OAR 436-030-0580
Penalties and Sanctions
(1)
Under ORS 656.745 (Civil penalty for inducing failure to report claims), the director or designee may assess a civil penalty against an employer or insurer who fails to comply with the statutes, rules, or orders of the director regarding reports or other requirements necessary to carry out the purposes of the Workers’ Compensation Law.(2)
An insurer or health care provider failing to meet the requirements set forth in these rules may be assessed a civil penalty.(3)
Under OAR 436-010-0340 (Sanctions and Civil Penalties), the director may impose sanctions for any health care provider where the insurer can provide sufficient documentation to substantiate lack of cooperation. The medical service provider will be sent a warning letter about the reporting requirements and possible penalties. Failure by the health care provider to submit the requested information within the specified period may result in civil penalties.(4)
Sufficient documentation to substantiate lack of cooperation by the health care provider includes:(a)
Copies of letters to the health care provider;(b)
Memos to the claim file of follow-up phone calls or the lack of response;(c)
Letters from the health care provider indicating a lack of cooperation; or(d)
Medical reports received by the insurer, after adequate instruction by the insurer or the director, which do not supply the requested information or which supply information that is not consistent with the Disability Rating Standards in OAR 436-035.
Source:
Rule 436-030-0580 — Penalties and Sanctions, https://secure.sos.state.or.us/oard/view.action?ruleNumber=436-030-0580.