Text Size:   A+ A- A   •   Text Only

    Rae Howe   
503-947-7018   

Employer-at-injury program
questions and answers

     
Past EAIP Q&A:  
Spring 2010 Q&A    
Summer 2008 Q&A    
Spring 2007 Q&A    
Winter 2006 Q&A    
Summer 2006 Q&A    
     
     

During the most recent revision of OAR 436-105, we attempted to clarify certain portions of the rules that were unclear, and we made an effort to simplify the process for obtaining reimbursement benefits. The following questions provide a summary of the changes we made during this revision:

Question

What are examples of "consumables," as defined in OAR 436-105-0005(3)?

Answer

OAR 436-105-0005(3) defines "Consumables" as "purchases required to support the functioning of tools or equipment during transitional work." Because previous versions of the rules were unclear about whether or not consumables were eligible for reimbursement under the Employer-at-Injury Program, the division added this definition to clarify that consumables are eligible for reimbursement, as mentioned in OAR 436-105-0520(3)(b). Examples include (but are not limited to) batteries, nails for a nail gun, or ink for a printer.


Question

How does the addition of "consumables" change the rules?

Answer

In older versions of the rules, the Division did not specifically mention that consumables were eligible EAIP purchases. Because of this, some employers said they could not purchase certain tools and equipment when those items also required an additional ongoing expense that was unaccounted for in their budgets.

Now it is clear, in OAR 436-105-0520(3)(b), that employers can purchase tools and equipment that require the use of these consumable materials. Consumables can be included within the maximum amount available for reimbursement through the EAIP category of "tools and equipment."


Question

What documentation is required during an audit of EAIP purchases?

Answer

In an audit, WCD looks for a legible copy of proof of payment for EAIP purchases, including proof the item was ordered during the EAIP. OAR 436-105-0500(7)(d).


Question

Do I have to provide proof that an item was delivered during the EAIP eligibility period?

Answer

No. OAR 436-105-0500(7)(d) only requires proof that the item was "ordered during the EAIP period, and proof of payment of the items…"

Even though items are ordered during the eligibility period, certain hang-ups may occur outside the employer's control that delay delivery of the purchases until after the eligibility period ends. The employer will not be penalized for things that are outside of their control, such as items being on back order, delays in shipment, etc. The employer's requirements are simply to order during the eligibility period and pay for the item.


Question What is the intent of the new language, "that resulted in the worker's EAIP eligibility, or to prevent a worsening of the worker's accepted or deferred conditions" in OAR 436-105-0520(2)?
   
Answer The intent of worksite modification purchases is to overcome restrictions caused by the worker's injury. This rule language specifies that worksite modification purchases must be tied to the restrictions that resulted from the injury while allowing for the purchase of items that help prevent a worsening of the worker's condition or provide greater comfort to the worker during the recovery process.

A common example may be the purchase of an anti-fatigue mat for a worker who can stand only for limited time periods. While the mat does not remove the worker's stand-duration restriction, the anti-fatigue mat can reduce the worker's discomfort in standing during the recovery period.

Question Wage subsidy reimbursements require payroll records showing the hours worked. However, our company does not track hours worked for our salaried employees. What documentation should I provide to show hours worked for a salaried employee?
   
Answer OAR 436-105-0500(7)(c) outlines the requirements for providing documentation of payroll records. In cases where standard payroll records do not include the dates and hours worked each day, the rules allow for "supplemental documentation" of hours worked and how the worker's earnings were calculated for the wage subsidy. Supplemental documentation can include a record of the worker's work schedule and irregularities of the worker's work schedule.

Question Does the EAIP program reimburse the shipping cost of items ordered for EAIP purchases?
   
Answer Yes, the shipping costs can be included in the total purchase cost, as long as the total does not exceed the maximum amount allowed for the category. Anything over the maximum can be purchased, but the program will only reimburse up to the maximum category amount.

Question What should I do if a worker has multiple claims that would have modified duty during the same time period? Should I submit documentation for both claims, or should I keep the claims separate?
   
Answer OAR 436-105-0520 and 0530 say that the EAIP can be used only once per worker per claim opening, and that a worker is eligible for only one EAIP at a time.

As an example, imagine that while a worker is in transitional work for injury #1, he has injury #2 and because of his restrictions, cannot continue doing the transitional work for injury #1. Because the worker can only do one individual EAIP at a time, transitional work for injury #1 would be put on hold in order to provide transitional work for injury #2. (The second injury is a different claim, so it would also be a different individual EAIP). When the individual EAIP for injury #2 is completed, you could resume transitional work and individual EAIP for injury #1 if still needed.

Question OAR 436-105-0500(7)(f) states that I must provide "documentation of the transitional work, which must include the start date, wage and hours, and a description of job duties." What constitutes a "description of job duties?"
   
Answer If the medical release is documented through a medical provider's statement that the worker is not released to regular employment, accompanied by a job description which includes the job duties and physical demands required for the transitional work, you have it covered. If there is a medical release that states the worker's specific restrictions, the description of job duties can be a brief description of duties sufficient to document that the job is not regular work and that the work is within the worker's injury-caused limitations.

Question Who receives the wage subsidy reimbursement when I am covered under an employer "wrap-up" policy?
   
Answer

A "wrap-up" policy is another term for Owner Controlled Insurance Program (OCIP). With this type of policy, the owner purchases insurance on behalf of all contractors employed for a specific project. The insurance covers contractors, subcontractors, construction management and state employees working on the construction site who are approved by the owner for participation in the program. The contractors are required to carry their own insurance for work off the site and to pay a deductible when claims occur.

When considering the recipient of EAIP benefits, the Workers' Compensation Division defines "employer" based on ORS 656.005(13)(a), which states that an employer is a person who "contracts to pay a remuneration for and secures the right to direct and control the services of any person." With this consideration, the Division will provide benefits to the employer that directs and controls the daily work activities of the worker.

If one of your workers is injured while working under an OCIP policy, you should file the injury report under the OCIP policy. In this case, the owner of the OCIP policy would be considered the legal employer for purposes of compensability - meaning it would be responsible for processing the claim. For this reason, the claim should be filed under the OCIP policy. However, the policy owner's involvement with the claim does not extend beyond processing the claim.

On the other hand, the contracted employer would be considered to be the employer for purposes of Employer-at-Injury Program benefits. The contracted employer directly controls the services of, and directly distributes the payroll to the worker, and therefore the contracted employer more closely fits the definition of "employer" as outlined in Oregon Revised Statute. As a result, because the contracted employer controls the daily work activities of the worker, s/he would receive the EAIP benefits, including wage subsidy. Any EAIP reimbursement paid to the owner of the OCIP policy should be passed through to the contracted employer.


Question If a worksite modification will cost more than $2500, can I itemize the separate components of the modification and utilize funds from the "tools and equipment" category to purchase some of the components of the modification?
   
Answer It depends on the nature of the worksite modification. If separate components of the worksite modification purchase are essential to the functioning of the worksite modification, they should be considered part of the modification and are not "tools and equipment." This is especially true when components are bundled and sold together with the modification. For example, if you were to purchase a table saw as worksite modification, the saw blades are part of the modification, and should not be itemized as "tools and equipment."

On the other hand, if the components of a worksite modification have completely different functions, then they may also qualify as "tools and equipment" purchases. For example, if the worksite modification includes an ergonomic workstation, ergonomic chair, and a cordless headset, then the chair and headset could qualify under either worksite modification or tools and equipment.


If you have questions about this webpage, please contact Rae Howe, 503-947-7018.