Criteria for Eligibility
(1)The criteria used to determine eligibility for relief from the Workers with Disabilities Program are:
(a)Without regard to employer knowledge, a worker must have a permanent physical or mental impairment, whether congenital or due to an injury or disease which would prevent the worker from obtaining or retaining employment. For the purpose of this section, a worker has a pre-existing permanent impairment if it is equal to or greater than twenty five percent (25%) of the whole person.
(b)There must be a subsequent compensable injury or injuries:
(A)To the worker with a disability resulting in cumulative claim(s) costs in excess of $1,000; or
(B)To other workers employed by the disabled worker’s employer resulting in cumulative claim(s) costs in excess of $1,000.
(c)The insurer or employer must demonstrate that the subsequent injury or injuries:
(A)Would not have been sustained except for the disabled worker’s impairment; or
(B)Would not have occurred, to workers of the same employer, except for the act or omission of a worker with a disability which resulted from the disabled worker’s impairment; or
(C)Resulted in disability which is at least one-fourth greater by reason of the worker’s pre-existing impairment, as determined by the division.
(2)An employer declared noncomplying in accordance with ORS 656.052 (Prohibition against employment without coverage) is not eligible for relief from the Workers with Disabilities Program for injuries to subject workers occurring during any period of noncompliance.
(3)A paying agency is not eligible for reimbursement from the Workers with Disabilities Program for any claim occurring to a worker during a period for which the employer is receiving premium reimbursement from the Re-employment Assistance Program, for that worker, pursuant to ORS 656.622 (Reemployment Assistance Program)(3).
Rule 436-040-0010 — Criteria for Eligibility,