reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0080 - Third Party Recoveries

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If a
			 third party recovery is made prior to a claim qualifying for Workers with
			 Disabilities Program relief, compensation recovered shall be credited against
			 the compensation of the claim prior to any request for reimbursement.
(2) The Workers with Disabilities Program
			 shall be a party to any third party recovery on a claim if payment from the
			 program has been made prior to the third party recovery as provided in ORS
			 656.591 and
			 656.593(1)(c).
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628, ¦286, ch. 70, OL
				  2007
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 40 - HANDICAPPED WORKERS RESERVE › Section 436-040-0090 - Assessment of Civil Penalties

Current through Register Vol. 63, No. 7, July 1, 2024
The director, through the division and pursuant to ORS
				656.745, may assess a civil
				penalty against an insurer. When the division imposes a penalty under this
				section, the order shall be issued in accordance with ORS
				656.447,
				656.704 and the contested case
				provisions of the Administrative Procedures Act (ORS chapter
				183).
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.628
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0001 - Authority for Rules

Current through Register Vol. 63, No. 7, July 1, 2024
These rules are promulgated under the Director's authority
				contained in ORS 656.726 and ORS
				656.625.
Stat. Auth.: ORS 656
Stats. Implemented: ORS
				  656.625 & ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0002 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of these rules is to establish guidelines for
				administering disbursements made from the Reopened Claims Program established
				to reimburse compensation paid as a result of awards made by the Board or
				voluntary claim reopenings pursuant to ORS
				656.278.
Stat. Auth.: ORS
				  656.625 & ORS
				  656.726
Stats. Implemented: ORS
				  656.625 & ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0003 - Applicability of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
(1) These rules
			 are effective July 1, 2008, and apply to all requests for reimbursement from
			 the Reopened Claims Program.
(2)
			 These rules apply to all awards ordered on claims opened by the Board under ORS
			 656.278 on or after January 1,
			 1988 and all voluntary claim reopenings on or after January 1, 2002.
(3) These rules carry out the provisions of
			 ORS 656.625.
(4) Applicable to this chapter, the director
			 may, unless otherwise obligated by statute, in the director's discretion waive
			 any procedural rules as justice so requires.
Stat. Auth.: ORS
				  656.625
Stats. Implemented: ORS
				  656.236,
				  656.289 &
				  656.625
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0005 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR
				436-045-0001 through
				436-045-0030 unless the context
				requires otherwise:
(1) "Board" means
			 the Workers' Compensation Board of the Department of Consumer and Business
			 Services.
(2) "Compensation"
			 includes all benefits payable as a result of any order or award made by the
			 Board or voluntary claim reopening pursuant to ORS
			 656.278.
(3) "Compliance" means the Compliance Section
			 of the Workers' Compensation Division of the Department of Consumer and
			 Business Services.
(4) "Department"
			 means the Department of Consumer and Business Services.
(5) "Director" means the director of
			 Department of Consumer and Business Services or the director's delegate for the
			 matter.
(6) "Disposition" or "claim
			 disposition" means the written agreement executed by all parties in which a
			 claimant agrees to release rights, or agrees to release an insurer or
			 self-insured employer from obligations, under ORS
			 656.001 to
			 656.794, except for medical
			 services, in an accepted claim.
(7)
			 "Hearings Division" means the Hearings Division of the Workers' Compensation
			 Board.
(8) "Paying Agency" means
			 the insurer, self-insured employer, self-insured employer group or designated
			 representative of the self-insured employer/group, responsible for paying
			 compensation for a compensable injury.
(9) "Reopened Claims Program" and "Program"
			 means the program established pursuant to ORS
			 656.625.
(10) "Voluntary Claim Reopening" means any
			 claim reopened by the insurer or self-insured employer to provide benefits or
			 to grant additional medical or hospital care to the claimant pursuant to ORS
			 656.278.
Stat. Auth.: ORS
				  656.726
Stats. Implemented: ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0006 - Administration of Rules

Current through Register Vol. 63, No. 7, July 1, 2024
Any orders issued by the divisions in carrying out the
				director's authority to enforce ORS Chapter 656 and these rules are considered
				orders of the director.
Stat. Auth.: ORS
				  656.704 & ORS
				  656.726
Stats. Implemented: ORS
				  656.704 & ORS
				  656.726
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0008 - Administrative Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any party as defined by ORS
			 656.005 aggrieved by a proposed
			 order or proposed assessment of civil penalty of the director or division
			 issued pursuant to ORS
			 656.745 may request a hearing by
			 the Hearings Division of the Workers' Compensation Board in accordance with ORS
			 656.740.
(a) The request for hearing must be sent in
			 writing to the Administrator of the Workers' Compensation Division. No hearing
			 shall be granted unless the request specifies the grounds upon which the person
			 requesting the hearing contests the proposed order or assessment.
(b) The request for hearing must be filed
			 with the Administrator of the Workers' Compensation Division by the aggrieved
			 person within 60 days after the mailing of the proposed order or assessment. No
			 hearing shall be granted unless the request is mailed or delivered to the
			 administrator within 60 days after the mailing of the proposed order or
			 assessment.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0010 - Criteria for Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In
			 order to qualify for reimbursement from the Reopened Claims Program there must
			 be:
(a) An order or award issued by the Board
			 upon its own motion pursuant to ORS
			 656.278 and as provided by OAR
			 chapter 438, division 12 or a voluntary claim reopening; and
(b) Verifiable compensation paid in
			 accordance with the order or award issued by the Board or voluntary claim
			 reopening, including permanent disability awarded as a result of a reopening
			 due to a new or omitted medical condition pursuant to ORS
			 656.278(1)(b).
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0020 - Limitation of Program

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Reimbursement shall be limited to the monies available in the Workers' Benefit
			 Fund.
(2) In the event of
			 insufficient funds in the Workers' Benefit Fund, the director shall have final
			 authority to determine an equitable distribution which will proportionately
			 distribute the available funds among the claims having qualified for
			 reimbursement under the Program.
Stat. Auth.: ORS
				  656.625
Stats. Implemented: ORS
				  656.625
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0025 - Dispositions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) In order for a
			 disposition of a claim by the parties to be considered for reimbursement
			 eligibility under the Reopened Claims Program, it must be submitted to the
			 director during the period of time in which the claim remains open under the
			 Board's Own Motion or voluntary claim reopening.
(2) Dispositions submitted in accordance with
			 (1) are not eligible to receive reimbursement from the Reopened Claims Program
			 unless made with the prior written approval of the director.
(3) Requests for written approval of proposed
			 dispositions shall include:
(a) A copy of the
			 proposed disposition which specifies the amount of the proposed contribution to
			 be made from the Reopened Claims Program;
(b) A statement from the insurer indicating
			 how the amount of the contribution was calculated;
(c) Any other information as required by the
			 director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 45 - REOPENED CLAIMS PROGRAM › Section 436-045-0030 - Reimbursement

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Reimbursement
			 shall be made by Compliance quarterly after receipt and approval of
			 documentation of compensation paid by the paying agent.
(2) The director, by bulletin, shall
			 prescribe the form and format for requesting reimbursement from the Program.
			 Documentation to support the reimbursement request shall include but not be
			 limited to:
(a) Net temporary disability
			 compensation paid, net permanent disability paid, and net medical compensation
			 paid for dates of injury prior to January 1, 1966. For purposes of this
			 section, "net" compensation paid means the total compensation paid less any
			 recoveries, including but not limited to, third party recovery, Retroactive
			 Program reimbursement, and Workers with Disabilities Program
			 reimbursement.
(b) Payment
			 certification statement.
(c) Any
			 other information deemed necessary by the director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0001 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.704 &
				  656.726(4)
Stats. Implemented: ORS
				  656.017,
				  656.018,
				  656.021,
				  656.023,
				  656.027,
				  656.029,
				  656.031,
				  656.037,
				  656.039,
				  656.126,
				  656.128,
				  656.140,
				  656.403,
				  656.407,
				  656.419,
				  656.423,
				  656.427,
				  656.430,
				  656.434,
				  656.440,
				  656.443,
				  656.447,
				  656.455,
				  656.614,
				  656.745,
				  656.750,
				  656.850,
				  656.855 &
				  731.475
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0002 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.704 &
				  656.726(4)
Stats. Implemented: ORS
				  656.017
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0003 - Purpose and Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Purpose.
These rules carry out the workers' compensation law related to
			 employers' and insurers' responsibilities to cover subject workers for
			 compensable injuries and illnesses.
(2)
Applicability.
(a) These rules apply to employers,
			 self-insured employers, and insurers.
(b) The requirements of OAR
			 436-050-0165,
			 436-050-0170,
			 436-050-0175,
			 436-050-0180,
			 436-050-0190,
			 436-050-0200,
			 436-050-0205,
			 436-050-0210 and
			 436-050-0220 apply to both
			 self-insured employers and self-insured employer groups. References in those
			 rules to "employer" include employer groups, and references to "self-insured
			 employer" include self-insured employer groups.
(c) The director may waive procedural rules
			 as justice requires, unless otherwise obligated by statute.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0006 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.704 &
				  656.726(4)
Stats. Implemented: ORS
				  656.704 &
				  656.726(4)
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0008 - Requests for Hearings or Administrative Review

Current through Register Vol. 63, No. 7, July 1, 2024
(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 the amount of compensation due, may request a hearing by the
			 board under ORS chapter 656 and OAR chapter 438.
(2)
Request for hearing on proposed
			 sanctions or civil penalties.
Any party, or assigned claims agent, that
			 disagrees with a proposed order, or proposed assessment of civil penalty, of
			 the director issued under ORS
			 656.254,
			 656.735, or
			 656.745 may request a hearing by
			 the board. To request a hearing, the party or assigned claims agent must:
(a) Mail or deliver a written request to the
			 division within 60 days of the mailing date of the proposed order or
			 assessment; and
(b) Specify, in the
			 request, the reasons why the party or assigned claims agent disagrees with the
			 proposed order or assessment.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0015 - Suspension and Revocation of Authorization to Issue Workers' Compensation Insurance Policies

Current through Register Vol. 63, No. 7, July 1, 2024
(1) General. The
			 director may suspend or revoke an insurer's authorization to issue or renew
			 workers' compensation insurance policies upon a determination that:
(a) The insurer has failed to comply with its
			 obligations under any workers' compensation policy; or
(b) The insurer has failed to comply with ORS
			 chapter 656, OAR chapter 436, or the orders of the director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0025 - Service of the Notice of Civil Penalty Orders

Current through Register Vol. 63, No. 7, July 1, 2024
When the director issues a civil penalty order, it will be
				served by certified mail, return receipt requested, or in any other manner
				provided by Oregon Rules of Civil Procedure (7)(D) available at:
https://www.oregonlegislature.gov/bills_laws/Pages/orcp.aspx
.
				Proof of service may include a hard copy signed receipt or electronic
				verification.
Stat. Auth: ORS
				  656.726(4)
Stats. Implemented: ORS
				  656.704,
				  656.726,
				  656.740
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0040 - Responsibility for Providing Coverage When a Contract is Awarded

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If a person,
			 including a person that is a sole proprietorship, that is responsible to
			 provide coverage for an individual performing labor under ORS
			 656.029, fails to comply with
			 ORS 656.017, that person is
			 considered a noncomplying employer. As used in this section, "sole
			 proprietorship" means a business entity or individual who performs labor
			 without the assistance of others.
(2) As used in ORS
			 656.029, "the performance of
			 labor where such labor is a normal and customary part or process of the
			 person's trade or business" includes the day-to-day activities or operations
			 which are necessary to successfully carry out the business or trade.
(3) A person contracting to pay remuneration
			 for professional real estate activity as defined in ORS chapter 696, to a
			 qualified real estate broker as defined in ORS
			 316.209, is not an employer of
			 the qualified real estate broker, and is not required to provide coverage under
			 ORS 656.017.
Statutory/Other Authority: ORS
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.029 & ORS
				  656.037
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0045 - Nonsubject Workers

Current through Register Vol. 63, No. 7, July 1, 2024
For the purposes of clarifying terms used in ORS
				656.027:
(1)
"Casual"
refers only to
			 employments where the work in any 30-day period, without regard to the number
			 of workers employed, involves a total labor cost lower than the dollar amount
			 published in Bulletin 387.
(2)
			 "
Home health worker
" does not include a worker employed by a home
			 health agency, as defined in ORS
			 443.014, or in-home care agency,
			 as defined in OAR 333-536-0005.
(3) "
Person performing foster parent or
			 adult foster care duties
" means:
(a) A
			 person performing foster parent duties, including, but not limited to:
(A) Any person certified as a foster parent
			 by the Oregon Department of Human Services under ORS chapter 418; or
(B) Any person employed by a certified foster
			 parent in the operation of a foster home as defined in ORS chapter 418;
			 or
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0050 - Corporate Officers, Partnerships; Limited Liability Company Members; Subjectivity

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A
			 corporation, limited liability company, or partnership may elect to provide
			 workers' compensation coverage for otherwise nonsubject workers:
(a) The election must be made in writing to
			 the insurer at the beginning of a coverage policy and remain in effect until a
			 revised written designation is given to the insurer;
(b) A self-insured employer must file the
			 election with the director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0055 - Extraterritorial Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For the
			 purposes of determining whether a worker is temporarily in or out of state
			 under ORS 656.126, the director will use
			 criteria including, but not limited to, the following:
(a) The extent to which the worker's work
			 within the state is of a temporary duration;
(b) The intent of the employer regarding the
			 worker's employment status;
(c)
			 The understanding of the worker regarding the employment status with the
			 employer;
(d) The permanent
			 location of the employer and its permanent facilities;
(e) The circumstances and directives
			 surrounding the worker's work assignment;
(f) The state laws and regulations to which
			 the employer is otherwise subject;
(g) The residence of the worker;
(h) The extent to which the employer's work
			 in the state is of a temporary duration, established by a beginning date and
			 expected ending date of the employer's work; and
(i) Other information relevant to the
			 determination.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0060 - Repealed

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.704 &
				  656.726(4)
Stats. Implemented: ORS
				  656.419 &
				  656.427
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0110 - Notice of Insurer's Place of Business in State; Records Insurer Must Maintain

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Oregon claims processing location required.
Except as described in
			 section (4) of this rule, every insurer that is authorized to issue workers'
			 compensation policies to Oregon subject employers must establish and maintain
			 at least one designated Oregon claims processing location as required by ORS
			 731.475, subject to the
			 following:
(a) The insurer must conduct all
			 claims processing activities necessary to meet the requirements of ORS chapter
			 656 and OAR chapter 436 from its designated claims processing locations,
			 including, but not limited to:
(A) Processing
			 claims;
(B) Making available all
			 records required under OAR
			 436-050-0120; and
(C) Responding to specific claims processing
			 inquiries;
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0120 - Records Insurers Must Maintain; Removal and Disposition

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Records
			 insurers must maintain.
Each insurer is required to maintain the
			 following records of Oregon workers' compensation claims, to make the records
			 available at an Oregon claims processing location, and to provide the director
			 access to the records upon request:
(a)
			 Written records used and relied upon in processing each claim;
(b) A written record of all payments made as
			 a result of any claim including documentation of:
(A) The amount of the payment;
(B) The date the payment was
			 issued;
(C) The date the payment
			 was mailed or delivered; and
(D) An
			 explanation of the time period between the date the payment was issued and the
			 date the payment was mailed or delivered, if any;
(c) Written records of the approval or denial
			 of claims for supplemental temporary disability benefits under ORS
			 656.210(5);
(d) Written records that show its insured
			 employers have complied with ORS
			 656.017; and
(e) Written records, or copies of records, of
			 claims processed by prior service companies.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0150 - Qualifications of a Self-Insured Employer

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
General
			 qualifications.
To qualify as a self-insured employer, the employer
			 must:
(a) Establish proof that the employer
			 has an adequate staff qualified to process claims;
(b) Establish proof of the financial ability
			 to make certain the prompt payment of all compensation and other payments due
			 under ORS chapter 656;
(c) Obtain
			 excess insurance coverage in the amounts approved by the director;
			 and
(d) Be registered and
			 authorized to do business in this state under ORS chapters 58, 60, 62, 63, 65,
			 67, 70, and 648, as applicable, or be a municipal or public corporation as
			 defined in ORS 297.405.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0165 - Security Deposit Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(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://2go.iccwbo.org/
;
			 and
(b) Copies of this publication
			 are available for review during regular business hours at the Workers'
			 Compensation Division, 350 Winter Street NE, Salem OR 97301.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0170 - Excess Insurance Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(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 this state, subject to the following:
(a) Except for endorsements requiring
			 pre-approval by the director under sections (3) and (4) of this rule, the
			 policy providing such coverage and any subsequent endorsements must be filed
			 with the director within 30 days after the effective date of the policy or
			 endorsement;
(b) A self-insured
			 public utility with assets in excess of $500 million as reflected by the
			 employer's audited financial statement submitted in accordance with OAR
			 436-050-0160 or
			 436-050-0175, may obtain the
			 required excess workers' compensation insurance coverage from an eligible
			 surplus lines insurer;
(c) The
			 excess insurance policy must include a provision for reimbursement to the
			 director of all expenses paid by the director on behalf of the self-insured
			 employer under ORS 656.614 and
			 656.443 as if the director were
			 the insured employer, subject to the policy limitations or amounts and limits
			 of liability to the insured employer;
(d) Coverage must be continuous and remain in
			 effect from the date of certification until the certification is revoked or
			 canceled;
(A) Coverage must be specific on a
			 per-occurrence basis;
(B) Coverage
			 may include aggregate excess insurance; and
(C) Coverage may include a deductible
			 endorsement acceptable to the director under sections (3) and (4) of this
			 rule;
(e) Excess
			 insurance obtained under this rule does not relieve any self-insured employer
			 from full responsibility for claims processing and the payment of compensation
			 required under ORS chapter 656 and OAR chapter 436. The excess insurance policy
			 may not contain provisions or endorsements that do not comply with Oregon law,
			 including but not limited to, provisions or endorsements that allow the excess
			 insurer to process claims, pay compensation, or change the location where a
			 claim is processed.
(f) A
			 self-insured employer may not transfer claims to any excess insurer or service
			 company acting on behalf of an excess insurer for the processing of the
			 employer's claims, regardless of the types and amounts of excess coverage;
			 and
(g) When an excess insurance
			 policy is canceled by the excess insurer or the employer, a copy of the notice
			 of cancellation must be filed with the director at least 30 days before the
			 effective date of cancellation.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0175 - Annual Reporting Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(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 audited financial statement
			 for the just completed fiscal year, and SEC Form 10K, if issued;
(b) The report must be filed within the
			 following time frames:
(A) A self-insured
			 employer that is not a municipal or public corporation as defined in ORS
			 297.405 must make the filing
			 within 120 days of the end of its fiscal year; or
(B) A self-insured employer that is a
			 municipal or public corporation as defined in ORS
			 297.405 must make the filing
			 within 180 days of the end of its fiscal year;
(c) If audited financial statements are not
			 available for filing within the time frames of subsection (b), the self-insured
			 employer may file a financial statement that is certified by the self-insured
			 employer that the financial statement is true and accurate and presents the
			 self-insured employer's financial condition and results of operations as of the
			 date of the statement. The director may require a self-insured employer to
			 submit an audited financial statement if the certified financial statement
			 submitted is insufficient to evaluate the self-insured employer's financial
			 status;
(d) The financial
			 statements and reports must include information sufficient to determine the
			 self-insured employer's financial viability under OAR
			 436-050-0150 or OAR
			 436-050-0260; and
(e) All financial statements and annual
			 financial reports filed under this section will be retained by the director for
			 a period of at least three years.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0180 - Determination of Amount of Self-Insured Employer's Deposit; Effective Date of Order to Increase Deposit

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Indicated
			 security deposit.
Except for self-insured cities, counties, or qualified
			 self-insured employer groups who are exempted under ORS
			 656.407(3) and
			 OAR 436-050-0185, each self-insured
			 employer is required to maintain a security deposit with the director in an
			 amount determined by the director, subject to the following:
(a) The deposit will not be less than the
			 greater of:
(A) $100,000;
(B) Future claim liability, including losses
			 incurred but not reported (IBNR), a claims processing administrative cost, and
			 the anticipated assessments payable to the director for the employer's next
			 fiscal year; or
(C) The annual
			 incurred losses for the self-insured employer's last fiscal year, including
			 IBNR, a claims processing administrative cost, and anticipated assessments
			 payable to the director for the employer's next fiscal year;
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0185 - Qualifications for Deposit Exemption for Self-Insured Cities, Counties, and Qualified Self-Insured Employer Groups, Application Procedures, Conditions and Requirements, Revocation and Requalification

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Requirements to
			 qualify for deposit exemption. A self-insured city, county, or self-insured
			 employer group that is a municipal or public corporation under ORS
			 297.405, may apply to be exempt
			 from the security deposit requirements of ORS
			 656.407(2) and
			 OAR 436-050-0150, if it meets the
			 following requirements:
(a) The city, county,
			 or qualified self-insured employer group must be in compliance with ORS
			 656.407(2) and
			 OAR 436-050-0180 as an independently
			 self-insured employer or self-insured employer group for the three consecutive
			 years immediately before applying for the exemption; and
(b) The city, county, or qualified
			 self-insured employer group must have in effect a workers' compensation loss
			 reserve account that is actuarially sound and that is adequately funded as
			 determined by the annual audit under ORS
			 297.405 to
			 297.740 to pay all compensation
			 to injured workers and amounts due the director under ORS chapter 656. The
			 workers' compensation loss reserve account must also be dedicated to and
			 expended only for payment of compensation and amounts due the director by the
			 city or county under ORS chapter 656.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 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

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Default,
			 decertification, or cancellation of self-insurance certification.
In the
			 event a self-insured employer defaults, or is unable to make all payments due
			 under ORS chapter 656:
(a) The director will,
			 on behalf of the self-insured employer, assure continued payments in accordance
			 with ORS 656.407,
			 656.443, and
			 656.614 and in such a manner as
			 to ensure minimum delay in the processing of injured workers' claims.
(b) The director may refer the self-insured
			 employer's claims for processing to an assigned claims agent selected under ORS
			 656.054, or designate the
			 service company responsible for continuing to process the employer's
			 claims.
(c) If a self-insured
			 employer group consisting of private employer members defaults, cancels its
			 self-insurance certification, or is decertified by the director under ORS
			 656.434, the director may order
			 private employer members of the group to pay an assessment for the group's
			 continuing claim liabilities, under ORS
			 656.430(7)(a)(D)(i).
			 Failure of the group's members to pay director-ordered assessments under this
			 rule will subject members to civil penalties under ORS
			 656.745.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0195 - Requirements for Changes in Self-Insured Employer Entity

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Notification of 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 of a self-insured
			 employer, the self-insured employer must notify the director in writing within
			 30 days after the change occurs.
(2)
Adding or deleting entities.
If a self-insured employer wishes to add or delete entities to a self-insured
			 employer's certification:
(a) The self-insured
			 employer must submit a completed Form 1865, "Endorsement to Include Legal
			 Entity in Self-Insured Certification," signed by an officer of the self-insured
			 employer;
(b) Each entity must
			 enter into an agreement, signed by an officer of the entity, making the entity
			 jointly and severally liable for the payment of any compensation and moneys due
			 to the director by the certified self-insured employer or any other entity
			 included in the self-insured employer's certification; and
(c) The director will determine, based on the
			 information provided, the effect of the change on the deposit required and
			 whether the entities can be combined for experience rating purposes.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0200 - Self-Insured Certification Cancellation; Revocation

Current through Register Vol. 63, No. 7, July 1, 2024
(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
(b) Canceled by the self-insured employer
			 with the approval of the director.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0205 - Notice of Self-Insurer's Personal Elections

Current through Register Vol. 63, No. 7, July 1, 2024
When a person makes an election under ORS
				656.039,
				656.128, or
				656.140, the self-insured must
				notify the director in writing of the election and of any cancellation of the
				election within 30 days of the effective date.
Statutory/Other Authority: ORS
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.039,
				  656.128 &
				  656.140
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0210 - Notice of Self-Insurer's Place of Business in State; Records Self-Insured Must Maintain

Current through Register Vol. 63, No. 7, July 1, 2024
(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 establish and maintain at least one designated Oregon claims
			 processing location as required by ORS
			 656.455, subject to the
			 following:
(a) The self-insured employer must
			 conduct all claims processing activities necessary to meet the requirements of
			 ORS chapter 656 and OAR chapter 436 from its designated claims processing
			 locations, including, but not limited to:
(A)
			 Processing claims;
(B) Making
			 available all records required under OAR
			 436-050-0220; and
(C) Responding to specific claims processing
			 inquiries;
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0220 - Records Self-Insured Employer Must Maintain; Period to be Retained, Removal and Disposition

Current through Register Vol. 63, No. 7, July 1, 2024
(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 Oregon claims processing location, and to provide the director
			 access to the records upon request:
(a)
			 Written records necessary to ensure compliance with ORS
			 656.506,
			 656.612,
			 656.614, and
			 656.622 including:
(A) A record of payroll by National Council
			 on Compensation Insurance classification; and
(B) Complete records of all assessments,
			 employer and employee contributions, and all such money due the
			 director;
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0230 - Out-of-State Recordkeeping and Claims Processing by Self-Insured Employer; Conditions and Procedure for Permit; Revocation

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Permission to keep records and
			 process claims outside of Oregon.
Notwithstanding OAR
			 436-050-0210 and
			 436-050-0220, with the prior
			 approval of the director a self-insured employer may process claims and make
			 claims records available at a claims processing location outside Oregon, under
			 the following conditions:
(a) The
			 self-insured employer must submit a written application to the director;
(A) The application must contain the reasons
			 for the request and the mailing address, telephone number, email address and
			 any other contact information of the location where the records will be kept
			 and the claims processed; and
(B)
			 The application must provide contact information for a designated person or
			 position within the company who will assure payment of penalties and resolution
			 of collections issues resulting from orders issued by the director, and a
			 company email address that is monitored on a regular basis;
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0260 - Qualifications of a Self-Insured Employer Group

Current through Register Vol. 63, No. 7, July 1, 2024
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 corporation or cooperative under ORS
			 chapter 60, 62, or 65;
(b) An
			 intergovernmental entity under ORS
			 190.003 to
			 190.110; or
(c) A public entity self-insurance program
			 under ORS 30.282(3).
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 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

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
Addition
			 of new members.
Prospective new members of a self-insured employer group
			 must submit an application to the board of trustees, or its administrator. The
			 administrator of a group consisting of private employer members may not be a
			 member of the group. The trustees, or administrator, may approve the
			 application for membership under the bylaws of the self-insured employer group.
			 Once approved, the administrator or board of trustees must submit to the
			 director, within 30 days of the effective date of membership, a completed Form
			 1869, "Endorsement to Self-Insured Group Application" or a form approved by the
			 director, which must be accompanied by:
(a) A
			 current financial statement of the employer applying;
(b) Evidence of at least $150,000 individual
			 net worth if the prospective new member is a private employer;
(c) An agreement signed by the administrator
			 of the self-insured employer group and the employer, making the employer
			 jointly and severally liable for the payment of any compensation and moneys due
			 to the director by the group or any member of the group; or, if a governmental
			 subdivision self-insured employer group, a resolution by the governing body of
			 each governmental subdivision binding it to be liable for the payment of any
			 compensation and other amounts due to the director under ORS chapter 656
			 incurred by that governmental subdivision during the period of group
			 self-insurance;
(d) A statement
			 showing the effect on the new combined net worth of the group; and
(e) The employer's payroll by class and
			 description and loss information for the last four fiscal or calendar
			 years.
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0300 - Self-Insured Employer Group, Common Claims Fund

Current through Register Vol. 63, No. 7, July 1, 2024
(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 direction and control of
			 the board of trustees and administrator, a common claims fund for the sole
			 purpose of ensuring the availability of funds to make certain the prompt
			 payment of all compensation and all other payments that may become due from
			 such self-insured employer group under the workers' compensation law. This
			 requirement does not apply in any year in which the director applies an
			 incurred but not reported (IBNR) factor of greater than zero percent in the
			 determination of the self-insured employer group's security deposit under OAR
			 436-050-0180.
(2) The common claims fund must be maintained
			 in an account held by an Oregon state chartered or a federally chartered bank.
			 Government subdivisions certified as a self-insured employer group may also
			 maintain the common claims fund in a "Local Government Investment Pool" account
			 held by the Office of the State Treasurer.
(3) Except as provided in section (6) of this
			 rule, the balance of the common claims fund must be maintained in an amount at
			 least equal to 30 percent of the average of the group's paid losses for the
			 previous four years. The full sum of the required common claims fund balance
			 must be maintained at all times.
(4) The director may require the self-insured
			 group to increase the amount maintained in the common claims fund.
(5) By March 1 of each year, a self-insured
			 employer group must provide the director with adequate documentation to
			 validate the balance in the common claims fund or notice that the amount
			 calculated under section (3) or (6) of this rule must be included in the
			 determination of the self-insured employer group's security deposit under OAR
			 436-050-0180. The director may
			 require a self-insured employer group to provide documentation of the common
			 claims fund balance more frequently.
(6) For governmental subdivisions certified
			 as a self-insured employer group, the balance of the common claims fund must be
			 maintained in an amount at least equal to 60 percent of the average of the
			 group's yearly paid losses for the previous four years.
Statutory/Other Authority: ORS
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.430
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0340 - Group Self-Insurance Revocation

Current through Register Vol. 63, No. 7, July 1, 2024
Notwithstanding ORS
				656.440, the certification of a
				self-insured employer group may be revoked by the director after giving 30 days
				notice if:
(1) The employer group does
			 not comply with ORS 656.430(7) or
			 (8),
			 436-050-0170 to
			 436-050-0190,
			 436-050-0260, or
			 436-050-0290;
(2) There are fewer than five employers
			 within a group;
(3) The net worth
			 of the group falls below that required by OAR
			 436-050-0260(3);
(4) The employer group defaults in payment of
			 compensation or other payments due the director;
(5) The employer group commits any violation
			 for which a civil penalty could be assessed under ORS
			 656.745; or
(6) The employer group or any member of the
			 group submits any false or misleading information.
Statutory/Other Authority: ORS
				  656.704 &
				  656.726(4)
Statutes/Other Implemented: ORS
				  656.434 &
				  656.440
Oregon Administrative Rules › Chapter 436 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, WORKERS' COMPENSATION DIVISION › Division 50 - EMPLOYER/INSURER COVERAGE RESPONSIBILITY › Section 436-050-0400

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  656.726(4),
				  656.850 &
				  656.855
Stats. Implemented: ORS
				  656.850 &
				  656.855