reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 85 - PREMIUM ASSESSMENT › Section 436-085-0030 - Premium Assessment; Manner and Intervals for Payments; Experience Rating Modification Factors: Self-Insured Employers and Self-Insured Employer Groups

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As used in
			 this rule, the term "self-insured employers" includes self-insured employer
			 groups.
(2) Self-insured employers
			 must report and pay premium assessments using a completed Form 900, "Payroll
			 and Assessment Quarterly Report - Retrospective rating plan," or Form 937,
			 "Payroll and Assessment Quarterly Report - Normal plan." The report must be
			 certified to be true and accurate by an authorized representative of the
			 self-insured employer.
(3) For
			 premium assessment purposes, the premium of all self-insured employers will be
			 calculated using rates developed by the director. The rates for each fiscal
			 year will be developed by applying a multiplier determined by the director to
			 the manual rates published by the National Council on Compensation Insurance
			 effective and published by April 1 of the previous fiscal year.
(a) The multiplier will be no greater than
			 the average of all loss cost multipliers filed with the Division of Financial
			 Regulation effective and filed by April 1 of the previous fiscal year, weighted
			 by market share.
(b) For the
			 purpose of determining the multiplier, the director may consider factors
			 including, but not limited to, the net difference between the maximum
			 multiplier possible under subsection (a) of this section and the modifier used
			 in the preceding fiscal year.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 85 - PREMIUM ASSESSMENT › Section 436-085-0035 - Audits

Current through Register Vol. 63, No. 7, July 1, 2024
The director will monitor and conduct periodic audits of
				insurers, self-insured employers, and self-insured employer groups to ensure
				compliance with these rules.
Statutory/Other Authority: ORS
				  656.726
Statutes/Other Implemented: ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 85 - PREMIUM ASSESSMENT › Section 436-085-0060 - Assessment of Civil Penalties

Current through Register Vol. 63, No. 7, July 1, 2024
The director may assess a civil penalty under ORS
				656.745(2)
				against an insurer, self-insured employer, or self-insured employer group that
				violates ORS chapter 656, OAR 436-085, or an order of the director.
Statutory/Other Authority: ORS
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.745
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0001 - Authority for Rules

Current through Register Vol. 63, No. 7, July 1, 2024
These rules are promulgated under the Director's author?ity
				contained in ORS 656.726 and
				656.727.
Stat. Auth.: ORS 656
Stats. Implemented: ORS
				  656.209,
				  656.726 & ORS
				  656.727
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0002 - Purpose of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of these rules is to establish requirements and
				procedures for offsetting permanent total disability benefits against social
				security disability benefits.
Stat. Auth.: ORS
				  656.209 &
				  656.727
Stats. Implemented: ORS
				  656.209
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0003 - Applicability of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
(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
			 security disability benefits; and
(b) Injured workers whose period of
			 disability under the Social Security Administration began on or after June 1,
			 1965.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(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 spouse, child or dependent of a
			 worker, who is entitled to receive payments under ORS
			 656.001 through
			 656.794.
(3) "Department" means the Department of
			 Consumer and Business Services.
(4) "Director" means the director of the
			 Department of Consumer and Business Services or the director's designee.
(5) "Division" means the Workers'
			 Compensation Division.
(6)
			 "Federal Disability Benefit Limitation" means the amount determined under 42
			 USC 224(a) and Social Security Administration rules.
(7) "Offset" means a reduction of permanent
			 total disability benefits based on the amount of federal social security
			 disability benefits received by a worker.
(8) "Paying agency" or "paying agent" means
			 the self-insured employer or insurer paying benefits to the worker or
			 beneficiaries.
(9) "Performance
			 Section" means the Performance Section of the Workers' Compensation Division.
(10) "Permanent total disability
			 benefits" means compensation to an injured worker awarded permanent total
			 disability compensation under ORS
			 656.206.
(11) "Worker" means any worker receiving
			 permanent total disability benefits.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.209
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0006 - Administration of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
In administration of these rules, orders of the Workers'
				Compensation Division are deemed orders of the director.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.209 &
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0008 - Administrative Review

Current through Register Vol. 63, No. 7, July 1, 2024
(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
			 656.283.
Stat. Auth.: ORS
				  656.726 &
				  656.727
Stats. Implemented: ORS
				  656.209
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0010 - Criteria for Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
(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 to an amount less than the greater of:
(a) The amount the worker would have received
			 under ORS chapter 656; or
(b) The
			 Federal Disability Benefit Limitation.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0020 - Requirements of Workers

Current through Register Vol. 63, No. 7, July 1, 2024
(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 the Social Security
			 Administration to make disclosure to the department of such information
			 regarding the injured workers as will enable the department to carry out the
			 provisions of ORS 656.209 and these rules.
(3) Whenever there is a change in
			 the federal social security beneficiary eligibility, the worker must notify the
			 Performance Section.
(4) Upon
			 request of the department, the worker may be required at any time to furnish
			 additional information regarding social security disability benefits.
Stat. Auth.: ORS
				  656.209 &
				  656.727
Stats. Implemented: ORS
				  656.209 &
				  656.727
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0030 - Authorization of Offset; Effective Date

Current through Register Vol. 63, No. 7, July 1, 2024
(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
			 disability offset only as authorized by the department.
(3) The department will review the social
			 security offset calculation when notified of a change in the status of a worker
			 subject to social security offset. An amended authorization will be issued, if
			 necessary.
(4) Whenever there is a
			 change in eligibility status of the worker or any one of the worker's
			 beneficiaries receiving benefits for permanent total disability subject to
			 offset, the paying agent must notify the Performance Section.
(5) The paying agent must, immediately upon
			 the death of a worker, terminate payment of previously authorized permanent
			 total disability benefits offset and begin payment of other compensation due
			 under ORS Chapter 656, if any.
(6)
			 The effective date of offset must be the effective date established in the
			 authorization.
Stat. Auth.: ORS
				  656.209 &
				  656.727
Stats. Implemented: ORS
				  656.209 &
				  656.727
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 100 - WORKERS' COMPENSATION BENEFITS OFFSET › Section 436-100-0040 - Sanctions Against Worker for Failure to Cooperate with the Department

Current through Register Vol. 63, No. 7, July 1, 2024
(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 fails to
			 comply with these rules, the director will make a written demand upon the
			 worker by personal service or registered mail. If the worker fails to comply
			 within 20 days of receipt of the demand, the director may authorize suspension
			 of benefits until the worker complies.
(3) An order of suspension of benefits will
			 continue in force from the date issued until the date the worker actually
			 complies with these rules.
(4) No
			 compensation will become due or be payable during a period of suspension of
			 benefits.
Stat. Auth.: ORS
				  656.209 &
				  656.727
Stats. Implemented: ORS
				  656.209 &
				  656.727
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0001 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.622 & ORS
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0002 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.622 &
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0003 - Purpose and Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
(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 workers by providing incentives from the
			 Workers' Benefit Fund to employers.
(c) The Employer-at-Injury Program is
			 activated by the employer and administered by the insurer.
(d) The purpose of Employer-at-Injury Program
			 assistance is to:
(A) Enable the worker to
			 perform transitional work within the worker's limitations that resulted in the
			 worker's eligibility for the Employer-at-Injury Program;
(B) Prevent a worsening of the worker's
			 compensable injury or occupational disease; or
(C) If the claim has not been accepted or
			 denied, prevent a worsening of the claimed workers' compensation injury or
			 occupational disease.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0004 - Submitting Documents or Information; Calculating Time

Current through Register Vol. 63, No. 7, July 1, 2024
(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 office;
(c) Faxed,
			 if the document transmitted indicates it has been delivered by fax, is sent to
			 the correct fax number, and indicates the date it was sent; or
(d) Sent by any other method authorized by
			 the director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
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 on a temporary or leased
			 basis.
(2)
"Director"
means the director of the Department of Consumer and Business Services, or the
			 director's designee.
(3)
"Division"
means the Workers' Compensation Division of the
			 Department of Consumer and Business Services.
(4)
"Employer at injury"
means
			 the organization that employed the worker when the worker:
(a) Sustained the injury or occupational
			 disease;
(b) Made the claim for
			 aggravation; or
(c) Requested an
			 Own Motion opening under ORS
			 656.278.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0006 - Workers' Benefit Fund

Current through Register Vol. 63, No. 7, July 1, 2024
(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 authority to determine how the funds
			 will be disbursed.
(2) Moneys in
			 the Workers' Benefit Fund may not be used to provide concurrent benefits under
			 the Employer-at-Injury Program and the Preferred Worker Program under OAR
			 436-110 for the same worker for the same period of time, with the exception of
			 claims costs reimbursed under OAR
			 436-110-0330.
(3) The director may use moneys from the
			 Workers' Benefit Fund for activities to provide information about and encourage
			 the re-employment of injured workers. A maximum of $250,000 may be used in a
			 fiscal year, July 1 to June 30. The director must approve all expenditures.
			 Activities include, but are not limited to:
(a) Advertisements and promotion of
			 re-employment assistance programs and associated production costs;
			 and
(b) Public re-employment
			 assistance program conferences and workshops.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0008 - Denial of Reimbursement, Reconsideration, Director's Review

Current through Register Vol. 63, No. 7, July 1, 2024
(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 Employer-at-Injury
			 Program assistance it determines is not reasonable, practical, or feasible, or
			 considers an abuse of the program.
(2)
Reconsideration.
(a) Parties directly affected by an
			 Employer-at-Injury Program decision may request reconsideration by submitting a
			 written request to the division no later than 60 days after the date the
			 decision was issued.
(b) The
			 request must specify the reasons why reconsideration is being requested and may
			 include additional documentation.
(c) The director will reconsider the decision
			 and will notify all directly affected parties of its decision upon
			 reconsideration.
(d)
			 Reconsideration must precede a director's review under section (3) of this
			 rule.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0500 - Insurer Participation in the Employer-at-Injury Program

Current through Register Vol. 63, No. 7, July 1, 2024
(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 of the available
			 assistance and administering the Employer-at-Injury Program as specified in
			 these rules.
(2)
Notice of
			 assistance available.
The insurer must notify the worker and employer at
			 injury in writing of the assistance available from the Employer-at-Injury
			 Program. A notice must be issued:
(a) Upon
			 acceptance or reopening of a claim; and
(b) Within five days of a worker's first
			 release for work after claim opening unless the release is for regular
			 work.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0510 - Employer Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS
				  656.622,
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0511 - Worker Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
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
				655.555 and OAR 125-160 are not
				eligible for the Employer-at-Injury Program.
Statutory/Other Authority: ORS
				  656.622 &
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0512 - End of Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
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
			 denied;
(3) When sanctions issued
			 under OAR 436-105-0560 preclude
			 eligibility;
(4) When the insurer
			 ends the Employer-at-Injury Program at any time while the worker's claim is
			 open;
(5) Two years after the
			 original date of acceptance of a nondisabling claim; or
(6) When Preferred Worker Program benefits
			 under OAR 436-110 begin for the same claim during the same claim opening,
			 including premium exemption but excluding claims costs reimbursed under OAR
			 436-110-0330.
Statutory/Other Authority: ORS
				  656.622 &
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0520 - Assistance Available from the Employer-at-Injury Program

Current through Register Vol. 63, No. 7, July 1, 2024
(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 date of
			 acceptance, the disabling claim is considered a new opening and the
			 Employer-at-Injury Program may be used again.
(b) Assistance available includes wage
			 subsidy, worksite modification, and purchases.
(c) Any modification and other purchases must
			 be ordered before the end of the Employer-at-Injury Program.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0530 - Employer-at-Injury Program Procedures for Concurrent Injuries

Current through Register Vol. 63, No. 7, July 1, 2024
(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-Injury Program is considered regular work for purposes of the
			 second Employer-at-Injury Program.
(3) If the new injury makes the first
			 Employer-at-Injury Program unsuitable, the worker may be eligible for a second
			 Employer-at-Injury Program under the new injury.
(4) When the worker is no longer eligible for
			 the second Employer-at-Injury Program, the first Employer-at-Injury Program may
			 be resumed if the employer and worker still meet eligibility criteria under
			 that claim.
Stat. Auth.: ORS
				  656.622 &
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0540 - Employer-at-Injury Program Reimbursement Procedures

Current through Register Vol. 63, No. 7, July 1, 2024
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 Program purchases,
			 and worksite modification.
(2)
Program administrative costs.
The insurer is entitled to a program
			 administrative cost of $120 for the first approved reimbursement request for an
			 Employer-at-Injury Program. Subsequent requests for reimbursement, including
			 amended requests, for the same Employer-at-Injury Program are not entitled to
			 additional program administrative costs.
(3)
Minimum reimbursement
			 request.
The first reimbursement request for an Employer-at-Injury
			 Program must be for a minimum of $100. Subsequent requests, including amended
			 requests, may be for less than $100.
(4)
Required documentation.
The
			 insurer must have all documentation required for reimbursement in its
			 possession at the time reimbursement is requested. The insurer must stamp or
			 display evidence of the initial date of receipt on each document as required
			 under OAR 436-060-0017(2).
(5)
Timeframe for submitting a
			 reimbursement request and required documentation.
(a) The employer must submit all required
			 documentation for reimbursement to the insurer within one year from the end of
			 the Employer-at-Injury Program.
(b)
			 The insurer must submit to the division within one year and 30 days from the
			 end of the Employer-at-Injury Program:
(A)
			 Form 2360, "Employer-at-Injury Program (EAIP) Reimbursement Request Form." The
			 form is published with Bulletin 260, both of which are available on the
			 division's website at wcd.oregon.gov; and
(B) For EAIP purchases and worksite
			 modifications:
(i) Documentation of the
			 transitional work that includes the start date, wage and hours, and a
			 description of the job duties;
(ii)
			 The corresponding medical release that the transitional work was based
			 on;
(iii) A legible copy of proof
			 of any purchase showing the item was ordered during the Employer-at-Injury
			 Program period and proof of payment for the item; and
(iv) Documentation of the insurer's approval
			 of any worksite modifications.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0550 - Audits

Current through Register Vol. 63, No. 7, July 1, 2024
(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 by the director directly or from future reimbursements by way of
			 offset. If the director finds upon audit that procedures that led to disallowed
			 reimbursements are still being used, the director may withhold further
			 reimbursements until corrections satisfactory to the director are made.
(2) An audit may include but not
			 be limited to a review of the records required in OAR
			 436-105-0500(6).
(3) When there is conflicting
			 documentation, the director will use a preponderance of evidence standard to
			 decide eligibility for reimbursement. If there is no clear preponderance,
			 reimbursement will be denied.
(4)
			 The director reserves the right to visit the worksite to determine compliance
			 with these rules.
Stat. Auth.: ORS
				  656.455,
				  656.622,
				  656.726(4)
				  & 731.475
Stats. Implemented: ORS
				  656.455,
				  656.622 &
				  731.475
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 105 - EMPLOYER-AT-INJURY PROGRAM › Section 436-105-0560 - Sanctions

Current through Register Vol. 63, No. 7, July 1, 2024
(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 Employer-at-Injury Program, or who knowingly
			 misrepresents the amount of a payroll or knowingly submits a false payroll
			 report, is subject to penalties under ORS
			 656.990.
(2)
Reasons for sanction.
Reasons for the director to sanction an insurer, self-insured employer,
			 employer, or their representative include, but are not limited to:
(a) Misrepresenting information in order to
			 receive Employer-at-Injury Program assistance;
(b) Making a serious error or omission that
			 resulted in the director approving reimbursement in error;
(c) Failing to respond to employer requests
			 for assistance or failing to administer Employer-at-Injury Program assistance;
			 or
(d) Failing to comply with any
			 condition in these rules.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0001 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.622 & ORS
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0002 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.622 &
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0003 - Purpose and Applicability of These Rules

Current through Register Vol. 63, No. 7, July 1, 2024
(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 whose
			 on-the-job injuries result in disability that may be a substantial obstacle to
			 employment by providing assistance from the Workers' Benefit Fund to eligible
			 injured workers and to the employers who employ them.
(c) The Preferred Worker Program is activated
			 by the worker or by the employer at injury.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
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 worker is a preferred
			 worker.
(3) "Date of hire" means
			 the date the worker starts work as a preferred worker.
(4) "Department" means the Department of
			 Consumer and Business Services.
(5) "Director" means the director of the
			 Department of Consumer and Business Services, or the director's delegate for
			 the matter.
(6) "Disability" means
			 a permanent physical or mental restriction or limitation caused by an accepted
			 disabling Oregon workers' compensation claim that limits the worker from
			 performing one or more of the worker's regular job duties.
(7) "Division" means the Workers'
			 Compensation Division of the Department of Consumer and Business Services.
(8) "Employer at injury" means the
			 organization that employed the worker when the worker sustained the injury or
			 occupational disease.
(9)
			 "Exceptional disability" means a disability equal to or greater than the
			 complete loss, or loss of use, of both legs or a brain injury that results in
			 impairment equal to or greater than a Class 3 under OAR
			 436-035-0390(10).
			 The director determines whether a worker has an exceptional disability based
			 upon the combined effects of all of the worker's Oregon compensable injuries
			 resulting in permanent disability.
(10) "Fund" means the Workers' Benefit Fund
			 under ORS 656.605.
(11) "Insurer" means the insurance company or
			 self-insured employer responsible for the workers' compensation claim.
(12) "Premium" means the monies
			 paid to an insurer for the purpose of purchasing workers' compensation
			 insurance.
(13) "Premium
			 assessment" means monies due the director under ORS
			 656.612 and
			 656.614.
(14) "Regular work" means the job the worker
			 held at the time of the injury, claim for aggravation, or Own Motion opening
			 under ORS 656.278.
Stat. Auth.: ORS
				  656.622 &
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0006 - Workers' Benefit Fund

Current through Register Vol. 63, No. 7, July 1, 2024
(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 disbursed.
(2) Monies in
			 the Workers' Benefit Fund may not be used to provide concurrent benefits under
			 the Preferred Worker Program and the Employer-at-Injury Program under OAR
			 436-105 for the same worker for the same period of time, with the exception of
			 claims costs reimbursed under OAR
			 436-110-0330.
(3) The director may use monies from the fund
			 for activities to provide information about and encourage re-employment of
			 injured workers. A maximum of $250,000 may be used in a fiscal year, July 1 to
			 June 30. The director must approve all expenditures. Activities include, but
			 are not limited to:
(a) Advertisements and
			 promotion of re-employment assistance programs and associated production costs;
			 and
(b) Public re-employment
			 assistance program conferences and workshops.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0007 - Denial of Requests, Reconsideration, Director's Review

Current through Register Vol. 63, No. 7, July 1, 2024
(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 not reasonable, practical, or feasible, or considers an abuse of
			 the program.
(2) Reconsideration.
(a) Parties directly affected by a Preferred
			 Worker Program decision of the director may request reconsideration by
			 submitting a written request to the division no later than 60 days after the
			 date the decision was issued.
(b)
			 The request for reconsideration must specify the reasons why the decision is
			 appealed and may include additional documentation.
(c) The director will reconsider the decision
			 and will notify all directly affected parties of its decision upon
			 reconsideration.
(d)
			 Reconsideration must precede a director's review under section (3) of this
			 rule.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0150 - Pilot Projects

Current through Register Vol. 63, No. 7, July 1, 2024
(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 bound
			 by the terms of the pilot project.
Stat. Auth.: ORS
				  656.622,
				  656.726(4)
Stats. Implemented: ORS
				  656.622
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0240 - Insurer Participation in the Preferred Worker Program

Current through Register Vol. 63, No. 7, July 1, 2024
(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
			 insurer must notify the worker and employer at injury in writing of the
			 assistance available from the Preferred Worker Program. A notice must be
			 issued:
(a) Within five days of the worker
			 being declared medically stationary;
(b) Upon determination of the worker's
			 eligibility or ineligibility for vocational assistance under ORS
			 656.340 and OAR 436-120;
			 and
(c) Upon approval of a claim
			 disposition agreement.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0290 - Employer at Injury Use of the Preferred Worker Program

Current through Register Vol. 63, No. 7, July 1, 2024
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 request
			 Preferred Worker Program assistance from the division within 180 days of the
			 worker's claim closure date, except as provided in subsection (1)(c).
(b) Conditions for employer at
			 injury activated premium exemption are provided in OAR
			 436-110-0325.
(c) When worksite modifications are provided,
			 and the modifications are completed and verified by the director more than 150
			 days after the worker's claim closure date, the employer at injury will have 30
			 calendar days from the verification date to request other assistance.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0310 - Eligibility and End of Eligibility for the Preferred Worker Program

Current through Register Vol. 63, No. 7, July 1, 2024
(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 purchases, are:
(a) The
			 employer has and maintains Oregon workers' compensation insurance
			 coverage;
(b) The employer complies
			 with the Oregon workers' compensation law;
(c) The employer must offer or provide
			 employment to an eligible preferred worker who is a subject Oregon worker
			 according to ORS 656.027;
(d) If the employer is a worker leasing
			 company, it must be licensed with the director under ORS
			 656.850; and
(e) The employer is not currently ineligible
			 for preferred worker benefits under OAR
			 436-110-0900.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0320 - Preferred Worker Card

Current through Register Vol. 63, No. 7, July 1, 2024
(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) Automatically at the time of claim
			 closure based upon insurer submission of preferred worker information as
			 specified in OAR 436-110-0240(4)(a);
			 or
(b) When the division
			 determines the worker is eligible for the Preferred Worker Program.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0325 - Premium Exemption

Current through Register Vol. 63, No. 7, July 1, 2024
(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 assessments on a preferred worker for three years from the date premium
			 exemption started. When premium exemption is in place, the employer does not
			 report, and the insurer may not use, the preferred worker's payroll for the
			 calculation of insurance premiums or premium assessments. However, the employer
			 must report and pay the Workers' Benefit Fund assessment and withhold employee
			 contributions as required by ORS
			 656.506 and OAR 436-070. The
			 employer must start paying insurance premiums and premium assessments when
			 premium exemption ends.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0330 - Claim Cost Reimbursement

Current through Register Vol. 63, No. 7, July 1, 2024
(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) Reimbursements will be made for the life
			 of the claim;
(b) Reimbursable
			 claim costs include disability benefits, medical benefits, vocational costs
			 under OAR 436-120-0720, claim disposition
			 agreements under ORS 656.236, disputed claim
			 settlements under ORS
			 656.289, stipulations, attorney
			 fees awarded the worker or the worker's beneficiaries, and administrative
			 costs;
(c) Reimbursable claim
			 costs for denied claims include costs incurred up to the date of denial, but
			 are limited to benefits the insurer is obligated to pay under ORS chapter 656
			 and diagnostic tests, including independent medical examinations necessary to
			 determine compensability of the claim;
(d) The administrative cost factor that will
			 apply to claim costs is published in Bulletin 316; and
(e) The claim may not be used for ratemaking,
			 individual employer rating, dividend calculations, or in any manner that would
			 affect the employer's insurance premiums or premium assessments with the
			 present or a future insurer. The insurer must be able to document that claim
			 data will not affect the employer's rates or dividend.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0335 - Wage Subsidy General Provisions

Current through Register Vol. 63, No. 7, July 1, 2024
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, "Preferred Worker Wage Subsidy Agreement," must be submitted to the
			 division. Signature and time frame requirements for employer at injury
			 activated wage subsidy are in OAR
			 436-110-0336(2),
			 and requirements for worker-activated wage subsidy are in OAR
			 436-110-0337(1).
(2) Effective date. The effective
			 date of the wage subsidy agreement is mutually agreed to by the director,
			 employer, and worker if applicable.
(3) Time limits, reimbursement rate. A wage
			 subsidy is limited to a duration of 183 calendar days and a reimbursement rate
			 of 50 percent for the approved period. For a worker with an exceptional
			 disability, a wage subsidy duration is limited to 365 calendar days and a
			 reimbursement rate of 75 percent for the approved period.
(4) Interruption and extension of agreement.
			 A wage subsidy agreement may be interrupted once for reasonable cause and
			 extended to complete the agreement on a whole workday basis. Reasonable cause
			 includes, but is not limited to, personal or family illness, death in the
			 worker's family, pregnancy of the worker or worker's spouse, a compensable
			 injury to the worker, participation in an Employer-at-Injury Program, or
			 layoff. A layoff must be a minimum of 10 consecutive work days. A period of
			 time during which the employer is without workers' compensation insurance
			 coverage is not reasonable cause and no extension will be granted.
(5) Pay structure. A preferred worker's pay
			 structure must be the same as the pay structure for other workers employed in
			 similar jobs by the employer.
(6)
			 Prevailing wage. Wages subject to reimbursement must be within the prevailing
			 wage range for that occupation. The prevailing wage range is determined as
			 follows:
(a) Examine the wages paid by the
			 employer for other workers doing the same job;
(b) If no other workers are doing the same
			 job, a labor market survey of the local labor market may be conducted; and
(c) If the labor market survey
			 does not support the wage rate requested, the director will determine the wage
			 subject to reimbursement.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0336 - Wage Subsidy - Employer at Injury Activated

Current through Register Vol. 63, No. 7, July 1, 2024
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 deferred until:
(a) The worksite modification is complete; or
(b) The employer accommodates the
			 worker's injury-caused restrictions while waiting for the worksite modification
			 to be complete.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0337 - Wage Subsidy - Worker Activated

Current through Register Vol. 63, No. 7, July 1, 2024
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) A preferred worker may use wage subsidy
			 as many times as needed, up to a maximum total reimbursement of $40,000. A
			 worker with an exceptional disability may use wage subsidy twice with no
			 maximum total reimbursement rate. The maximum total reimbursement will be
			 restored if there is a subsequent claim closure, and the worker is unable to
			 return to regular work.
(3) If the
			 employer at injury uses wage subsidy for a job, the worker may not use wage
			 subsidy for the same job.
(4) A
			 worker can use a second wage subsidy with the same employer for a new job if:
(a) The majority of job duties have changed;
			 and
(b) At least one year has
			 passed from the end of the first wage subsidy period.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 110 - PREFERRED WORKER PROGRAM › Section 436-110-0346 - Employment Purchases - Employer at Injury Activated

Current through Register Vol. 63, No. 7, July 1, 2024
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 required of the worker to perform
			 the job for which the worker is employed; and
(2) The employer may use each employment
			 purchase category once per eligibility period.
Stat. Auth.: ORS
				  656.726(4)
				  & 656.622
Stats. Implemented: ORS
				  656.622