(1) Insurer or provider may issue. The
insurer is responsible for mailing all notices and warnings required by these
rules but may delegate that responsibility to the provider that is providing
vocational assistance to the worker.
(2) Required content. All notices and
warnings to the worker issued under these rules must:
(a) Use the applicable heading. If a notice
is used for more than one purpose, it must include all the headings that apply;
(b) Be in writing, signed, and
dated;
(c) State the basis for the
decision;
(d) Include the
effective date of each action in the heading;
(e) Cite the relevant rules;
(f) Include the worker's appeal rights. All
notices and warnings except those notifying a worker of entitlement to training
or deferral of vocational assistance eligibility must contain the worker's
appeal rights in bold type, as follows:
"If you disagree with this decision, you should contact [insert
the person's name and the insurer name] within five days of receiving this
letter to discuss your concerns. If you are still dissatisfied, you must
contact the Workers' Compensation Division within 60 days of receiving this
letter or you will lose your right to appeal this decision. A consultant with
the division can talk with you about the disagreement and, if necessary, will
review your appeal. The address and telephone number of the division are:
Employment Services Team, Workers' Compensation Division, P.O. Box 14480,
Salem, Oregon 97309-0405; 503-947-7816 or 1-800-452-0288."; and
(g) Include the telephone number
of the Ombudsman for Injured Workers: 1-800-927-1271.
(3) Mailing and copies. All notices and
warnings must:
(a) Be mailed to the worker's
last known address by both regular and certified mail; and
(b) Be copied to the division and worker's
attorney, if any, at the same time the notice or warning is mailed to the
worker.
(4) Effective
date. A notice is not effective until it is sent to all required parties
including the worker's attorney.
(5) Requirements for warning letters.
(a) A warning letter can be issued at any
time during the vocational eligibility evaluation or vocational assistance
process.
(b) Warning letters do
not require specific language in the headings but must include a heading
clearly indicating the purpose of the warning.
(c) A warning letter must state what the
worker must do, and by when, to avoid ineligibility or the ending of
eligibility or training.
Notes
Or. Admin. R.
436-120-0012
WCD 6-2000, f. 4-27-00,
cert. ef. 6-1-00, Renumbered from 436-120-0600, 436-120-0610 & 436-120-0620
[WCD 11-1987, f. 12-17-87, ef. 1-1-88; WCD 10-1994, f. 11-1-94, cert. ef.
1-1-95; WCD 6-1996, f. 2-6-96, cert. ef. 3-1-96; WCD 7-2002, f. 5-30-02, cert.
ef. 7-1-02; WCD 3-2004, f. 3-5-04 cert. ef. 4-1-04; WCD 6-2005, f. 6-9-05,
cert. ef. 7-1-05; WCD 8-2007, f. 11-1-07, cert. ef. 12-1-07; WCD 3-2009, f.
12-1-09, cert. ef. 1-1-10; Renumbered from 436-120-0004, WCD 5-2010, f.
9-15-10, cert. ef. 11-15-10; WCD 5-2012, f. 10-3-12, cert. ef. 11-1-12;
WCD
4-2016, f. 11-28-16, cert. ef.
1/1/2017
Stat. Auth.: ORS
656.340(9),
656.726(4)
Stats. Implemented: ORS
656.340
