OAR 436-060-0137
Vocational Evaluations for Permanent Total Disability Benefits; and Suspension of Compensation

(1) Requests for vocational evaluations. A worker receiving permanent total disability benefits must attend a vocational evaluation reasonably requested by the insurer or the director.
(2) Allowed number of vocational evaluations. The insurer may request no more than three separate vocational evaluations without authorization from the director. Insurers that fail to obtain authorization from the director for additional vocational evaluations may be assessed a civil penalty.
(a) To request authorization the insurer must:
(A) Submit a written request for authorization that includes:
(i) The reasons for an additional vocational evaluation;
(ii) The conditions to be evaluated;
(iii) The dates, times, places, and purposes of previous evaluations;
(iv) Copies of previous vocational evaluation notification letters to the worker; and
(v) Any other information requested by the director;
(B) Provide a copy of the request to the worker and the worker’s attorney, if any.
(b) The director will review the request and determine if additional information is needed.
(A) Upon receipt of a request for additional information from the director, the parties will have 14 days to respond.
(B) If the parties do not provide the requested information, the director will approve or disapprove the request for authorization based on available information.
(c) The director’s decision approving or denying more than three vocational evaluations may be appealed to the board within 60 days of the order.
(d) For purposes of determining the number of insurer required vocational evaluations, any evaluations scheduled but not completed are not counted as a statutory vocational evaluation.
(3) Notice to worker. The insurer must notify the worker of the evaluation at least 10 days before the date of evaluation.
(a) The notice sent for each evaluation, including evaluations that have been rescheduled, must contain the following:
(A) The name of the vocational assistance provider or facility;
(B) A statement of the specific purpose for the evaluation;
(C) The date, time and place of the evaluation;
(D) The first and last name of the attending physician or authorized nurse practitioner or a statement that there is no attending physician or authorized nurse practitioner, whichever is appropriate;
(E) If applicable, confirmation that the director has approved the evaluation;
(F) Notice to the worker that the reasonable cost of public transportation or use of a private vehicle will be reimbursed; when necessary, reasonable cost of child care, meals, lodging and other related services will be reimbursed; a request for reimbursement must be accompanied by a sales slip, receipt or other evidence necessary to support the request; should an advance of costs be necessary for attendance, a request for advancement must be made in sufficient time to ensure a timely appearance; and
(G) The following notice in prominent or bold face type:
(b) The insurer may contract with a third party to schedule vocational evaluations. If the third party notifies the worker of a scheduled evaluation on behalf of the insurer, the third party must send the notice on the insurer’s stationery and the notice must meet the requirements of this section.
(4) Reimbursements of costs. The insurer must pay the costs of the vocational evaluation and related services necessary to allow the worker to attend the evaluation, including a reasonable cost of public transportation or use of a private vehicle, and when necessary, a reasonable cost of child care, meals, lodging and other related services. Child care costs reimbursed at the rate prescribed by the State of Oregon Department of Human Services, comply with this rule.
(5) Suspension of compensation. When the worker refuses or fails to attend, or otherwise obstructs, a vocational evaluation reasonably requested by the insurer or the director, the director may suspend the worker’s compensation by order, under the following conditions:
(a) The insurer must send the request for suspension to the division. A copy of the request, including all attachments, must be sent simultaneously to the worker and the worker’s attorney by registered or certified mail or by personal service;
(b) The request must include the following information:
(A) That the insurer requests suspension of benefits under ORS 656.206 (Permanent total disability) and OAR 436-060-0137 (Vocational Evaluations for Permanent Total Disability Benefits; and Suspension of Compensation);
(B) What specific actions of the worker prompted the request;
(C) The dates of any prior vocational evaluations the worker has attended and the names of the vocational assistance provider or facilities, or a statement that there have been no prior evaluations, whichever is appropriate;
(D) A copy of any approvals given by the director for more than three vocational evaluations, or a statement that no approval was necessary, whichever is appropriate;
(E) Any reasons given by the worker for failing to attend, whether or not the insurer considers the reasons invalid, or a statement that the worker has not given any reasons, whichever is appropriate;
(F) The date and with whom failure to comply was verified. Any written verification of the worker’s refusal to attend the vocational evaluation received by the insurer from the worker or the worker’s attorney will be sufficient documentation with which to request suspension;
(G) A copy of the letter required in section (3) of this rule and a copy of any written verification received under paragraph (F) of this subsection;
(H) Any other information that supports the request; and
(I) The following notice in prominent or bold face type:
(c) If the director suspends compensation:
(A) The suspension will be effective from the date the worker fails to attend a vocational evaluation or such other date the director determines is appropriate until the date the worker attends the evaluation;
(B) The worker is not entitled to compensation during or for the period of suspension;
(C) The insurer must assist the worker to meet requirements necessary for the resumption of compensation payments. When the worker has attended the vocational evaluation, the insurer must verify the worker’s participation and resume compensation effective the date of the worker’s compliance;
(D) The director may modify or set aside the suspension order before or after filing of a request for hearing;
(E) The director may order payment of compensation previously suspended where the director finds the suspension to have been made in error; and
(F) The director may re-evaluate the necessity of continuing a suspension;
(d) If the insurer fails to comply with this rule, the director may deny the request for suspension. Any delay in requesting suspension may result in suspension being denied or the date of suspension being modified; and
(e) A suspension order becomes final unless, within 60 days after the date of mailing of the order, a party files a request for hearing on the order with the board.

Source: Rule 436-060-0137 — Vocational Evaluations for Permanent Total Disability Benefits; and Suspension of Compensation, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=436-060-0137.

436‑060‑0003
Purpose, Applicability, Forms, and Bulletins 436‑060‑0005
Definitions 436‑060‑0008
Administrative Review and Contested Cases 436‑060‑0010
Employer Responsibilities 436‑060‑0011
Insurer Reporting Requirements 436‑060‑0012
Notices and Correspondence Following the Death of a Worker 436‑060‑0015
Required Notice and Information 436‑060‑0017
Release of Claim Documents 436‑060‑0018
Nondisabling and Disabling Claim Reclassification 436‑060‑0019
Determining and Paying the Three Day Waiting Period 436‑060‑0020
Payment of Temporary Total Disability Compensation 436‑060‑0025
Worker’s Weekly Wage Calculation and Rate of Temporary Disability Compensation 436‑060‑0030
Payment of Temporary Partial Disability Compensation 436‑060‑0035
Supplemental Disability for Workers with Multiple Jobs at the Time of Injury 436‑060‑0040
Payment of Permanent Partial Disability Compensation 436‑060‑0045
Payment of Compensation During Worker Incarceration 436‑060‑0055
Payment of Medical Services on Nondisabling Claims 436‑060‑0060
Lump Sum Payment of Permanent Partial Disability Awards 436‑060‑0075
Payment of Death Benefits 436‑060‑0095
Medical Examinations 436‑060‑0105
Suspension of Compensation for Insanitary or Injurious Practices, Refusal of Treatment or Failure to Participate in Rehabilitation 436‑060‑0135
Injured Worker, Worker’s Attorney Responsible to Assist in Investigation 436‑060‑0137
Vocational Evaluations for Permanent Total Disability Benefits 436‑060‑0140
Acceptance or Denial of a Claim 436‑060‑0141
Claims for COVID-19 or Exposure to SARS-CoV-2 436‑060‑0147
Worker Requested Medical Examination 436‑060‑0150
Timely Payment of Compensation 436‑060‑0153
Electronic Payment of Compensation 436‑060‑0155
Penalty to Worker for Untimely Processing 436‑060‑0160
Use of Sight Draft to Pay Compensation Prohibited 436‑060‑0170
Recovery of Overpayment of Benefits 436‑060‑0180
Designation and Responsibility of a Paying Agent 436‑060‑0190
Monetary Adjustments among Parties and Department of Consumer and Business Services 436‑060‑0195
Miscellaneous Monetary Adjustments Among Insurers 436‑060‑0200
Assessment of Civil Penalties 436‑060‑0400
Penalty and Attorney Fee for Untimely Payment of Disputed Claims Settlement 436‑060‑0500
Reimbursement of Supplemental Disability for Workers with Multiple Jobs at the Time of Injury 436‑060‑0510
Reimbursement of Permanent Total Disability Benefits from the Workers’ Benefit Fund
Last Updated

Jun. 8, 2021

Rule 436-060-0137’s source at or​.us