (1) If a worker is deceased, regardless of the cause of death, an insurer must: (a) Address all future notices and correspondence to the estate of the worker or qualified beneficiaries; (b) Provide a written …

436-060-0015 Required Notice and Information (1) Notice to worker’s attorney. If a worker is represented by an attorney, and the attorney has given written notice of representation, the insurer must provide written notice to the worker’s attorney before, or at the same time, as t…

436-060-0017 Release of Claim Documents (1) For the purpose of this rule: (a) "Documents" means the written records making up, or relating to, the worker’s claim, including but not limited to: (A) Medical records, including any correspondence to and from medical experts who provi…

436-060-0018 Nondisabling and Disabling Claim Reclassification (1) General. If the insurer changes the classification of an accepted claim, the insurer must: (a) Notify the director under OAR 436-060-0011; (b) Send the worker and the worker’s attorney, if any, a "Modified Notice …

436-060-0019 Determining and Paying the Three Day Waiting Period (1) Determining the three-day waiting period. The three-day waiting period is three consecutive calendar days, beginning with the first day the worker leaves work or loses wages as a result of the compensable injury…

436-060-0020 Payment of Temporary Total Disability Compensation (1) Employer payment of temporary disability. An employer may pay temporary disability compensation with the approval of the insurer. If the insurer approves an employer to make such payment: (a) The insurer continue…

436-060-0025 Worker’s Weekly Wage Calculation and Rate of Temporary Disability Compensation (1) Continuation of wages, insured employers. An employer may not continue to pay wages in place of temporary disability benefits. However, with the worker’s consent, the employer may pay …

436-060-0030 Payment of Temporary Partial Disability Compensation (1) Rate of temporary partial disability. The amount of temporary partial disability compensation due a worker must be determined by multiplying the worker’s rate of compensation for temporary total disability by t…

436-060-0035 Supplemental Disability for Workers with Multiple Jobs at the Time of Injury (1) For the purpose of this rule: (a) "Primary job" means the job at which the injury occurred, or the job where the worker was employed at the time of medical verification that the worker i…

436-060-0040 Payment of Permanent Partial Disability Compensation (1) General. A permanent partial disability award exceeding $6,000 may be paid monthly by the insurer. If it is paid monthly, it must be paid at 4.35 times the weekly temporary disability rate at the time of closur…

436-060-0045 Payment of Compensation During Worker Incarceration (1) General. A worker is not eligible to receive temporary disability compensation for periods of time during which the worker is incarcerated for commission of a crime. All other compensation must be provided the w…

436-060-0055 Payment of Medical Services on Nondisabling Claims; Employer/Insurer Responsibility (1) General. Notwithstanding the choice made by the employer under this rule, the employer and insurer must process nondisabling claims in accordance with all statutes and rules gover…

436-060-0060 Lump-Sum Payment of Permanent Partial Disability Awards (1) General. (a) This section applies to claims in which a Notice of Closure is issued on or after Jan. 1, 2026. (b) When the total amount of the award for permanent partial disability is $6,000 or less, the ins…

436-060-0075 Payment of Death Benefits If death results from a worker’s compensable injury or occupational disease, benefits must be paid as follows: (1) Final disposition of the body and funeral expenses. (a) The insurer must pay the cost of final disposition of the body and fun…

436-060-0095 Medical Examinations; Suspension of Compensation; and Independent Medical Examination Notice (1) General. A worker must submit to independent medical examinations reasonably requested by the insurer or the director. (a) The conditions of the examination must be consi…

436-060-0105 Suspension of Compensation for Insanitary or Injurious Practices, Refusal of Treatment or Failure to Participate in Rehabilitation; Reduction of Benefits (1) General. The director may suspend compensation by order when the worker commits insanitary or injurious acts …

436-060-0135 Injured Worker, Worker’s Attorney Responsible to Assist in Investigation; Suspension of Compensation and Notice to Worker (1) Worker’s responsibility to assist in investigation. A worker must submit to and fully cooperate with in person or telephone interviews and ot…

436-060-0137 Vocational Evaluations for Permanent Total Disability Benefits; and Suspension of Compensation (1) Requests for vocational evaluations. A worker receiving permanent total disability benefits must attend a vocational evaluation reasonably requested by the insurer or t…

436-060-0140 Acceptance or Denial of a Claim (1) Claim investigations. The insurer is required to conduct a "reasonable" investigation based on all available information in determining whether to deny a claim. (a) A reasonable investigation is whatever steps a reasonably prudent …