OAR 471-070-1260: Benefits: Authorized Agent of an Incapacitated or Deceased Claimant

(1) The director may designate an individual as an authorized agent to act on behalf of an incapacitated claimant or on behalf of a deceased claimant as specified in ORS 657B.090(5). The Paid Leave Oregon program will recognize only one individual representative for a claimant at a given time. If multiple individuals request to become an authorized agent of a deceased claimant, and the decedent’s estate does not have a personal representative or executor, or a person otherwise authorized by a probate court to manage the estate, the department will follow the order of individuals in ORS 293.490 when approving the designation. (2) If a claimant is incapacitated due to a serious health condition, as defined in OAR 471-070-1000, and is physically or mentally unable to designate a representative under OAR 471-070-1250 an individual who is a family member of the claimant, as defined in ORS 657B.010, may request to become an authorized agent of the incapacitated claimant. (3) An individual family member who is seeking to be designated as an authorized agent of a claimant who is incapacitated due to a serious health condition must submit the form approved by the department for this purpose, electronically or by regular mail. At a minimum, the form must include: (a) The claimant’s information: (A) First and last name; (B) Social Security Number or Individual Taxpayer Identification Number; (C) Date of birth; and (D) Contact information; including mailing address; (b) The authorized agent information: (A) First and last name; (B) Relationship to claimant; and (C) Contact information, including mailing address, and telephone number; (c) An authorization beginning date; (d) A dated certification with a handwritten signature from a health care provider, as defined in OAR 471-070-1000, who is treating the claimant due to their incapacitation and attests that the claimant is incapacitated and unable to complete the requirements for filing or providing information on a Paid Leave Oregon claim and unable to independently designate a representative; and (e) A dated attestation with a handwritten signature from the individual requesting to be designated as the authorized agent of the incapacitated claimant, declaring that they will: (A) Act in the best interest of the claimant; (B) Maintain claimant confidentiality; and (C) Inform the department within three calendar days of learning that the claimant is no longer incapacitated; (f) One or more of the following documents that show the individual’s family relationship to the claimant: (A) Certified Declaration of Domestic Partnership; (B) Legal marriage certificate; (C) Legal birth certificate; or (D) At the discretion of the department, other documents issued by an independent and verifiable third party that establish marriage, domestic partnership, parenthood, or other family relationship between the individual and claimant. (4)(a)The authorization referenced in section (2) of this rule will automatically end on the earlier of the following dates, as applicable: the date the department is informed that the claimant is no longer incapacitated, the last day of the claimant’s current benefit year, or the claimant’s date of death. (b) If no application for benefits is submitted for the incapacitated claimant within 30 calendar days of the department approving the individual as the authorized agent for the incapacitated claimant, the authorization ends. (5) In addition to family members referenced in section (2) of this rule, the following individuals may act on behalf of an incapacitated claimant: (a) An individual who has been court-appointed as a claimant’s legal guardian or conservator with the authority to make decisions on the claimant’s behalf, if the authorized individual provides a copy of the guardianship or conservatorship documentation to the department; or (b) An individual granted power of attorney by the claimant to act as the claimant’s ‘agent’ or ‘attorney-in-fact’ with respect to the claimant’s Paid Leave Oregon benefits or contributions, if the authorized individual provides documentation satisfactory to the department. (6) The documentation referenced in section (5) of this rule, at a minimum, must: (a) Show that the individual has specific authority to act on behalf of the claimant for Paid Leave Oregon purposes; (b) Provide dates that establish the period during which the individual has the authority to act on behalf of the claimant; (c) Include the name of the claimant and the name of the claimant’s legal guardian or conservator or the individual granted power of attorney; and (d) Include any other information the department specifies as necessary to establish the individual’s authority to act on behalf of the claimant. (7) If the authorized agent of an incapacitated claimant, a claimant’s court-appointed legal guardian or conservator, or the individual granted power of attorney by a claimant do not provide the information required in this rule or provide inaccurate information to the department, the claimant is responsible for any resulting delay, denial, overpayment, or disqualification for Paid Leave Oregon benefits. (8) If a claimant dies before submitting a claim for Paid Leave benefits or before a final decision is made regarding the claim, any of the individuals described in ORS 293.490(3) may request to become an authorized agent of a deceased claimant. (9) An individual seeking approval to be designated as an authorized agent for a deceased claimant must submit: (a) The form approved by the department for this purpose, electronically or by regular mail. At a minimum, the form must include: (A) The information listed in section (3)(a) and (b) of this rule; (B) The claimant’s date of death; (b) A death certificate or other documentation approved by the department that is sufficient to establish the date of death; (c) A dated attestation with a handwritten signature from the individual requesting to represent the deceased claimant, declaring that they will: (A) Act in the best interest of the claimant’s estate; (B) Maintain claimant confidentiality; and (d) One or more of the following documents that show the individual’s relationship to the deceased claimant: (A) Legal marriage certificate; (B) Legal birth certificate; (C) At the discretion of the department, other documents issued by an independent and verifiable third party that establish marriage, parenthood, or other relationship between the individual and claimant listed in ORS 293.490. (10) In addition to individuals referenced in section (8) of this rule, an executor or personal representative of the deceased claimant’s estate or person otherwise authorized by a probate court may be designated as authorized agent of the deceased claimant if the individual provides satisfactory documentation to the department that shows the individual’s authority. (11) The authority provided to the authorized agent of a deceased claimant automatically ends on the last day of the claimant’s current benefit year. If no application for benefits is submitted for the deceased claimant within 30 calendar days of the department approving the individual as the authorized agent for the deceased claimant, the authorization ends. (12) The individuals described in sections (2), (5), (8) and (10) of this rule must provide documentation approved by the department that is sufficient to establish the identity of the claimant and the individual seeking to be designated as an authorized agent of the incapacitated or deceased claimant. [Publications: Contact the Oregon Employment Department for information about how to obtain a copy of the publication referred to or incorporated by reference in this rule.]