Or. Admin. R. 436-050-0220

Current through Register Vol. 63, No. 6, June 1, 2024

Section 436-050-0220 - Records Self-Insured Employer Must Maintain; Period to be Retained, Removal and Disposition

(1)Records self-insured employers must maintain. Each self-insured employer is required to maintain the following records in Oregon, to make the records available at an Oregon claims processing location, and to provide the director access to the records upon request:

(a) Written records necessary to ensure compliance with ORS 656.506, 656.612, 656.614, and 656.622 including:

(A) A record of payroll by National Council on Compensation Insurance classification; and

(B) Complete records of all assessments, employer and employee contributions, and all such money due the director;

(b) Written records relating to its safety and health program as required by ORS 656.430(10) and OAR 437-001;

(c) Written records used and relied upon in processing each claim;

(d) A written record of all payments made as a result of any claim, including documentation of:

(A) The amount of the payment;

(B) The date the payment was issued;

(C) The date payment was mailed or delivered; and

(D) An explanation of the time period between the date the payment was issued and the date the payment was mailed or delivered, if any;

(e) A written record of all reimbursements and recoveries received on each claim;

(f) A written record of the approval or denial of claims for supplemental temporary disability benefits under ORS 656.210(5);

(g) A summary sheet for each claim showing all payments made, separated into disability, medical, and vocational assistance payments showing all reimbursements made and cumulative totals, subject to the following:

(A) The record of disability payments should be limited to statutory benefits and not include any additional employer obligations; and

(B) Expenses must not be included in any of the three columns required on the summary sheet. "Expenses" are defined in National Council on Compensation Insurance, Workers' Compensation Statistical Plan, Part IV(available from NCCI, www.ncci.com, 800-622-4123); and

(h) Written records, or copies of records, of claims processed by prior service companies.

(2)Availability of records. A self-insured employer must make records available by one or more of the following methods:

(a) By making the records electronically accessible from an Oregon claims processing locations in real time;

(b) By keeping physical copies of the records at an Oregon claims processing location; or

(c) By archiving physical copies of the records at a location other than an Oregon claims processing location, under the following conditions:

(A) Records of a denied claim may be archived after all the appellate procedures have been exhausted and the denial is final by operation of law;

(B) Records of any claim for a compensable injury, including a denied claim that is later found to be compensable, may be archived after the expiration of the aggravation rights or not less than one year following the final payment of compensation, whichever is the last to occur; and

(C) If administrative or judicial review is requested, the claim records may not be archived or disposed of until the review is concluded and the time for an appeal from such review has expired, or at least one year after final payment of compensation has been made, whichever is the last to occur.

(3)Destruction of claims records. The self-insured employer may destroy claim records when the self-insured employer can verify that all potential for benefits to the injured worker or the worker's beneficiaries is gone.

(4)Retention of payroll records required under this rule. Payroll records retained under subsection (1)(a) of this rule may be archived or destroyed at the end of three full calendar years after the calendar year in which the money was remitted.

Or. Admin. R. 436-050-0220

WCD 18-1975(Admin), f. 12-19-75, ef. 1-1-76; WCD 3-1980(Admin), f. & ef. 4-2-80; WCD 4-1982(Admin), f. 2-10-82, ef. 2-15-82; WCD 7-1983(Admin), f. 12-22-83, ef. 12-27-83; WCD 5-1985(Admin), f. 12-10-85, cert. ef. 1-1-86; Renumbered from 436-051-0335; WCD 9-1985(Admin), f. 12-12-85, ef. 1-1-86; WCD 9-1987, f. 12-18-87, ef. 1-1-88; WCD 7-1989, f. 12-22-89, cert. ef. 1-1-90; WCD 5-2001, f. 6-22-01, cert. ef. 7-1-01; WCD 12-2003, f. 12-4-03, cert. ef. 1-1-04; WCD 8-2005, f. 12-6-05, cert. ef. 1-1-06; WCD 1-2008, f. 6-13-08, cert. ef. 7-1-08; WCD 6-2012, f. 10-4-12, cert. ef. 1-1-13; WCD 5-2016, f. 11-28-16, cert. ef. 1/1/2017; WCD 20-2018, amend filed 11/15/2018, effective 1/1/2019; WCD 18-2021, amend filed 12/13/2021, effective 1/1/2022; WCD 7-2022, amend filed 11/07/2022, effective 1/1/2023

Statutory/Other Authority: ORS 656.455 & ORS 656.726(4)

Statutes/Other Implemented: ORS 656.455