(a)Prescribe uniform standards for determining eligibility, delivery, and payment for vocational services to injured workers;
(b)Prescribe procedures for resolving disputes; and
(c)Establish standards for the certification of counselors and providers.
(a)These rules govern vocational assistance under the workers’ compensation law on or after the effective date of these rules except as OAR 436-120 otherwise provides.
(b)Except as outlined below, the director’s decisions under OAR 436-120-0008 (Administrative Review and Hearings) regarding eligibility will be based on the rules in effect on the date the insurer issued the notice. If an eligibility decision involves the weekly wage under OAR 436-120-0147 (Establishing the Adjusted Weekly Wage)(3)(b)(B), the director’s decisions under OAR 436-120-0008 (Administrative Review and Hearings) regarding eligibility will rely on OAR 436-120-0147 (Establishing the Adjusted Weekly Wage)(3)(b)(B) in effect on the date of the director’s order. The director’s decisions regarding the nature and extent of assistance will be based on the rules in effect at the time the assistance was provided. If the director orders future assistance, such assistance must be provided in accordance with the rules in effect at the time assistance is provided.
(c)Under these rules a claim for aggravation or reopening a claim to process a newly accepted condition is considered a new claim for purposes of vocational assistance eligibility and vocational assistance, except as otherwise provided in these rules.
(a)The director may waive procedural rules as justice requires, unless otherwise obligated by statute.
(b)If the worker has returned to work with the employer at injury, the director reserves the right to verify whether the employment is suitable.
(a)Documents or information required under these rules to be submitted to the division may be submitted in any of the following ways:
(A)Mailed to the division’s mailing address with sufficient postage and placed in the custody of the U.S. Postal Service;
(B)Physical delivery to the division’s Salem office;
(C)Faxed, if the document transmitted indicates it has been delivered by fax, is sent to the correct fax number, and indicates the date it was sent; or
(D)Any other method authorized by the director.
(b)Timeliness of any document required by these rules to be submitted to the division is determined as follows:
(A)If a document is mailed, it will be considered submitted on the date it is postmarked.
(B)If a document is faxed, it must be received by 11:59 p.m. Pacific Time to be considered submitted on that date.
(C)If a document is delivered, it must be delivered during regular business hours and marked as received to be considered submitted on that date.
(c)Time periods allowed under these rules are calculated in calendar days. The first day is not included. The last day is included unless it is a Saturday, Sunday, or legal holiday. In that case, the period runs until the end of the next day that is not a Saturday, Sunday, or legal holiday. Legal holidays are those listed in ORS 187.010 (Legal holidays) and 187.020 (Additional legal holidays).
Rule 436-120-0003 — General Provisions,