ORS 656.340
Vocational assistance procedure

  • eligibility criteria
  • service providers
  • resolution of vocational assistance disputes
  • rules

(1)

Intentionally left blank —Ed.

(a)

The insurer or self-insured employer shall cause vocational assistance to be provided to an injured worker who is eligible for assistance in returning to work.

(b)

For this purpose the insurer or self-insured employer shall contact a worker with a claim for a disabling compensable injury or claim for aggravation for evaluation of the worker’s eligibility for vocational assistance within five days of:

(A)

Having knowledge of the worker’s likely eligibility for vocational assistance, from a medical or investigation report, notification from the worker, or otherwise; or

(B)

The time the worker is medically stationary, if the worker has not returned to or been released for the worker’s regular employment or has not returned to other suitable employment with the employer at the time of injury or aggravation and the worker is not receiving vocational assistance.

(c)

Eligibility may be redetermined by the insurer or self-insured employer upon receipt of new information that would change the eligibility determination.

(2)

Contact under subsection (1) of this section shall include informing the worker about reemployment rights, the responsibility of the worker to request reemployment, and wage subsidy and job site modification assistance and the provisions of the preferred worker program pursuant to rules adopted by the Director of the Department of Consumer and Business Services.

(3)

Within five days after notification that the attending physician or nurse practitioner authorized to provide compensable medical services under ORS 656.245 (Medical services to be provided) has released a worker to return to work, the insurer or self-insured employer shall inform the worker about the opportunity to seek reemployment or reinstatement under ORS 659A.043 (Reinstatement of injured worker to former position) and 659A.046 (Reemployment of injured worker in other available and suitable work). The insurer shall inform the employer of the worker’s reemployment rights, wage subsidy and the job site modification assistance and the provisions of the preferred worker program.

(4)

As soon as possible, and not more than 30 days after the contact required by subsection (1) of this section, the insurer or self-insured employer shall cause an individual certified by the director to provide vocational assistance to determine whether the worker is eligible for vocational assistance. The insurer or self-insured employer shall notify the worker of the decision regarding the worker’s eligibility for vocational assistance. If the insurer or self-insured employer decides that the worker is not eligible, the worker may apply to the director for review of the decision as provided in subsection (16) of this section. A worker determined ineligible upon evaluation under subsection (1)(b)(B) of this section, or because the worker’s eligibility has fully and finally expired under standards prescribed by the director, may not be found eligible thereafter unless that eligibility determination is rejected by the director under subsection (16) of this section or the worker’s condition worsens so as to constitute an aggravation claim under ORS 656.273 (Aggravation for worsened conditions). A worker is not entitled to vocational assistance benefits when possible eligibility for such benefits arises from a worsening of the worker’s condition that occurs after the expiration of the worker’s aggravation rights under ORS 656.273 (Aggravation for worsened conditions).

(5)

The objectives of vocational assistance are to return the worker to employment which is as close as possible to the worker’s regular employment at a wage as close as possible to the weekly wage currently being paid for employment which was the worker’s regular employment even though the wage available following employment may be less than the wage prescribed by subsection (6) of this section. As used in this subsection and subsection (6) of this section, “regular employment” means the employment the worker held at the time of the injury or the claim for aggravation under ORS 656.273 (Aggravation for worsened conditions), whichever gave rise to the potential eligibility for vocational assistance; or, for a worker not employed at the time of the aggravation, the employment the worker held on the last day of work prior to the aggravation.

(6)

Intentionally left blank —Ed.

(a)

A worker is eligible for vocational assistance if the worker will not be able to return to the previous employment or to any other available and suitable employment with the employer at the time of injury or aggravation, and the worker has a substantial handicap to employment.

(b)

As used in this subsection:

(A)

A “substantial handicap to employment” exists when the worker, because of the injury or aggravation, lacks the necessary physical capacities, knowledge, skills and abilities to be employed in suitable employment.

(B)

“Suitable employment” means:
(i)
Employment of the kind for which the worker has the necessary physical capacity, knowledge, skills and abilities;
(ii)
Employment that is located where the worker customarily worked or is within reasonable commuting distance of the worker’s residence; and
(iii)
Employment that produces a weekly wage within 20 percent of that currently being paid for employment that was the worker’s regular employment as defined in subsection (5) of this section. The director shall adopt rules providing methods of calculating the weekly wage currently being paid for the worker’s regular employment for use in determining eligibility and for providing assistance to eligible workers. If the worker’s regular employment was seasonal or temporary, the worker’s wage shall be averaged based on a combination of the worker’s earned income and any unemployment insurance payments. Only earned income evidenced by verifiable documentation such as federal or state tax returns shall be used in the calculation. Earned income does not include fringe benefits or reimbursement of the worker’s employment expenses.

(7)

Vocational evaluation, help in directly obtaining employment and training shall be available under conditions prescribed by the director. The director may establish other conditions for providing vocational assistance, including those relating to the worker’s availability for assistance, participation in previous assistance programs connected with the same claim and the nature and extent of assistance that may be provided. Such conditions shall give preference to direct employment assistance over training.

(8)

An insurer or self-insured employer may utilize its own staff or may engage any other individual certified by the director to perform the vocational evaluation required by subsection (4) of this section.

(9)

The director shall adopt rules providing:

(a)

Standards for and methods of certifying individuals qualified by education, training and experience to provide vocational assistance to injured workers;

(b)

Standards for registration of vocational assistance providers;

(c)

Conditions and procedures under which the certification of an individual to provide vocational assistance services or the registration of a vocational assistance provider may be suspended or revoked for failure to maintain compliance with the certification or registration standards;

(d)

Standards for the nature and extent of services a worker may receive, for plans for return to work and for determining when the worker has returned to work; and

(e)

Procedures, schedules and conditions relating to the payment for services performed by a vocational assistance provider, that are based on payment for specific services performed and not fees for services performed on an hourly basis. Fee schedules shall reflect a reasonable rate for direct worker purchases and for all vocational assistance providers and shall be the same within suitable geographic areas.

(10)

Insurers and self-insured employers shall maintain records and make reports to the director of vocational assistance actions at times and in the manner as the director may prescribe. The requirements prescribed shall be for the purpose of assisting the Department of Consumer and Business Services in monitoring compliance with this section to insure that workers receive timely and appropriate vocational assistance. The director shall minimize to the greatest extent possible the number, extent and kinds of reports required. The director shall compile a list of organizations or agencies registered to provide vocational assistance. A current list shall be distributed by the director to all insurers and self-insured employers. The insurer shall send the list to each worker with the notice of eligibility.

(11)

When a worker is eligible to receive vocational assistance, the worker and the insurer or self-insured employer shall attempt to agree on the choice of a vocational assistance provider. If the worker agrees, the insurer or self-insured employer may utilize its own staff to provide vocational assistance. If they are unable to agree on a vocational assistance provider, the insurer or self-insured employer shall notify the director and the director shall select a provider. Any change in the choice of vocational assistance provider is subject to the approval of the director.

(12)

Notwithstanding ORS 656.268 (Claim closure), a worker actively engaged in training may receive temporary disability compensation for a maximum of 16 months. The insurer or self-insured employer may voluntarily extend the payment of temporary disability compensation to a maximum of 21 months. The director may order the payment of temporary disability compensation for up to 21 months upon good cause shown by the injured worker. The costs related to vocational assistance training programs may be paid for periods longer than 21 months, but in no event may temporary disability benefits be paid for a period longer than 21 months.

(13)

As used in this section, “vocational assistance provider” means a public or private organization or agency that provides vocational assistance to injured workers.

(14)

Intentionally left blank —Ed.

(a)

Determination of eligibility for vocational assistance does not entitle all workers to the same type or extent of assistance.

(b)

Training shall not be provided to an eligible worker solely because the worker cannot obtain employment, otherwise suitable, that will produce the wage prescribed in subsection (6) of this section unless such training will enable the worker to find employment which will produce a wage significantly closer to that prescribed in subsection (6) of this section.

(c)

Nothing in this section shall be interpreted to expand the availability of training under this section.

(15)

A physical capacities evaluation shall be performed in conjunction with vocational assistance or determination of eligibility for such assistance at the request of the insurer or self-insured employer or worker. The request shall be made to the attending physician or nurse practitioner authorized to provide compensable medical services under ORS 656.245 (Medical services to be provided). The attending physician or nurse practitioner, within 20 days of the request, shall perform a physical capacities evaluation or refer the worker for such evaluation or advise the insurer or self-insured employer and the worker in writing that the injured worker is incapable of participating in a physical capacities evaluation.

(16)

Intentionally left blank —Ed.

(a)

The Legislative Assembly finds that vocational rehabilitation of injured workers requires a high degree of cooperation between all of the participants in the vocational assistance process. Based on this finding, the Legislative Assembly concludes that disputes regarding eligibility for and extent of vocational assistance services should be resolved through nonadversarial procedures to the greatest extent possible consistent with constitutional principles. The director shall adopt by rule a procedure for resolving vocational assistance disputes in the manner provided in this subsection.

(b)

If a worker is dissatisfied with an action of the insurer or self-insured employer regarding vocational assistance, the worker must apply to the director for administrative review of the matter. Application for review must be made not later than the 60th day after the date the worker was notified of the action. The director shall complete the review within a reasonable time.

(c)

If the worker’s dissatisfaction is resolved by agreement of the parties, the agreement shall be reduced to writing, and the director and the parties shall review the agreement and either approve or disapprove it. The agreement is subject to reconsideration by the director under limitations prescribed by the director, but is not subject to review by any other forum.

(d)

If the worker’s dissatisfaction is not resolved by agreement of the parties, the director shall resolve the matter in a written order based on a record sufficient to permit review. The order is subject to review under ORS 656.704 (Actions and orders regarding matters concerning claim and matters other than matters concerning claim). The request for a hearing must be filed within 60 days of the date the order was issued. At the hearing, the order of the director shall be modified only if it:

(A)

Violates a statute or rule;

(B)

Exceeds the statutory authority of the agency;

(C)

Was made upon unlawful procedure; or

(D)

Was characterized by abuse of discretion or clearly unwarranted exercise of discretion.

(e)

For purposes of this subsection, the term “parties” does not include a noncomplying employer. [1981 c.535 §2; 1985 c.600 §11; 1987 c.884 §15; 1990 c.2 §27; 1995 c.332 §42; amendments by 1995 c.332 §42a repealed by 1999 c.6 §1; 2003 c.811 §§15,16; 2007 c.365 §8; 2009 c.35 §1; 2009 c.312 §1; 2013 c.103 §1]

Source: Section 656.340 — Vocational assistance procedure; eligibility criteria; service providers; resolution of vocational assistance disputes; rules, https://www.­oregonlegislature.­gov/bills_laws/ors/ors656.­html.

Notes of Decisions

Fixing maximum fees is within Department of Insurance and Finance’s authority and determination that established rates are reasonable was within agency’s range of discretion. Oregon Assn. of Rehab. Prof. v. Dept. of Ins., 99 Or App 613, 783 P2d 1014 (1989)

Vocational assistance is not available where claim for new medical condition is initiated after worker’s aggravation rights have expired. Lloyd v. American Manufacturers Mutual Insurance, 202 Or App 592, 123 P3d 357 (2005), Sup Ct review denied

Director of Department of Consumer and Business Services may establish prerequisites for vocational assistance eligibility that supplement statutory conditions for eligibility. Carreon v. Commerce and Industry Insurance Co., 233 Or App 440, 226 P3d 73 (2010)

If worker becomes eligible more than once to receive training-related benefits under ORS 656.268, limitations on payment of training-related temporary disability apply to each period of eligibility separately. Intel Corp. v. Batchler, 267 Or App 782, 341 P3d 837 (2014)

Weekly wage from regular employment for worker holding multiple employments is total wage from all regular employments worker held at time of injury or claim for aggravation. Chu v. SAIF, 290 Or App 194, 415 P3d 68 (2018), Sup Ct review denied

Law Review Citations

32 WLR 217 (1996)

656.001
Short title
656.003
Application of definitions to construction of chapter
656.005
Definitions
656.006
Effect on employers’ liability law
656.008
Extension of laws relating to workers’ compensation to federal lands and projects within state
656.010
Treatment by spiritual means
656.012
Findings and policy
656.017
Employer required to pay compensation and perform other duties
656.018
Effect of providing coverage
656.019
Civil negligence action for claim denied on basis of failure to meet major contributing cause standard
656.020
Damage actions by workers against noncomplying employers
656.021
Coverage exception for laborers under contracts with construction and landscape contractor licensees
656.023
Who are subject employers
656.025
Individuals engaged in commuter ridesharing not subject workers
656.027
Who are subject workers
656.029
Obligation of person awarding contract to provide coverage for workers under contract
656.031
Coverage for municipal volunteer personnel
656.033
Coverage for participants in work experience or school directed professional training programs
656.035
Status of workers in separate occupations of employer
656.037
Exemption from coverage for persons engaged in certain real estate activities
656.039
Election of coverage for workers not subject to law
656.041
City or county may elect to provide coverage for adults in custody
656.043
Governmental agency paying wages responsible for providing coverage
656.044
State Accident Insurance Fund Corporation may insure liability under Longshoremen’s and Harbor Workers’ Compensation Act
656.046
Coverage of persons in college work experience and professional education programs
656.052
Prohibition against employment without coverage
656.054
Claim of injured worker of noncomplying employer
656.056
Subject employers must post notice of manner of compliance
656.070
Definitions for ORS 656.027, 656.070 and 656.075
656.075
Exemption from coverage for newspaper carriers
656.126
Coverage while temporarily in or out of state
656.128
Sole proprietors, limited liability company members, partners, independent contractors may elect coverage by insurer
656.132
Coverage of minors
656.135
Coverage of deaf school work experience trainees
656.138
Coverage of apprentices, trainees participating in related instruction classes
656.140
Coverage of persons operating equipment for hire
656.154
Injury due to negligence or wrong of a person not in the same employ as injured worker
656.156
Intentional injuries
656.160
Effect of incarceration on receipt of compensation
656.170
Validity of provisions of certain collective bargaining agreements
656.172
Applicability of and criteria for establishing program under ORS 656.170
656.174
Rules
656.202
Compensation payable to subject worker in accordance with law in effect at time of injury
656.204
Death
656.206
Permanent total disability
656.208
Death during permanent total disability
656.209
Offsetting permanent total disability benefits against Social Security benefits
656.210
Temporary total disability
656.211
“Average weekly wage” defined
656.212
Temporary partial disability
656.214
Permanent partial disability
656.216
Permanent partial disability
656.218
Continuance of permanent partial disability payments to survivors
656.222
Compensation for additional accident
656.225
Compensability of certain preexisting conditions
656.226
Cohabitants and children entitled to compensation
656.228
Payments directly to beneficiary or custodian
656.230
Lump sum award payments
656.232
Payments to aliens residing outside of United States
656.234
Compensation not assignable nor to pass by operation of law
656.236
Compromise and release of claim matters except for medical benefits
656.240
Deduction of benefits from sick leave payments paid to employees
656.245
Medical services to be provided
656.247
Payment for medical services prior to claim acceptance or denial
656.248
Medical service fee schedules
656.250
Limitation on compensability of physical therapist services
656.252
Medical report regulation
656.254
Medical report forms
656.256
Considerations for rules regarding certain rural hospitals
656.258
Vocational assistance service payments
656.260
Certification procedure for managed health care provider
656.262
Processing of claims and payment of compensation
656.263
To whom notices sent under ORS 656.262, 656.265, 656.268 to 656.289, 656.295 to 656.325 and 656.382 to 656.388
656.264
Compensable injury, denied claim and other reports
656.265
Notice of accident from worker
656.266
Burden of proving compensability and nature and extent of disability
656.267
Claims for new and omitted medical conditions
656.268
Claim closure
656.273
Aggravation for worsened conditions
656.277
Request for reclassification of nondisabling claim
656.278
Board has continuing authority to alter earlier action on claim
656.283
Hearing rights and procedure
656.285
Protection of witnesses at hearings
656.287
Use of vocational reports in determining loss of earning capacity at hearing
656.289
Orders of Administrative Law Judge
656.291
Expedited Claim Service
656.295
Board review of Administrative Law Judge orders
656.298
Judicial review of board orders
656.304
When acceptance of compensation precludes hearing
656.307
Determination of issues regarding responsibility for compensation payment
656.308
Responsibility for payment of claims
656.310
Presumption concerning notice of injury and self-inflicted injuries
656.313
Stay of compensation pending request for hearing or review
656.319
Time within which hearing must be requested
656.325
Required medical examination
656.327
Review of medical treatment of worker
656.328
List of authorized providers and standards of professional conduct for providers of independent medical examinations
656.331
Contact, medical examination of worker represented by attorney prohibited without written notice
656.340
Vocational assistance procedure
656.360
Confidentiality of worker medical and vocational claim records
656.362
Liability for disclosure of worker medical and vocational claim records
656.382
Penalties and attorney fees payable by insurer or employer in processing claim
656.383
Attorney fees in cases prior to decision or after request for hearing
656.385
Attorney fees in cases regarding certain medical service or vocational rehabilitation matters
656.386
Recovery of attorney fees, expenses and costs in appeal on denied claim
656.388
Approval of attorney fees required
656.390
Frivolous appeals, hearing requests or motions
656.403
Obligations of self-insured employer
656.407
Qualifications of insured employers
656.419
Workers’ compensation insurance contracts
656.423
Cancellation of coverage by employer
656.427
Termination of workers’ compensation insurance contract or surety bond liability by insurer
656.430
Certification of self-insured employer
656.434
Certification effective until canceled or revoked
656.440
Notice of certificate revocation
656.441
Advancement of funds from Workers’ Benefit Fund for compensation due workers insured by certain decertified self-insured employer groups
656.443
Procedure upon default by employer or self-insured employer group
656.445
Advancement of funds from Workers’ Benefit Fund for compensation due workers insured by insurer in default
656.447
Sanctions against insurer for failure to comply with contracts, orders or rules
656.455
Self-insured employers to process claims and make records available at authorized locations
656.502
“Fiscal year” defined
656.504
Rates, charges, fees and reports by employers insured by State Accident Insurance Fund Corporation
656.505
Estimate of payroll when employer fails to file payroll report
656.506
Assessments for programs
656.508
Authority to fix premium rates for employers
656.526
Distribution of dividends from surplus in Industrial Accident Fund
656.536
Premium charges for coverage of reforestation cooperative workers based on prevailing wage
656.552
Deposit of cash, bond or letter of credit to secure payment of employer’s premiums
656.554
Injunction against employer failing to comply with deposit requirements
656.556
Liability of person letting a contract for amounts due from contractor
656.560
Default in payment of premiums, fees, assessments or deposit
656.562
Moneys due Industrial Accident Fund as preferred claims
656.564
Lien for amounts due from employer on real property, improvements and equipment on or with which labor is performed by workers of employer
656.566
Lien on property of employer for amounts due
656.576
“Paying agency” defined
656.578
Workers’ election whether to sue third person or noncomplying employer for damages
656.580
Payment of compensation notwithstanding cause of action for damages
656.583
Paying agency may compel election and prompt action
656.587
Paying agency must join in any compromise
656.591
Election not to bring action operates as assignment of cause of action
656.593
Procedure when worker or beneficiary elects to bring action
656.595
Precedence of cause of action
656.596
Damage recovery as offset against compensation
656.602
Disbursement procedures
656.605
Workers’ Benefit Fund
656.612
Assessments for department activities
656.614
Self-Insured Employer Adjustment Reserve
656.622
Reemployment Assistance Program
656.625
Reopened Claims Program
656.628
Workers with Disabilities Program
656.630
Oregon Institute of Occupational Health Sciences funding
656.632
Industrial Accident Fund
656.634
Trust fund status of Industrial Accident Fund
656.635
Reserve accounts in Industrial Accident Fund
656.636
Reserves in Industrial Accident Fund for awards for permanent disability or death
656.640
Creation of reserves
656.642
Emergency Fund
656.644
Petty cash funds
656.702
Disclosure of records of corporation, department and insurers
656.704
Actions and orders regarding matters concerning claim and matters other than matters concerning claim
656.708
Hearings Division
656.709
Ombudsman for injured workers
656.712
Workers’ Compensation Board
656.714
Removal of board member
656.716
Board members not to engage in political or business activity that interferes with duties as board member
656.718
Chairperson
656.720
Prosecution and defense of actions by Attorney General and district attorneys
656.722
Authority to employ subordinates
656.724
Administrative Law Judges
656.725
Duties and status of Administrative Law Judges
656.726
Duties and powers to carry out workers’ compensation and occupational safety laws
656.727
Rules for administration of benefit offset
656.730
Assigned risk plan
656.732
Power to compel obedience to subpoenas and punish for misconduct
656.735
Civil penalty for noncomplying employers
656.740
Review of proposed order declaring noncomplying employer or nonsubjectivity determination
656.745
Civil penalty for inducing failure to report claims
656.751
State Accident Insurance Fund Corporation created
656.752
State Accident Insurance Fund Corporation
656.753
State Accident Insurance Fund Corporation exempt from certain financial administration laws
656.754
Manager
656.758
Inspection of books, records and payrolls
656.772
Annual audit of State Accident Insurance Fund Corporation by Secretary of State
656.774
Annual report by State Accident Insurance Fund Corporation to Secretary of State
656.776
Notice to Secretary of State regarding action on audit report
656.780
Certification and training of claims examiners
656.790
Workers’ Compensation Management-Labor Advisory Committee
656.794
Advisory committee on medical care
656.795
Informational materials for nurse practitioners
656.797
Certification by nurse practitioner of review of required materials
656.798
Duty of insurer, self-insured employer and self-insured employer group to provide information to director
656.799
Informational materials for other health care professionals
656.802
Occupational disease
656.804
Occupational disease as an injury under Workers’ Compensation Law
656.807
Time for filing of claims for occupational disease
656.850
License
656.855
Licensing system for worker leasing companies
656.990
Penalties
Green check means up to date. Up to date