Or. Admin. R. 436-120-0700 - Direct Worker Purchases
(1)
Purchases, generally.
(a) The insurer must
provide the direct worker purchase categories listed in OAR 436-120-0710 as
necessary for the worker's participation in vocational assistance and to meet
the requirements of a suitable job.
(b) The worker is no longer eligible for
these purchases once eligibility ends unless the purchases are necessary to
complete a plan.
(c) Direct worker
purchases include partial purchase, lease, rental, and payment.
(2) Exclusions. Direct worker
purchases do not include:
(a) Purchases of
real property;
(b) Payment of
fines or other penalties; or
(c)
Payment of additional driver's license costs, increased insurance costs, or any
other costs attributable to problems with the worker's driving record.
(3) Alternative
purchases. In making its decision regarding a direct worker purchase, the
insurer may choose the least expensive, adequate alternative. If the worker
wants a direct worker purchase that is more expensive than that authorized by
the insurer, the worker may select that alternative and pay the difference in
cost.
(4) Approval or denial.
Within 14 days of its receipt of a request for a direct worker purchase, the
insurer must approve the purchase or notify the worker of its denial.
(5) Payment. The insurer must pay
for approved direct worker purchases in time to prevent delay in the provision
of services, but in no event later than 30 days after the insurer receives the
worker's request or proof of payment, whichever is later.
(6) Advancement of costs, worker
reimbursement. The worker may pay for mileage, child or senior care, or for
purchases such as clothing, books, and supplies or the worker may request an
advance of any of these costs based on documentation of need.
(a) The insurer must reimburse costs within
30 days of receiving a written request from the worker and any supporting
documentation.
(b) The insurer
must return denied requests for reimbursement to the worker within 30 days of
receiving the request with an explanation of the reason for nonpayment.
(7) Right and title to
nonexpendable purchases. The insurer must assign to the worker right and title
to the nonexpendable direct worker purchases paid by the insurer.
(a) The insurer must make such assignment no
later than the 60th day of continuous employment unless the worker remains
eligible and the suitability of the employment is in question.
(b) The insurer may repossess nonexpendable
property if the worker no longer requires the property for training or
employment.
(c) The insurer may
require repayment of advancements or reimbursements if the worker
misrepresented information material to the purchase decision or if the worker
used the funds for something other than the approved purchase.
Notes
Stat. Auth.: ORS 656.340(9), 656.726(4)
Stats. Implemented: ORS 656.340
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