OAR 436-060-0200: Assessment of Civil Penalties

(1) Penalties for inducing failure to report claims. The director will assess a civil penalty under ORS 656.745(1) against an employer or insurer that intentionally or repeatedly induces workers to fail to report accidental injuries, causes employees to collect accidental injury claims as off-the-job injury claims, persuades workers to accept less than the compensation due or makes it necessary for workers to resort to proceedings against the employer to secure compensation due. For the purpose of this section: (a) "Intentionally" means the employer or insurer acted with a conscious objective to engage in the conduct or cause any result described in this section; and (b) "Repeatedly" means more than once in any 12-month period. (2) Penalties for failure to comply with statutes, rules, and orders. The director may assess a civil penalty under ORS 656.745(2) against an employer or insurer that violates ORS chapter 656, OAR chapter 436, or orders of the director regarding reports or other requirements necessary to carry out the purposes of ORS chapter 656. Except as provided in ORS 656.780, the director may assess a civil penalty against a service company only for claims processing violations identified in the director’s annual audits of claims processing performance. The director may assess only one penalty for each separate violation by an employer, insurer, or service company identified in an annual audit. (3) Penalties for misrepresentation to obtain claims records. The director may assess a civil penalty of $1,000 against any employer or insurer that misrepresents itself in any manner to obtain workers’ compensation claims records from the director, or that uses such records in a manner contrary to these rules. In addition, the director may suspend or revoke: (a) An employer’s or insurer’s access to workers’ compensation claims records for such time as the director may determine; or (b) Any other person’s access to workers’ compensation claims records if the director determines they have misrepresented themselves or used records in a manner contrary to these rules. (4) Performance audits. Insurers will be subject to periodic performance audits. Civil penalties may be issued for each area where the insurer’s performance falls below the acceptable standards specified for audits. (5) Penalty to worker’s attorney for failure to cooperate with insurer’s investigation. The director may assess a civil penalty not to exceed $1,000 against a worker’s attorney that is unreasonably unwilling or unavailable to participate in an insurer’s interview as required by ORS 656.262(14).