OAR 436-120-0755
Reimbursement from the Workers’ Benefit Fund


(1)

Reimbursement. The director will reimburse the insurer for costs associated with providing vocational benefits when:

(a)

The director issues an order overturning the insurer’s denial of vocational benefits; and

(b)

The insurer’s denial is later upheld by a final order.

(2)

Required documentation. To receive reimbursement from the Workers’ Benefit Fund, the insurer must provide the division with the following documentation, within one year from the date of the final order:

(a)

Worker’s name and Workers’ Compensation Division’s claim file number;

(b)

Date and order number of the director’s order appealed;

(c)

Itemized listing with dates of service for all costs incurred after the date of the director’s order that was reversed. All costs, in order to be reimbursed, must meet all conditions set forth in these rules, and reimbursement requests must:

(A)

Use terms, “direct employment” or “training” to show the category of vocational assistance provided;

(B)

List provider costs by category of “professional services”;

(C)

List direct worker purchases by the categories in OAR 436-120-0710 (Direct Worker Purchases: Categories), and include purchase dates and costs;

(D)

Show temporary total disability paid between the start and end dates of the return to work plan; and

(E)

List any other costs incurred in providing vocational benefits as a result of the order that was appealed.

(d)

Signed statement certifying that the requested reimbursement amount was actually paid; and

(e)

The insurer’s name and address where reimbursement is to be sent.

(3)

Administrative costs not reimbursable. No reimbursement is allowed for the insurer’s administrative costs.

Source: Rule 436-120-0755 — Reimbursement from the Workers’ Benefit Fund, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=436-120-0755.

436‑120‑0003
General Provisions
436‑120‑0005
Definitions
436‑120‑0008
Administrative Review and Hearings
436‑120‑0012
General Requirements For Notices and Warnings
436‑120‑0115
Vocational Eligibility Evaluation
436‑120‑0117
Deferral of Eligibility Evaluation
436‑120‑0145
Vocational Assistance Eligibility
436‑120‑0147
Establishing the Adjusted Weekly Wage
436‑120‑0157
Determining Substantial Handicap to Employment
436‑120‑0165
End of Eligibility for Vocational Assistance
436‑120‑0175
Redetermining Eligibility for Vocational Assistance
436‑120‑0177
Selection of Category of Vocational Assistance
436‑120‑0185
Choosing a Counselor
436‑120‑0187
Optional Services
436‑120‑0197
Direct Employment
436‑120‑0410
Determining a Vocational Goal
436‑120‑0443
Training — General
436‑120‑0445
Training Requirements
436‑120‑0500
Training: Development and Implementation
436‑120‑0510
Training Plan Support
436‑120‑0520
Responsibilities of the Worker and the Counselor
436‑120‑0523
Re-evaluating a Training Plan
436‑120‑0527
Ending a Training Plan
436‑120‑0530
Director Review of Return-to-Work Plan
436‑120‑0700
Direct Worker Purchases
436‑120‑0710
Direct Worker Purchases: Categories
436‑120‑0720
Fee Schedule
436‑120‑0755
Reimbursement from the Workers’ Benefit Fund
436‑120‑0800
Registration of Providers
436‑120‑0810
Certification and Classification of Provider Staff
436‑120‑0820
Renewal of Certification
436‑120‑0840
Professional Standards for Providers and Counselors
436‑120‑0900
Audits, Penalties and Sanctions
436‑120‑0915
Sanctions of Providers and Counselors
Last Updated

Jun. 8, 2021

Rule 436-120-0755’s source at or​.us