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Benefit Consultation Team
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Purpose
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Respond to inquiries from
injured workers, insurers, employers, medical providers and attorneys in an effort
to resolve misunderstandings and differences which might otherwise result in sanctions
or litigation.
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Responsibilities
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General
inquiries: Interpret workers' compensation law and respond in person, by phone or
in writing.
Litigation - Review/interpret litigation orders to determine the effect they may
have on claims and if further division action is required.
Insurer responsibility - When responsibility for a claim
is the only issue between insurers, the benefit consultation team
will designate a paying agent until this issue can be resolved
at hearing. The teams directs any necessary monetary adjustments
between parties. This is also called a 307 order.
Pro rata distributions - When concurrent disability is
due the worker on two or more accepted claims the benefit consultant
may make a pro rata distribution between two or more insurers. |
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Functions
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benefit consultants respond to general inquiries in person, over the
telephone or by letter, including written responses for signature
by the administrator, the director, a legislator or the governor.
Workers' compensation issues related to injured worker benefits are
usually resolved by letter or phone, but in some cases, the benefit
consultants issue administrative orders. |
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Primary
governing rules
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| OAR
436-060: Claims Administration |
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For
more information contact:
Resolution
Section: 503-947-7585
Workers' Compensation Info-line: 1-800-452-0288
workcomp.questions@state.or.us
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