Oregon Administrative Rules
Chapter 471 - EMPLOYMENT DEPARTMENT
Division 70 - Paid Family Medical Leave Insurance
Section 471-070-1250 - Benefits: Claimant Designated Representative and Representation of Incapacitated Claimants

(1) A claimant may designate as a claimant designated representative an individual, 18 years of age or older, who is authorized by the claimant to represent the claimant by exchanging information with the Paid Family and Medical Leave Insurance (PFMLI) program on behalf of the claimant as specified in section (2) of this rule.

(2) A claimant designated representative, or an individual otherwise approved by the department to represent a claimant, is authorized to do the following:

(3) Except as otherwise specified in this rule, to designate a representative, the claimant must complete and submit the department's Designated Representative Form, electronically or by mail. In order for the representative to be approved by the department to exchange information, the form must be complete. At a minimum, it must include the following:

(4) The claimant may revoke the authorization at any time by providing written notification to the department.

(5) The authorization will automatically end on the last day of the claimant's current benefit year. If no application for benefits is submitted, authorization will end 30 days after the department has issued an approval of the designation. If a claimant's application for benefits is submitted more than 30 calendar days after the designation has been approved, the claimant must submit a new form to designate a representative.

(6) The claimant designated representative must maintain the confidentiality of any information they receive from the department on behalf of the claimant. The department is not responsible for any disclosure of the claimant's information by the claimant designated representative.

(7) 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 by filling out the department's Designated Representative Form, an individual who has a family relationship to the claimant as defined in ORS 657B.010 may request to represent the claimant as described in section (8) of this rule to exchange information with the PFMLI program on behalf of the claimant as specified in section (2) of this rule. For the purposes of this rule, 'incapacitated' has the meaning given that term in ORS 125.005.

(8) To request representation of a claimant who is incapacitated due to a serious health condition as provided in section (7) of this rule, the requesting individual must submit:

(9) The authorization referenced in section (7) of this rule will automatically end on the date the department is informed that the claimant is no longer incapacitated, or on the last day of the claimant's current benefit year, whichever is earliest. The claimant may choose to continue the authorization by independently designating the representative as described in section (3) of this rule. If no application for benefits is submitted for the claimant, authorization will end 30 calendar days after the date the department has approved the individual to represent the incapacitated claimant.

(10) In addition to individuals referenced in sections (1) and (7) of this rule, the following individuals are authorized to provide information to and receive information from the PFMLI program as specified in section (2) of this rule:

(11) The documentation referenced in section (10) of this rule, at a minimum, must:

(12) Individuals listed in section (10) of this rule must also provide documentation approved by the department for this purpose that is sufficient to establish the identity of the claimant and the identity of the court-appointed legal guardian or conservator or the individual with granted power of attorney.

(13) If the claimant designated representative, the representative of an incapacitated claimant, the claimant's court-appointed legal guardian or conservator, or the individual with granted power of attorney by the claimant do not provide information required in this rule or provide inaccurate information to the department, the claimant is responsible for any resulting delay, denial, overpayment, or disqualification of PFMLI benefits.