Oregon Department of Consumer and Business Services, Workers' Compensation Division

Rule Rule 436-060-0015
Required Notice and Information


(1) Notice to worker’s attorney. If a worker is represented by an attorney, and the attorney has given written notice of representation, the insurer must provide written notice to the worker’s attorney before, or at the same time, as the insurer:
(a) Requests the worker to submit to a medical examination;
(b) Contacts the worker regarding any matter that may result in denial, reduction, or termination of the worker’s benefits; or
(c) Contacts the worker regarding any matter relating to the disposition of a claim under ORS 656.236 (Compromise and release of claim matters except for medical benefits).
(2) Penalty for failure to provide notice to worker’s attorney. The director may assess a civil penalty against an insurer that intentionally or repeatedly fails to give notice as required under section (1) of this rule.
(3) Information provided to worker. The insurer or service company must provide:
(a) Form 1138, “What happens if I’m hurt on the job?” to every worker who has a disabling claim with the first disability check or earliest written correspondence. For nondisabling claims, Form 3283, “A Guide for Workers Recently Hurt on the Job,” may be provided in place of Form 1138, unless the worker specifically requests Form 1138;
(b) Form 3283 to its insured employers. Form 3283 may be printed on the back of Form 801;
(c) Form 3058, “Notice to Worker,” or an equivalent form, to the worker with the initial notice of acceptance of the claim under OAR 436-060-0140 (Acceptance or Denial of a Claim)(6). If an equivalent form is provided, it must include all of the information included on Form 3058; and
(d) The additional notices required under OAR 436-060-0018 (Nondisabling and Disabling Claim Reclassification), 436-060-0030 (Payment of Temporary Partial Disability Compensation), 436-060-0035 (Supplemental Disability for Workers with Multiple Jobs at the Time of Injury), 436-060-0095 (Medical Examinations; Suspension of Compensation; and Independent Medical Examination Notice), 436-060-0105 (Suspension of Compensation for Insanitary or Injurious Practices, Refusal of Treatment or Failure to Participate in Rehabilitation; Reduction of Benefits), 436-060-0135 (Injured Worker, Worker’s Attorney Responsible to Assist in Investigation; Suspension of Compensation and Notice to Worker), 436-060-0140 (Acceptance or Denial of a Claim), and 436-060-0180 (Designation and Responsibility of a Paying Agent).
(4) Notice of change of processing location. When the insurer changes claims processing locations, service companies, or self-administration, the insurer must provide at least 10 days prior notice to workers with open or active claims, their attorneys, and attending physicians. The notice must provide the name of a contact person, telephone number, email address, and mailing address of the new claim processor.
(5) Notice of change in rate of compensation and benefit amounts. When the insurer changes the rate of compensation, the wage used to calculate benefit amounts, or the method of calculation used to determine benefits, the insurer must provide a written explanation of any change to the worker and the worker’s attorney, if any.
(6) Notice of wage used to calculate benefits at closure. Before closure of a disabling claim the insurer must send a notice to the worker that:
(a) Documents the wage upon which benefits were based;
(b) Informs the worker that work disability, if applicable, will be determined when the claim is closed; and
(c) Explains how the worker can appeal the insurer’s wage calculation if the worker disagrees with the wage.
Source

Last accessed
Jun. 8, 2021