Or. Admin. R. 461-195-0310 - Notice of Claim or Action by Applicant or Recipient

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(1) Within 10 days after a claim (see OAR 461-195-030) or action (see OAR 461-195-0301) to enforce a claim is initiated on behalf of an applicant (see OAR 461-195-0301 or recipient (see OAR 461-195-0301), or, if the claim or action was initiated prior to the application for assistance (see OAR 461-195-0301), then at the time of application, the first existing person on the following list who is enforcing the claim or action must notify the Department (see OAR 461-195-0301) and any CCO (see OAR 461-195-0301) that provided services to the applicant or recipient after the personal injury (see OAR 461-195-0301):

(a) Any attorney;

(b) Any personal representative, as defined in ORS 111.005, or any affiant, as defined in ORS 114.505, for the estate of the applicant or recipient;

(d) Any guardian;

(e) Any personal representative, as defined in OAR 407-014-0000;

(f) Any authorized representative, as defined in OAR 410-200-0015 or 461-115-0090;

(g) Any resource parent or foster parent;

(h) Any caretaker relative, as defined in OAR 461-001-0000;

(i) Any parent of the applicant or recipient; or

(j) The applicant or recipient.

(2) Within 10 days after entry of any judgment on a claim or the execution of any settlement or compromise of a claim, the first existing person on the following list must notify the Department and any CCO that provided assistance to the applicant or recipient after the personal injury:

(a) Any attorney representing a party against whom the claim was made or action to enforce the claim was initiated;

(b) Any insurer making payment on the judgment, settlement, or compromise; or

(3) The notifications required under sections (1) and (2) of this rule must include -

(a) The names and addresses of all parties against whom the action is brought or claim is made;

(b) A copy of each claim demand;

(d) A copy of any judgment, settlement or compromise of the claim or action to enforce the claim; and

(e) For notices submitted through the injury reporting website (see section 4 of this rule) the notification may be required to include:

(A) Information regarding the recipient or applicant,

(B) Information regarding the attorney, and

(4) Notification required under section (1) of this rule must be sent to the Personal Injury Liens Unit, Office of Payment Accuracy and Recovery, Oregon Department of Human Services, as follows:

(a) When the party required to provide notice is an attorney or insurer, notification must be sent through the secure injury reporting portal website. The website for the Personal Injury Lien Unit's secure injury reporting portal is https://apps.oregon.gov/OPAR/PIL/

(b) When the party required to provide notice is not an attorney or insurer, by mail, facsimile, or through the injury reporting portal website.

(A) The mailing address for the Personal Injury Liens Unit is: Personal Injury Liens Unit, PO Box 14512, Salem OR 97309-0416.

(B) The facsimile number for the Personal Injury Liens Unit is (503) 378-2577 and the telephone number is (503) 378-4514.

(5) Other than notices submitted through the injury reporting website, notices required by ORS 416.530 to be sent to the Oregon Health Authority (Authority) may be consolidated with similar notices to the Department and sent to the Personal Injury Liens Unit. A consolidated notice is considered notice to the Authority if the Authority's interest or claim in the matter is identified in the notice consistent with requirements in the applicable statute. (See also OAR 943-001-0020(2)(e))

(6) At least 30 days prior to commencing an action under ORS 416.610, the Personal Injury Liens Unit and the CCO, if any, must consult with each other.

Notes

Or. Admin. R. 461-195-0310

AFS 62-1989, f. 10-5-89, cert. ef. 10-15-89; AFS 26-1993, f. 10-29-93, cert. ef. 11-1-93; Renumbered from 461-010-0110; AFS 5-2002, f. & cert. ef. 4-1-02; AFS 13-2002, f. & cert. ef. 10-1-02; SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14; SSP 25-2015, f. 9-29-15, cert. ef. 10/1/2015; SSP 11-2023, amend filed 03/22/2023, effective 4/1/2023

Statutory/Other Authority: ORS 409.050, 410.070, 411.060, 411.070, 412.049, 413.033, 413.042, 413.085, 414.619 & 416.570

Statutes/Other Implemented: ORS 409.050, 410.070, 411.060, 411.070, 412.049, 413.033, 413.042, 413.085, 414.619, 416.570, 416.510, 416.530 & 416.610

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.

(1) An applicant (see OAR 461-195-0301) for or recipient (see OAR 461-195-0301) of assistance (see OAR 461-195-0301) who has a claim (see OAR 461-195-0301) for a personal injury (see OAR 461-195-0301) or begins an action (see OAR 461-195-0301) to enforce such claim - or the attorney, personal representative (see OAR 407-014-0000), or authorized representative (see OAR 410-200-0015 and 461-115-0090) for the applicant or recipient - must notify the Department (see OAR 461-195-0301) and the CCO (see OAR 461-195-0301) of the recipient, if the recipient is receiving services from the CCO, within ten days of initiating that claim or action, unless the action was initiated prior to the application for assistance.

(a) If the action was initiated prior to the application for assistance, the applicant must notify the Department at the time of application.

(b) The notification must include:

(A) The names and addresses of all parties against whom the action is brought or claim is made;

(B) A copy of each claim demand; and

(c) A parent, guardian, foster parent, caretaker relative, attorney, personal representative, or authorized representative must make the notification on behalf of an individual under the age of 18 or an incompetent adult.

(2) Notification required under section (1) of this rule must be sent to the Personal Injury Liens Unit, Office of Payment Accuracy and Recovery, Department of Human Services, by mail or facsimile (see sections (4) and (5) of this rule).

(3) Notices required by ORS 416.530 to be sent to the Oregon Health Authority (Authority) may be consolidated with similar notices to the Department and sent to the Personal Injury Liens Unit. A consolidated notice is considered notice to the Authority if the Authority's interest or claim in the matter is identified in the notice consistent with requirements in the applicable statute. (See also OAR 943-001-0020(2)(e).)

(4) The mailing address for the Personal Injury Liens Unit is: Personal Injury Liens Unit, PO Box 14512, Salem OR 97309-0416.

(5) The facsimile number for the Personal Injury Liens Unit is (503) 378-2577 and the telephone number is (503) 378-4514.

(6) If an applicant for or recipient of assistance- or the attorney, personal representative, or authorized representative for the applicant or recipient - fails to give the notification as required by this rule, the Department or the CCO of the recipient, if the recipient is receiving services from the CCO, has a cause of action under ORS 416.610 against the recipient for amounts received by the recipient pursuant to a judgment (see OAR 461-195-0301), settlement (see OAR 461-195-0301), or compromise (see OAR 461-195-0301) to the extent that the Department or the CCO could have had a lien against such amounts had such notice been given. At least 30 days prior to commencing an action under ORS 416.610, the Personal Injury Liens Unit and the CCO, if any, must consult with each other.

Notes

Or. Admin. R. 461-195-0310

Stat. Auth.: ORS 409.050, 410.070, 411.060, 411.070, 412.049, 413.033, 413.042, 413.085, 414.685

Stats. Implemented: ORS 409.050, 410.070, 411.060, 411.070, 412.049, 413.033, 413.042, 413.085, 414.685, 416.510, 416.530, 416.610