Or. Admin. Code § 436-075-0070 - Reimbursement
(1) Reimbursement
from the Retroactive Program will be authorized by the Workers' Compensation
Division on a quarterly basis.
(2)
Requests for reimbursement must be mailed or delivered to the Workers'
Compensation Division within 30 days after the end of each calendar quarter to
be processed in that quarterly disbursement.
(3) Requests for reimbursement mailed or
delivered to the Workers' Compensation Division more than 30 days after the end
of the quarter will be processed with the next quarterly disbursement.
(4) A separate request for
reimbursement must be submitted for each insurer and include a signed
certification that the payments reported on the request have been made in the
amounts reported.
(5) The insurer
must use Form 3285, "Request for Reimbursement from the Retroactive Program,"
or an equivalent form, to request reimbursement from the Retroactive Program.
(a) If an equivalent form is used, it must
include all of the data elements on Form 3285; and
(b) Each request must accurately reflect the
marital and dependency status in effect and eligible for reimbursement in the
period requested.
(6)
The director will not process any request that does not meet the requirements
of section (4) and (5) of this rule.
(7) The department will recover any
overpayment made to an insurer as a result of an insurer reporting error or
incorrect information submitted on a quarterly request form.
(8) If a denied claim is found to be
compensable by an administrative law judge, the Workers' Compensation Board, or
the Court of Appeals, and that decision is subsequently reversed by a higher
level of appeal, the insurer will receive reimbursement for Retroactive Program
benefit payments required to be made while the claim was in an accepted
status.
Notes
Statutory/Other Authority: ORS 656.506 & ORS 656.726(4)
Statutes/Other Implemented: ORS 656.506
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