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

Rule Rule 438-005-0053
Notice of Denial of Responsibility

(1)

If a self-insured employer or insurer intends to deny responsibility for a claim on the basis of injury or exposure with another employer, the self-insured employer or insurer shall, within the period allowed under ORS 656.262 (Processing of claims and payment of compensation) for processing the claim, so indicate in or as part of a denial otherwise meeting the requirements of 656.262 (Processing of claims and payment of compensation), OAR 436-001-0600 (Multilingual Help Page) (including Bulletin No. 379) and OAR 438-005-0055 (Notice of Claim Denial and Hearing Rights).

(2)

The notice shall:

(a)

Identify the condition(s) for which responsibility is being denied;

(b)

State the factual and legal reasons for the denial; and

(c)

Advise the claimant to file separate, timely claims against other potentially responsible insurers or self-insured employers, including other insurers for the same employer, in order to protect the claimant’s rights to obtain benefits on the claim.

(3)

The denial may:

(a)

List the names and addresses of other insurers or self-insured employers who may be responsible for the claimant’s condition; and

(b)

State whether the self-insured employer or insurer has requested the appointment of a paying agent pursuant to ORS 656.307 (Determination of issues regarding responsibility for compensation payment).
Source

Last accessed
Jun. 8, 2021

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