Oregon Administrative Code

436-100-0003 Applicability of Rules (1) These rules are effective January 1, 2016, to carry out the provisions of ORS 656.209 and 656.727. (2) These rules apply to: (a) Those workers receiving awards for permanent total disability and eligible for and receiving federal social sec…

436-100-0005 Definitions (1) “Authorization” means an order issued by the Workers’ Compensation Division directing the paying agent to offset the worker’s permanent total disability benefits by the amount specified in the order. (2) “Beneficiary” means an injured worker, and the …

436-100-0006 Administration of Rules In administration of these rules, orders of the Workers’ Compensation Division are deemed orders of the director. Statutory/Other Authority: ORS 656.726 Statutes/Other Implemented: ORS 656.209 & 656.726 History: WCD 7-2015, f. 10-12-15, cert. …

436-100-0008 Administrative Review (1) Any worker aggrieved by any offset authorization of the division may apply to the Workers’ Compensation Division for a reconsideration of that authorization before requesting a hearing. (2) Any party aggrieved may request a hearing under ORS…

436-100-0010 Criteria for Eligibility (1) Permanent total disability benefits must be offset by the workers’ social security disability benefits. However, the total combined benefit, permanent total disability benefits plus social security disability benefits, must not be offset …

436-100-0020 Requirements of Workers (1) Workers entitled to receive permanent total disability benefits must make application for federal social security disability benefits. (2) Workers and eligible beneficiaries must, upon department request, execute a release form authorizing…

436-100-0030 Authorization of Offset; Effective Date (1) Authorization issued by the department will be directed to the paying agent with a copy to the injured worker. (2) A paying agent making payment of permanent total disability benefits will be entitled to social security dis…

436-100-0040 Sanctions Against Worker for Failure to Cooperate with the Department (1) Any worker entitled to receive permanent total disability benefits who fails to comply with these rules will be subject to suspension of benefits until the worker has complied. (2) If a worker …

436-105-0003 Purpose and Applicability (1) Purpose. (a) The rules in OAR 436-105 explain who qualifies for and how to request assistance and reimbursements from the Employer-at-Injury Program. (b) The Employer-at-Injury Program encourages the early return to work of injured worke…

436-105-0004 Submitting Documents or Information; Calculating Time (1) Documents submitted to the division may be: (a) Mailed to the division’s mailing address with sufficient postage and placed in the custody of the U.S. Postal Service; (b) Hand delivered to the division’s Salem…

436-105-0005 Definitions Unless a term is defined in these rules or the context otherwise requires, the definitions of ORS chapter 656 are incorporated by reference and made part of these rules. (1) "Client" means a person to whom workers are provided under contract and for a fee…

436-105-0006 Workers’ Benefit Fund (1) The department maintains the financial integrity of the Workers’ Benefit Fund under ORS 656.605 and all reimbursement is subject to the availability of funds. If the funds are too low for all reimbursements, the director has the final author…

436-105-0008 Denial of Reimbursement, Reconsideration, Director’s Review (1) Denial of reimbursement. The director will deny any reimbursement for Employer-at-Injury Program assistance it finds violates these rules. The director has the discretion to deny any reimbursement of Emp…

436-105-0500 Insurer Participation in the Employer-at-Injury Program (1) Insurer participation. An insurer must be an active participant in providing re-employment assistance under the Employer-at-Injury Program with the employer’s consent. Participation includes issuing notices …

436-105-0510 Employer Eligibility To be eligible for the Employer-at-Injury Program, an employer must: (1) Maintain Oregon workers’ compensation insurance coverage; (2) Be the employer at injury; and (3) Employ an eligible worker. Statutory/Other Authority: ORS 656.622 & 656.726(…

436-105-0511 Worker Eligibility To be eligible for the Employer-at-Injury Program, a worker must have an Oregon workers’ compensation injury or occupational disease claim at the time of the Employer-at-Injury Program. Adults in custody eligible for benefits under ORS 655.505 to 6…

436-105-0512 End of Eligibility Employer-at-Injury Program eligibility ends at the earliest of any of the following: (1) When the worker or employer no longer meets the eligibility provisions stated in OAR 436-105-0510 and 436-105-0511; (2) When the worker's claim is closed or de…

436-105-0520 Assistance Available from the Employer-at-Injury Program (1) General provisions. (a) The Employer-at-Injury Program may be used only once per worker per claim opening or request for reopening. If a nondisabling claim becomes a disabling claim after one year from the …

436-105-0530 Employer-at-Injury Program Procedures for Concurrent Injuries (1) A worker is eligible for only one Employer-at-Injury Program at a time. (2) When a worker in an Employer-at-Injury Program incurs a new compensable injury, transitional work for the first Employer-at-I…

436-105-0540 Employer-at-Injury Program Reimbursement Procedures The following provisions apply when the insurer requests reimbursement from the division under the Employer-at-Injury Program: (1) Reimbursable benefits. Reimbursements may include wage subsidy, Employer-at-Injury P…

436-105-0550 Audits (1) Insurers and employers are subject to periodic program and fiscal audits by the director. All reimbursements are subject to subsequent audits, and may be disallowed on any of the grounds set forth in these rules. Disallowed reimbursements may be recovered …

436-105-0560 Sanctions (1) Penalties for false statement or report or misrepresentation. Any person who knowingly makes a false statement or misrepresentation to the director or an employee of the director for the purpose of obtaining any benefits or reimbursement from the Employ…

436-110-0003 Purpose and Applicability of These Rules (1) Purpose. (a) The rules in OAR 436-110 explain who qualifies for and how to request assistance and reimbursements from the Preferred Worker Program. (b) The Preferred Worker Program encourages the re-employment of workers w…

436-110-0005 Definitions For the purpose of these rules, unless the context requires otherwise: (1) “Client” means a person to whom workers are provided under contract and for a fee on a temporary or leased basis. (2) “Date of eligibility” means the date the director determines a…

436-110-0006 Workers’ Benefit Fund (1) The department maintains the financial integrity of the fund and all reimbursement is subject to the availability of funds. If the funds are too low for all reimbursements, the director has final authority to determine how the funds will be …

436-110-0007 Denial of Requests, Reconsideration, Director’s Review (1) Denial of requests for assistance. The director will deny any request for Preferred Worker Program assistance it finds violates these rules. The director has the discretion to deny a request it determines is …

436-110-0150 Pilot Projects (1) The director may develop one or more pilot projects to test alternatives to the current system of re-employing preferred workers. (2) Notwithstanding any other provision of these rules, the director and others participating in pilot projects are bo…

436-110-0240 Insurer Participation in the Preferred Worker Program (1) Insurer participation. The insurer of the employer at injury must be an active participant in providing re-employment assistance under the Preferred Worker Program. (2) Notice of assistance available. The insu…

436-110-0290 Employer at Injury Use of the Preferred Worker Program The conditions for the employer at injury to activate the Preferred Worker Program are: (1) Time frame. (a) For Preferred Worker Program assistance other than premium exemption, the employer at injury must reques…

436-110-0310 Eligibility and End of Eligibility for the Preferred Worker Program (1) Employer eligibility. The eligibility requirements for the Preferred Worker Program for an employer, including the employer at injury, except as provided in OAR 436-110-0345(1) for employment pur…

436-110-0320 Preferred Worker Card (1) The division will issue a preferred worker card to eligible workers. The card identifies a worker as being eligible to offer an employer Preferred Worker Program assistance. (2) The division will issue a preferred worker card: (a) Automatica…

436-110-0325 Premium Exemption (1) General provisions. (a) The purpose of premium exemption is to provide an incentive for employers to hire and retain preferred workers. (b) Premium exemption releases an employer from paying workers’ compensation insurance premiums and premium a…

436-110-0330 Claim Cost Reimbursement (1) General provisions. Claim cost reimbursement provides reimbursement to the insurer for claim costs when a preferred worker files a claim for injury or occupational disease while employed under premium exemption as follows: (a) Reimburseme…

436-110-0335 Wage Subsidy General Provisions Wage subsidy provides an employer with partial reimbursement of a worker’s gross wages for a specified period. Wage subsidy benefits are subject to the following conditions: (1) Wage subsidy agreement form. A completed Form 2190, “Pref…

436-110-0336 Wage Subsidy — Employer at Injury Activated Wage subsidy may be activated by the employer at injury as follows: (1) The job must be within the worker’s injury-caused restrictions. If a worksite modification is necessary to meet this requirement, wage subsidy will be …

436-110-0337 Wage Subsidy — Worker Activated A wage subsidy may be requested by a worker as follows: (1) The worker and employer must complete and sign Form 2190, “Preferred Worker Wage Subsidy Agreement,” and submit it to the division within three years of the date of hire. (2) …

436-110-0345 Employment Purchases and Placement Services (1) General provisions. An employment purchase is assistance necessary for a worker to find, accept, or retain employment in Oregon. Purchases may be provided for a job with a nonsubject employer in Oregon, as long as that …

436-110-0346 Employment Purchases – Employer at Injury Activated Conditions for use of employment purchases by the employer at injury are: (1) The employer must submit to the division a completed Form 2350, “Preferred Worker Employment Purchase Agreement,” listing items that are …

436-110-0347 Employment Purchases — Worker Activated (1) Conditions for use of employment purchases by a worker are: (a) Except for moving expenses, placement assistance, and miscellaneous purchases needed to find a job, the worker and employer must submit a completed employment …

436-110-0350 Worksite Modification — General Provisions (1) Worksite modification defined. (a) Worksite modification means altering a worksite by purchasing, modifying, or supplementing equipment, or changing the work process, to enable a worker to work within the restrictions ca…

436-110-0351 Worksite Modification — Employer at Injury Activated Conditions for use of worksite modifications by the employer at injury are as follows: (1) The employer at injury may use worksite modification assistance once for a job provided for its injured worker, or a second…

436-110-0352 Worksite Modification — Worker Activated Conditions for use of worksite modification assistance by the worker are as follows: (1) Modifications may be provided for requests received within three years from the date of hire; (2) A worker may use worksite modification …

436-110-0850 Audits (1) Insurers and employers are subject to periodic program and fiscal audits by the director. All reimbursements are subject to subsequent audits, and may be disallowed on any of the grounds set forth in these rules. Disallowed reimbursements may be recovered …

436-110-0900 Sanctions (1) Penalties for false statement or report or misrepresentation. Any person who knowingly makes any false statement or representation to the director or an employee of the director for the purpose of obtaining any benefit or payment from the Preferred Work…

436-120-0003 Purpose and Applicability of These Rules (1) Purpose of these rules. The purpose of the rules in OAR 436-120 is to: (a) Prescribe uniform standards for determining eligibility, delivery, and payment for vocational services to injured workers; (b) Prescribe procedures…

436-120-0005 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 re…

436-120-0008 Administrative Review and Hearings (1) Administrative review. (a) A worker wanting review of any vocational eligibility evaluation or vocational assistance matter must request administrative review by the director. (b) Under ORS 656.340(11) and OAR 436-120-0185 when …

436-120-0009 Submitting Documents or Information, Calculating Time, Availability of Forms (1) Submitting documents or information, calculating time. (a) Documents or information required under these rules to be submitted to the division may be: (A) Mailed to the following address…

436-120-0012 General Requirements For Notices and Warnings (1) Insurer or provider may issue. The insurer is responsible for mailing all notices and warnings required by these rules but may delegate that responsibility to the provider that is providing vocational assistance to th…

436-120-0115 Vocational Eligibility Evaluation (1) Purpose of eligibility evaluation. An eligibility evaluation is done to determine whether the worker is or is not eligible for vocational assistance. (2) When an eligibility evaluation is not required. An eligibility evaluation i…