(1)
Benefits
paid a worker. An insurer may recover overpayment of benefits paid to a
worker as specified by ORS
656.268(12), (13), (14), and
(16), unless authority is granted by an
administrative law judge or the board.
(2)
Benefits due a worker. An
insurer may recover an overpayment from any benefits currently due on any claim
the worker has with that insurer. The insurer must explain in writing the
reason, the amount, and the method of recovery to the worker and the worker's
attorney, if any, or to the worker's beneficiaries.
(3)
Permanent partial disability
offsets. When overpaid benefits are offset against monthly permanent
partial disability award payments, the insurer must recover the benefits from
the total amount of the award. The insurer must pay out the remainder of the
award at 4.35 times the temporary total disability rate, or at least $108.75,
starting with the first month's payment.
(4)
Supplemental disability
benefits.
The director, through its assigned processing administrator
described under OAR 436-060-0035(2)(d),
may recover overpayments of supplemental disability benefits under the same
conditions provided under ORS
656.268(12), (13), (14), and
(16), or may require the insurer to do so. If
the insurer recovers an overpayment on behalf of the assigned processing
administrator, the insurer must reimburse the assigned processing
administrator.
Notes
Or. Admin. Code §
436-060-0170
WCD
1-1980(Admin), f. & ef. 1-11-80; WCD 6-1981(Admin), f. 12-23-81, ef.
1-1-82; WCD 8-1983(Admin), f. 12-29-83, ef. 1-1-84; WCD 3-1984(Admin), f. &
ef. 4-4-84;WCD 8-1985, f. 12-12-85, cert. ef. 1-1-86, Renumbered from
436-054-0320; WCD 4-1987, f. 12-18-87, cert. ef. 1-1-88; WCD 6-1989, f.
12-22-89, cert. ef. 1-1-90; WCD 9-1990(Temp), f. 6-18-90, cert. ef. 7-1-90; WCD
29-1990, f. 11-30-90, cert. ef. 12-26-90; WCD 5-1996, f. 2-6-96, cert. ef.
2-12-96; WCD 10-2002, f. 10-2-02 cert. ef. 11-1-02; WCD 9-2004, f. 10-26-04,
cert. ef. 1-1-05;
WCD
6-2016, f. 11-28-16, cert. ef.
1/1/2017; WCD 7-2020, amend filed 3/13/2020,
effective 4/1/2020;
WCD
14-2022, amend filed 12/20/2022, effective
1/1/2024;
WCD
14-2024, amend filed 06/07/2024, effective
7/1/2024
Statutory/Other Authority: ORS
656.726(4)
Statutes/Other Implemented: ORS
656.268(12) (13),(14), &
(16)
