Angel MedFlight Worldwide Air Ambulance Serv. v. SAIF Corp. (In re Keely)

430 P.3d 188, 293 Or. App. 710
CourtCourt of Appeals of Oregon
DecidedSeptember 6, 2018
DocketA163313
StatusPublished

This text of 430 P.3d 188 (Angel MedFlight Worldwide Air Ambulance Serv. v. SAIF Corp. (In re Keely)) is published on Counsel Stack Legal Research, covering Court of Appeals of Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Angel MedFlight Worldwide Air Ambulance Serv. v. SAIF Corp. (In re Keely), 430 P.3d 188, 293 Or. App. 710 (Or. Ct. App. 2018).

Opinion

GARRETT, J.

*711Petitioners challenge a final order of the Department of Consumer and Business Services (department) in which the director concluded that respondent, a medical transportation company, had established good cause for its untimely filing of a request for hearing. The director's order reversed and remanded an order of an administrative law judge (ALJ), concluding that respondent had not established good cause. On judicial review, petitioners contend that substantial evidence does not support the director's determination that respondent established "excusable neglect" for its late request for a hearing. We agree with petitioners, and reverse the order and remand for further proceedings.

Our review is confined to the administrative record, ORS 183.482(7), and the following facts are not contested on review. This dispute arose from the medical transport of petitioner Horton, an injured worker, covered by petitioner SAIF. The worker, while traveling in New Mexico, developed a medical problem related to his compensable condition. He began traveling home to Oregon in his family's own vehicle, but his condition worsened during the trip, requiring hospitalization in Nevada. After treatment there, the *190worker requested transport to Oregon. The hospital requested bids from various medical transport providers, including respondent. Respondent gave a preliminary quote of $15,000 for jet aircraft transportation. On September 30, 2014, SAIF indicated to respondent that it would authorize jet aircraft transportation if respondent could confirm a bid of approximately $15,000.

Respondent never replied to SAIF's request for a confirmed bid. The next day, respondent provided jet aircraft transportation to the worker. Respondent then billed SAIF for $277,825.

SAIF refused to pay the amount billed on the ground that the services and charges were inappropriate, unnecessary, unreasonable, and excessive. In February 2015, respondent requested administrative review by the Medical Resolution Team (MRT) of the department's Workers' Compensation Division (WCD). MRT reviewer Sheppard was assigned the case and began corresponding with SAIF's *712attorney as well as one of respondent's attorneys identified in the record only as "Amanda."

On April 13, 2015, Sheppard issued an administrative order determining that the amount billed by respondent was unreasonable and ordered SAIF to pay the "appropriate" amount of $19,475. A copy of the April 13 order was mailed to respondent at its street address in Scottsdale, Arizona, which was later confirmed to be correct. That copy was not returned by the United States Postal Service as undeliverable or unclaimed. A separate copy of the order was mailed to a different attorney for respondent, Snider, at an incorrect address, and was returned as undeliverable.

The April 13 order included a statement notifying respondent of its right to a hearing and of the requirement that such a request be made within 30 days. See OAR 436-001-0019.

On May 26, 2015, Martinez, an employee in respondent's legal department, left Sheppard a voicemail saying that she had just been assigned to the case. Martinez asked if there were any upcoming deadlines. Sheppard returned her call later that day and asked if respondent had received the April 13 order. Martinez said that she would "look it up," and, during the same conversation, replied that, although respondent had received multiple documents and correspondence about the matter up to April 13, 2015, there was no order from Sheppard in respondent's files. Sheppard faxed a copy of the April 13 order to Martinez that same day.

Two days later, on May 28, Snider left Sheppard a voicemail saying that he had received a copy of the order on May 27 and that he did not know why respondent had not received a copy earlier, as it had been sent to the correct address.

On June 1, Snider, on behalf of respondent, requested a hearing before the WCD regarding the April 13 order. On June 2, WCD denied that request as untimely but advised respondent that it could request a limited hearing solely on the question of whether respondent had good cause for its untimely request. On July 1, respondent filed a request for a limited hearing, which was granted, and a hearing occurred *713on October 6, 2015. After that hearing, the ALJ entered an order on October 30, 2015, concluding that respondent had failed to establish good cause.

The ALJ noted that respondent had the burden of establishing "good cause," which is defined by rule to include "mistake, inadvertence, surprise, or excusable neglect." OAR 436-001-0019(7)(b). The ALJ rejected respondent's position that the April 13 order had never been received, as evidenced by Martinez's "surprise" when she learned about that order from Sheppard on May 26. The ALJ reasoned that the record clearly established that the notice had been mailed to respondent's correct address, and that respondent had presented no countervailing evidence that it was not received. Concluding that the April 13 order had been timely mailed to respondent's correct address, the ALJ determined that respondent had failed to establish good cause for its untimely request for hearing.

Respondent sought review by the department's director, who reviewed the matter de novo and reversed and remanded the ALJ's order in a final order dated September 15, *1912016. The director accepted the ALJ's factual findings but reached a different conclusion on the issue of good cause. Citing case law, the director framed the question as whether respondent's untimely request "was caused by the excusable neglect of someone who was not responsible for deciding whether a request for hearing should be filed." See, e.g. , Brown v. EBI Companies , 289 Or. 455, 460, 616 P.2d 457 (1980) ("[I]t is * * * within the range of discretion to relieve a claimant from a default caused by the mistake or neglect of an employee who is not charged with responsibility for recognizing and correctly handling the message that constitutes the legally crucial notice from which the time to respond is measured." (Emphasis added.) ). In that regard, the director concluded that, although an "unsupported assertion" that an order or notice was not received or lost is insufficient, "it is not necessary to affirmatively establish how the order was lost, misplaced, or otherwise neglected." (Emphasis added.)

Applying that standard, the director explained:

"Ms. Martinez *** stated that the only thing [respondent] had received dated April 13, 2015, was an exhibit packet *714from SAIF's counsel. The veracity of Ms. Martinez's representation has not been questioned. That evidence is also consistent with Mr.

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Related

Ogden Aviation v. Lay
921 P.2d 1321 (Court of Appeals of Oregon, 1996)
Cogswell v. SAIF Corp.
702 P.2d 81 (Court of Appeals of Oregon, 1985)
Brown v. EBI Companies
616 P.2d 457 (Oregon Supreme Court, 1980)
SAIF Corp. v. Martinez
182 P.3d 873 (Court of Appeals of Oregon, 2008)
Campbell v. Employment Department
303 P.3d 957 (Court of Appeals of Oregon, 2013)

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Bluebook (online)
430 P.3d 188, 293 Or. App. 710, Counsel Stack Legal Research, https://law.counselstack.com/opinion/angel-medflight-worldwide-air-ambulance-serv-v-saif-corp-in-re-keely-orctapp-2018.