Oregon WCD implements new rejection policy for incomplete or incorrect 801 forms
In a June 27, 2017 Industry Notice, the Oregon WCD announced it will reject incomplete or incorrect insurer/employer created 801 and 1502 forms. Insurers and self-insured employers are required to process and file claims and reports with the WCD in compliance with ORS 656 and OAR chapter 436. OAR 436-060-0011 requires insurers/self-insured employers file a 1502 form within 14 days of (1) the initial decision to accept or deny the claim; (2) the date of any reopening of the claim; (3) the date of change in the acceptance or classification of the claim; (4) the date of a litigation order or the insurer’s decision that changes the acceptance or classification of the claim or causes the claim to be reopened; (5) the date a worker is enrolled in an MCO if this occurs after the initial form 1502 has been filed; (6) the date of a denial that occurs after the initial form 1502 has been filed; (7) the date the insurer has knowledge that a previously filed form 1502 contained erroneous information; or (8) the date first payment of temporary disability is issued, if the date was not included on the initial 1502.
Each 1502 form filed by the insurer must include: (1) the worker’s legal name; (2) the worker’s Social Security Number; (3) the insurer’s claim number; (4) date of injury; (5) the employer’s legal name; (6) the employer’s policy number; (7) the status of the claim; and (8) the reason for filing. The initial 1502 form must be accompanied by an 801 form. All workers’ compensation forms generated by the insurer must include: (1) the insurer’s name; (2) the service company’s name if applicable; and (3) the mailing address and phone number of the location responsible for processing the claim.
As of August 1, 2017, any insurer prepared 801 or 1502 form that is missing the required information or is illegible will be rejected by the division and returned to the claim processor by mail. The rejected form will include a checklist stating the reasons the form was rejected. A rejected form is considered not filed. Failure to properly file required notice and forms within the time frames can result in civil penalty.