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    Barbara Belcher   
503-947-7687   

Claims examiner certification

WCD has set standards (OAR 436-055) for certification to be administered by insurers, self-insured employers, and third party administrators (service companies).

All insurers, self-insurers, and third-party administrators processing Oregon Workers' Compensation claims shall maintain records of their claims examiners employed to process claims. These records shall include:

A listing of all certified claims examiners

Identification of all certified claims examiners, which includes:
a. Verifiable documentation of current certification
b. Beginning and ending dates of these certifications

Identification of all temporary claims examiners, including:
a. Documentation verifying the 2 year experience requirement
b. Dates of employment for the 12 month period (or audit period)
c. Name of supervising certified claims examiner

Identification of all claims examiner trainees, including:
a. Dates of employment for the 12 month training period (or audit period)
b. Name of supervising certified claims examiner

Records of qualified training for certified claims examiners, subsequent to most recent certification, including:
a. Name of instructor(s)
b. Syllabus
c. Date(s) of training
d. Time(s) of training
e. Hours of training
f. Type of training (note if related to changes in workers’ compensation statutes, administrative rules, case law, and training
   related to interacting with independent medical examination providers.)

Records supporting initial acknowledgments of certification and renewals issued by the insurer, self-insurer or service companies

 

 

Certified claims examiners may wish to maintain copies of these items for their own records.

These records shall be subject to inspection or audit by the Workers' Compensation Division. The division may require submission of the records in lieu of an on-site inspection or audit.


If you have questions about this webpage, please contact Barbara Belcher, 503-947-7687.