Chapter 927 Oregon Laws 1999
Session Law
AN ACT
HB 2022
Relating to workers'
compensation benefits; amending ORS 656.202, 656.204 and 656.206.
Be It Enacted by the People of the State of Oregon:
SECTION 1.
ORS 656.202 is amended to read:
656.202. (1) If any subject worker sustains a compensable
injury, the worker or the beneficiaries of the worker, if the injury results in
death, shall receive compensation as provided in this chapter, regardless of
whether the worker was employed by a complying or noncomplying employer.
(2) Except as otherwise provided by law, payment of benefits
for injuries or deaths under this chapter shall be continued as authorized, and
in the amounts provided for, by the law in force at the time the injury giving
rise to the right to compensation occurred.
(3) When compensation is paid to a claimant or other payment is
made to the provider of service pursuant to this chapter, the insurer or
self-insured employer shall notify the payment recipient in writing of the
specific purpose of the payment. When applicable, the notice shall indicate the
time period for which the payment is made and the reimbursable expenses or
other bills and charges covered. If any portion of the claim is denied, the
notice shall identify that portion of the claimed amounts that is not being
paid.
(4) Notwithstanding subsections (1) to (3) of this section, the
amendments to ORS 656.325 by section 4, chapter 723, Oregon Laws 1981, and ORS
656.335 (1993 Edition) apply to all workers regardless of the date of injury.
(5) This section does not apply to vocational assistance
benefits.
(6) Notwithstanding subsection (2) of this section, the increase in benefits to the
surviving spouse of an injured worker made by the amendment to ORS 656.204
(2)(c) (1993 Edition) by section 1, chapter 108, Oregon Laws 1985, applies to a
surviving spouse who remarries after September 20, 1985, regardless of the date
of injury or death of the worker.
(7) Notwithstanding
subsection (2) of this section, the increase in benefits to the surviving
spouse of an injured worker made by the amendments to ORS 656.204 (3)(a) and
(b) (1997 Edition) by section 2 of this 1999 Act applies to a surviving spouse
who remarries on or after the effective date of this 1999 Act, regardless of
the date of injury or death of the worker.
SECTION 2.
ORS 656.204 is amended to read:
656.204. If death results from the accidental injury, payments
shall be made as follows:
(1) The cost of burial, including transportation of the body,
shall be paid, not to exceed 10 times the average weekly wage in any case.
(2)(a) If the worker is survived by a spouse, monthly benefits
shall be paid in an amount equal to 4.35 times 66-2/3 percent of the average
weekly wage to the surviving spouse until remarriage. The payment shall cease
at the end of the month in which the remarriage occurs.
(b) If the worker is survived by a spouse, monthly benefits
also shall be paid in an amount equal to 4.35 times 10 percent of the average
weekly wage for each child of the deceased
who is substantially dependent on the spouse for support, until such child
becomes 18 years of age.
(c) If the worker is
survived by a spouse, monthly benefits also shall be paid in an amount equal to
4.35 times 25 percent of the average weekly wage for each child of the deceased
who is not substantially dependent on the spouse for support, until such child
becomes 18 years of age.
[(c)] (d) If a surviving spouse receiving
monthly payments dies, leaving a child [under
18 years of age] who is entitled to compensation on account of the death of
the worker, a monthly benefit equal to 4.35 times 25 percent of the average
weekly wage shall be paid to each such child until the child becomes 18 years
of age or the child's entitlement to
benefits under subsection (8) of this section ceases, whichever is later.
[(d)] (e) If a child who has become 18 years
of age is a full-time high school student, benefits shall be paid as provided
in subsection (8) of this section.
[(e)] (f) In no event shall the total monthly
benefits provided for in this subsection exceed 4.35 times 133-1/3 percent of
the average weekly wage. If the sum of the individual benefits exceeds this
maximum, the benefit for each child will be reduced proportionally.
(3)(a) Upon remarriage, a surviving spouse shall be paid [24] 36
times the monthly benefit in a lump sum as final payment of the claim, but the
monthly payments for each child shall continue as before.
(b) If, after the date of the subject worker's death, the
surviving spouse cohabits with another person for an aggregate period of more
than one year and a child has resulted from the relationship, the surviving
spouse shall be paid [24] 36 times the monthly benefit in a lump
sum as final payment of the claim, but the monthly payment for any child who is
entitled to compensation on account of the death of the worker shall continue
as before.
(4)(a) If the worker leaves neither wife nor husband, but a
child under 18 years of age, a monthly benefit equal to 4.35 times 25 percent
of the average weekly wage shall be paid to each such child until the child
becomes 18 years of age.
(b) If a child who has become 18 years of age is a full-time
high school student, benefits shall be paid as provided in subsection (8) of
this section.
(c) In no event shall the total benefits provided for in this
subsection exceed 4.35 times 133-1/3 percent of the average weekly wage. If the
sum of the individual benefits exceeds this maximum, the benefit for each child
will be reduced proportionally.
(5)(a) If the worker leaves a dependent other than a surviving
spouse or a child, a monthly payment shall be made to each dependent equal to
50 percent of the average monthly support actually received by such dependent
from the worker during the 12 months next preceding the occurrence of the
accidental injury. If a dependent is under the age of 18 years at the time of
the accidental injury, the payment to the dependent shall cease when such
dependent becomes 18 years of age. The payment to any dependent shall cease
under the same circumstances that would have terminated the dependency had the
injury not happened.
(b) If the dependent who has become 18 years of age is a
full-time high school student, benefits shall be paid as provided in subsection
(8) of this section.
(c) In no event shall the total benefits provided for in this
subsection exceed 4.35 times 10 percent of the average weekly wage. If the sum
of the individual benefits exceeds this maximum, the benefit for each dependent
will be reduced proportionally.
(6) If a child is an invalid at the time the child otherwise
becomes ineligible for benefits under this section, the payment to the child
shall continue while the child remains an invalid. If a person is entitled to
payment because the person is an invalid, payment shall terminate when the
person ceases to be an invalid.
(7) If, at the time of the death of a worker, the child of the
worker or dependent has become 17 years of age but is under 18 years of age,
the child or dependent shall receive the payment provided in this section for a
period of one year from the date of the death. However, if after such period
the child is a full-time high school student, benefits shall be paid as
provided in subsection (8) of this section.
(8)(a) Benefits under this section which are to be paid as
provided in this subsection shall be paid for the child or dependent until the
child or dependent becomes 19 years of age. If, however, the child or dependent
is attending higher education or begins attending higher education within six
months of the date the child or dependent leaves high school, benefits shall be
paid until the child or dependent becomes 23 years of age, ceases attending
higher education or graduates from an approved institute or program, whichever
is earlier.
(b) As used in this subsection, "attending higher
education" means regularly attending community college, college or
university, or regularly attending a course of vocational or technical training
designed to prepare the participant for gainful employment. A child or
dependent enrolled in an educational course load of less than one-half of that
determined by the educational facility to constitute "full-time"
enrollment is not "attending higher education."
(9) As used in this section, "average weekly wage"
has the meaning for that term provided in ORS 656.211.
SECTION 3.
ORS 656.206 is amended to read:
656.206. (1) As used in this section:
(a) Notwithstanding ORS 656.225, "permanent total
disability" means the loss, including preexisting disability, of use or
function of any scheduled or unscheduled portion of the body which permanently
incapacitates the worker from regularly performing work at a gainful and
suitable occupation. As used in this section, a gainful occupation is one that
pays wages equal to or greater than the state mandated hourly minimum wage. As
used in this section, a suitable occupation is one that the worker has the
ability and the training or experience to perform, or an occupation that the
worker is able to perform after rehabilitation.
(b) "Wages" means wages as determined under ORS
656.210.
(2)[(a)] When
permanent total disability results from the injury, the worker shall receive
during the period of that disability compensation benefits equal to 66-2/3
percent of wages not to exceed 100 percent of the average weekly wage nor less
than the amount of 90 percent of wages a week or the amount of $50, whichever
amount is lesser.
[(b) In addition, the
worker shall receive $5 per week for each additional beneficiary not to exceed
five. However:]
[(A) If the beneficiary
is a child under the age of 18 years at the time of the compensable injury, the
benefits for such child shall cease when the child becomes 18 years of age.]
[(B) If the beneficiary
is a child who has become 18 years of age and who is a full-time high school
student, benefits shall be paid for such child until the child becomes 19 years
of age or graduates from high school, whichever is earlier.]
[(C) If the beneficiary
is a child who is enrolled, or enrolls within six months of the date the child
leaves high school, as a full-time student in an accredited institution of
higher education, a technical institute or an approved on-the-job training or
apprenticeship program, benefits shall be paid until the child becomes 23 years
of age or graduates from such an institute or program, whichever is earlier.]
(3) The worker has the burden of proving permanent total
disability status and must establish that the worker is willing to seek regular
gainful employment and that the worker has made reasonable efforts to obtain
such employment.
(4) When requested by the Director of the Department of
Consumer and Business Services, a worker who receives permanent total
disability benefits shall file on a form provided by the director, a sworn statement
of the worker's gross annual income for the preceding year along with such
other information as the director considers necessary to determine whether the
worker regularly performs work at a gainful and suitable occupation.
(5) Each insurer shall reexamine periodically each permanent
total disability claim for which the insurer has current payment responsibility
to determine whether the worker is currently permanently incapacitated from
regularly performing work at a gainful and suitable occupation. Reexamination
shall be conducted every two years or at such other more frequent interval as
the director may prescribe. Reexamination shall include such medical
examinations, reports and other records as the insurer considers necessary or
the director may require. The insurer shall forward to the director the results
of each reexamination.
Approved by the Governor
August 4, 1999
Filed in the office of
Secretary of State August 4, 1999
Effective date October 23,
1999
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