Posted by T. Urtle on March 19, 1999 at 09:06:51:
In Reply to: Re: Reply to T. Urtle posted by Del on March 17, 1999 at 13:56:10:
I reviewed the Oregon Administrative Rules and I agree that the insurance carrier is not required to send the Notice of Closure by certified mail. However, you can request civil penalties against the insurance company if they do not provide a copy of the NOC to the worker or their attorney. Also, a hearing could be requested to address the issues that should have been argued on reconsideration.
A recent audit of the evaluations unit revealed that their closures were extremely inaccurate, (up to 50% of the closures). By and large, these inaccuracies were not interpretations of the law, but were simple math errors. I don't believe that this unit is "protecting" workers, because it is not their mission. We are left with a unit that is doing less and less work, highly inaccurate work, and no longer has a viable mission. Given these facts, what would you recommend if you were the administrator of the workers' compensation division?
Why do continue to advocate for this unit? They admit that they only close 25% of the claims and
this number is probably much less if you take out self-insured companies that don't have the resources to close their own claims. Just to be clear, the evaluations unit is not allowed to advocate for workers and does not have the power to reverse closures performed by insurance carriers. The appellate unit is responsible for reconsidering claim closures and they are not affected by SB 220. The wasted money on the evaluations unit would be better spent on increasing the number of auditors and increasing staff for the ombudsmans office.
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