Oregon Administrative Code

436-120-0117 Deferral of Eligibility Evaluation (1) Deferral of eligibility evaluation. The eligibility evaluation may be deferred when all of the following circumstances exist: (a) The employer at injury has activated Preferred Worker Program benefits under OAR 436-110; (b) The …

436-120-0145 Vocational Assistance Eligibility (1) A worker whose permanent total disability benefits have been terminated by a final order is eligible for vocational assistance. (2) A worker is eligible for vocational assistance if all of the following conditions are met: (a) Th…

436-120-0147 Establishing the Adjusted Weekly Wage (1) General provisions. (a) To determine a suitable wage the insurer must first establish the adjusted weekly wage as described in this rule. (b) The insurer must calculate the adjusted weekly wage whenever determining or redeter…

436-120-0157 Determining Substantial Handicap to Employment (1) A counselor must do a substantial handicap evaluation as part of the eligibility evaluation when applicable. (2) To complete the substantial handicap evaluation the counselor must submit a report documenting the foll…

436-120-0165 End of Eligibility for Vocational Assistance (1) Reasons for ending eligibility. A worker’s eligibility for vocational assistance ends when any of the following conditions apply: (a) Based on new information that did not exist or that could not have been obtained wit…

436-120-0175 Redetermining Eligibility for Vocational Assistance (1) If the worker was previously determined ineligible for vocational assistance or the worker’s eligibility for vocational assistance ended, the insurer must redetermine eligibility within 30 days of notification o…

436-120-0177 Selection of Category of Vocational Assistance (1) The insurer must select one of the following categories of vocational assistance before referring a worker to a counselor: (a) Direct employment services, if the worker has the necessary transferable skills to obtain…

436-120-0185 Choosing a Counselor (1) Choosing a counselor. (a) The insurer and worker must agree on a counselor within 14 days of the worker being determined eligible for vocational assistance. (b) When the parties agree on a counselor, the insurer must mail the worker a NOTICE …

436-120-0187 Optional Services (1) Optional services are services provided to: (a) A worker who is not eligible for vocational assistance; or (b) A worker who is eligible for vocational assistance, in excess of the services described in these rules. (2) Optional services are prov…

436-120-0197 Direct Employment (1) Direct employment services, generally. (a) Direct employment services may include, but are not limited to: (A) Employment counseling; (B) Job search skills instruction, which teaches workers how to write resumes, research the job market, locate …

436-120-0410 Determining a Vocational Goal A counselor must determine a suitable vocational goal for the worker using one or more of the following: (1) Vocational testing. Vocational testing must be administered by an individual certified to administer the test. (2) Job analysis.…

436-120-0443 Training — General (1) Training services include but are not limited to plan development, training, monthly monitoring of training progress, and job placement services. (2) The training plan must be developed and monitored by a counselor. (3) The selection of plan ob…

436-120-0445 Training Requirements (1) Basic education. Basic education is limited to nine months unless extended by the insurer. (2) On-the-job training. (a) On-the-job training time is limited to 12 months unless extended by the insurer. (b) The insurer must reimburse the train…

436-120-0500 Training: Development and Implementation (1) Collaborative effort. A training plan should be a collaborative effort between the counselor and the worker and should include all the rights and responsibilities of the worker, the insurer, and the counselor. (2) Review o…

436-120-0510 Training Plan Support (1) Considerations in training plan. The worker and counselor must work together to develop an appropriate training plan that considers the worker’s: (a) Transferable skills; (b) Physical and mental capacities and limitations; (c) Vocational int…

436-120-0511 Limited Training (1) Eligibility. A worker who is not authorized to work in the United States is only eligible for limited training. The worker must meet all eligibility requirements under OAR 436-120-0145. (2) Limited training plan requirements and benefits. (a) A l…

436-120-0520 Responsibilities of the Worker and the Counselor (1) Worker responsibilities. The worker is responsible for all of the following in a training plan: (a) Actively participate in all aspects of the plan; (b) Maintain regular contact with the counselor throughout plan d…

436-120-0523 Re-evaluating a Training Plan (1) Reasons to re-evaluate a plan. The insurer must re-evaluate a training plan and modify or replace the plan when appropriate to ensure the worker’s success, when: (a) A change occurs in the worker’s limitations that may make the train…

436-120-0527 Ending a Training Plan (1) Reasons to end training. Training ends when: (a) The worker has successfully completed training; (b) The worker’s eligibility for vocational assistance has ended under OAR 436-120-0165; (c) The worker is not actively engaged in the training…

436-120-0530 Director Review of Return-to-Work Plan The director may review return-to-work plans and supporting information. If the director finds a return-to-work plan or its supporting information does not conform to these rules: (1) The director will notify the insurer and pro…

436-120-0700 Direct Worker Purchases (1) Purchases, generally. (a) The insurer must provide the direct worker purchase categories listed in OAR 436-120-0710 as necessary for the worker’s participation in vocational assistance and to meet the requirements of a suitable job. (b) Th…

436-120-0710 Direct Worker Purchases: Categories The insurer must provide the direct worker purchases listed in this rule if necessary for the worker to participate in vocational assistance or to meet the requirements of a suitable job. The insurer may not require the worker to s…

436-120-0720 Fee Schedule (1) The director has established the fee schedule in section (3) of this rule for professional costs and direct worker purchases. The schedule sets maximum spending limits per claim opening for each category; however, the insurer may spend more than the …

436-120-0755 Reimbursement from the Workers’ Benefit Fund (1) Reimbursement. The director will reimburse the insurer for costs associated with providing vocational benefits when: (a) The director issues an order overturning the insurer’s denial of vocational benefits; and (b) The…

436-120-0800 Registration of Providers (1) A provider may not provide vocational assistance services unless the provider is first registered by the director under this rule. (2) A provider must submit an application, Form 2814, “Vocational Assistance Certification Program Registr…

436-120-0810 Certification and Classification of Provider Staff (a) Individuals determining workers’ eligibility and providing vocational assistance must be certified by the director and on the staff of a provider. (b) An applicant for certification must submit Form 1880, “Vocati…

436-120-0820 Renewal of Certification (1) Required documentation. A certified individual must renew their certification every five years by submitting Form 1880, “Vocational Assistance Certification Program Individual Certification under OAR 436-120,” and the following documentat…

436-120-0840 Professional Standards for Providers and Counselors (1) Providers and counselors must: (a) Determine eligibility and provide assistance in an objective manner not subject to any conditions other than those prescribed in these rules; (b) Fully inform the worker of the…

436-120-0900 Audits, Penalties and Sanctions (1) Insurers and employers at injury must fully participate in any department audit, periodic program review, investigation, or review, and provide records and other information as requested. (2) If the director finds the insurer or em…

436-120-0915 Sanctions of Providers and Counselors (1) Providers and counselors must fully participate in any department audit, periodic program review, investigation, or review, and provide records and other information as requested. (2) If the director finds any provider or cou…

436-140-0001 Authority for Rules These rules are promulgated under the director's authority pursuant to ORS 656.726(4) and 656.174. Statutory/Other Authority: ORS 656.726(4) & 656.174 Statutes/Other Implemented: ORS 656.170, 656.172 & 656.174 History: WCD 10-2000, f. 12-11-00, ce…

436-140-0002 Purpose The purpose of these rules is to implement ORS 656.170 and 656.172, and to establish and provide procedures and requirements for the administration and enforcement of programs entered into under ORS 656.170 and 656.172. Statutory/Other Authority: ORS 656.726(…

436-140-0003 Applicability of Rules (1) These rules shall be applicable on their effective date and thereafter to carry out the provisions of ORS 656.170 and 656.172. (2) Notwithstanding sections 2 and 3, chapter 841, Oregon Laws 1999 (ORS 656.170 and 656.172), prior to January 1…

436-140-0005 Definitions For the purpose of these rules, unless the context requires otherwise: (1) "Alternative dispute resolution system" means a process that exists outside the normal Workers' Compensation system to settle disputes arising from a workers' compensation claim. (…

436-140-0006 Administration of Rules Any orders issued by the division in carrying out the director's authority under ORS Chapter 656 and these rules are considered orders of the director. Statutory/Other Authority: ORS 656.726(4) & 656.174 Statutes/Other Implemented: ORS 656.170…

436-140-0008 Administrative Review (1) If the director determines that a proposed construction carve-out program is not eligible, the director will issue a notice to the employer or collective bargaining representative. (a) Under ORS 656.704(2), if the employer or collective barg…

436-140-0010 Qualifying (1) An employer, group of employers or collective bargaining representative may not establish or continue to participate in a construction carve-out program under ORS 656.170 until the proposed program has been approved by the director and the director has…

436-140-0020 Alternative Dispute Resolution (1) A construction carve-out program may establish and operate an alternative dispute resolution system governing disputes between employees, employers, and their insurers. Any such system may include, but not be limited to: (a) Limitat…

436-140-0030 Medical Services (1) A construction carve-out program may establish a list of medical service providers that the parties agree is the exclusive source of all medical treatment provided under ORS Chapter 656. (2) A construction carve-out program shall establish a meth…

436-140-0040 Compensation Benefit amounts that exceed the statutory rates under ORS Chapter 656 shall not be subject to reimbursement from the Workers’ Benefit Fund. Statutory/Other Authority: ORS 656.726(4) & 656.174 Statutes/Other Implemented: ORS 656.170, 656.172 & 656.174 His…

436-140-0045 Multiple Claims; Expiration or Termination of Collective Bargaining Agreement; Responsibility (1) Disputes involving multiple claims when one or more of the claims are not subject to the collective bargaining agreement shall be resolved pursuant to ORS 656.307, 656.3…

436-140-0050 Duties and Responsibilities of Employer (1) An employer or group of employers that participates in a construction carve-out program shall comply with coverage requirements under ORS 656.017. (2) The participating employer or group of employers shall report all claims…

436-140-0060 Insurer Duties and Responsibilities (1) An insurer who contracts to provide coverage to an employer or group of employers under a construction carve-out program shall timely report claims made under the construction carve-out program to the director. (2) The insurer …

436-140-0070 Reporting Requirements (1) In order to ensure the construction carve-out program continues to comply with the eligibility requirements of these rules, the employer, or group of employers, and collective bargaining representative shall: (a) Upon renegotiation of the c…

436-140-0090 Suspension or Revocation (1) Prior eligibility of a construction carve-out program may be suspended or revoked if any of the following occur: (a) The director finds a serious danger to the public health or safety; (b) The construction carve-out program fails to provi…

436-140-0100 Monitoring/Auditing (1) The director may conduct periodic audits of construction carve-out programs as necessary to ensure compliance with ORS 656.170, 656.172, and these rules. (2) All records of a construction carve-out program shall be produced upon request of the…

436-140-0120 Sanctions and Civil Penalties; Rule Violations (1) The director may assess a civil penalty under ORS 656.745 against an employer, group of employers, or insurer that violates ORS chapter 656, OAR 436-140, or an order of the director. (2) Any complaint alleging a viol…

436-140-0130 Service of Orders (1) An order or notice of the director shall include a notice of the party's appeal rights and shall be served upon the party when the director does any of the following: (a) Notifies an applicant that a program is not approved pursuant to OAR 436-1…

436-150-0001 Authority for Rules These rules are promulgated under the director’s authority contained in ORS 656.726(4) and ORS 656.445. Statutory/Other Authority: ORS 656.445 & 656.726(4) Statutes/Other Implemented: ORS 656.445 History: WCD 3-2021, minor correction filed 04/07/2…

436-150-0002 Purpose The purpose of these rules is to establish guidelines for regulating, managing, and disbursing moneys in the Workers’ Benefit Fund for the purpose of advancing funds to injured workers who have not received payment of compensation due from an insurer in defau…