Barrett Business Services, Inc. v. Stewart

35 P.3d 1055, 178 Or. App. 145, 2001 Ore. App. LEXIS 1761
CourtCourt of Appeals of Oregon
DecidedNovember 14, 2001
Docket98-06193 and 98-03468; A111407
StatusPublished
Cited by4 cases

This text of 35 P.3d 1055 (Barrett Business Services, Inc. v. Stewart) 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
Barrett Business Services, Inc. v. Stewart, 35 P.3d 1055, 178 Or. App. 145, 2001 Ore. App. LEXIS 1761 (Or. Ct. App. 2001).

Opinion

*147 SCHUMAN, J.

This workers’ compensation case requires us to determine whether Barrett Business Services, Inc. (Barrett), having accepted responsibility for claimant’s compensable injury, was entitled subsequently to issue a “back-up” denial based on evidence obtained after claim acceptance, indicating that an earlier employer, Freightliner LLC (Freightliner), was responsible. The Workers’ Compensation Board (Board) rejected Barrett’s argument, concluding that the denial was not based on ‘later obtained evidence.” We review the Board’s understanding of what ‘later obtained evidence” means for errors of law, ORS 183.482(8)(a); Curry Educational Service Dist. v. Bengtson, 175 Or App 252, 27 P3d 526 (2001), and its factual findings for substantial evidence, ORS 183.482(8)(c); Greenbriar Ag Management v. Lemus, 156 Or App 499, 965 P2d 493 (1998), rev den 328 Or 594 (1999), and affirm.

In November 1994, claimant injured his right wrist while working for Freightliner. Freightliner accepted the condition as a disabling injury. On October 26,1995, a determination order awarded periods of temporary partial and temporary total disability.

Thereafter, claimant left Freightliner and went to work for Barrett. In March 1997, while on the job at Barrett, he twisted his right wrist lifting a propane tank. He was examined in an emergency room for severe pain. While there, he mentioned that he had experienced wrist pain in the past. He was given a splint and medication.

Several days later, as a result of repeated bouts of discomfort in the wrist, claimant saw Dr. Yarusso. He told the doctor that he had originally injured the wrist while at Freightliner and had continued to wear a band for it. Yarusso diagnosed wrist tendinitis and noted that claimant’s symptoms might stem from the injury on his old job. Claimant was referred to Dr. Van Allen, a surgeon. In May 1997, claimant consulted Van Allen and again recounted the history of his earlier wrist injury at Freightliner, reporting that he had experienced intermittent pain since its occurrence. Van Allen suggested surgery and advised Barrett’s processing agent *148 that, in his opinion, claimant suffered from the acute injury he received in March 1997 at Barrett, rather than from an exacerbation of a preexisting condition, but that there was no way to confirm this opinion because medical records were not available for the earlier injury.

On July 14, 1997, Barrett’s processing agent accepted a claim for complete scapholunate dissociation with static carpal instability and classified it as nondisabling. Subsequently, the claim was classified as disabling.

On July 30, 1997, Van Allen performed wrist surgery on claimant. His postoperative report indicated that he still believed that claimant’s injury was caused by the 1997 incident that occurred while employed by Barrett. However, Dr. Gambee, an orthopedic surgeon, reviewed claimant’s charts in February 1998 and concluded that claimant’s condition was related to the earlier injury suffered on the job at Freightliner.

On July 27,1998, claimant was seen by Gambee and Dr. Vessely. Gambee noted that he now had more information than when he made his chart review and acknowledged that he was changing his opinion as a result of this more complete examination: He now opined that claimant’s condition was the result of the injury while at Barrett. The next day Freightliner denied responsibility for the claim.

Van Allen then reviewed the records that predated his involvement with the case and concluded that claimant had a preexisting injury, the symptoms of which were only exacerbated by the later Barrett injury — thus contradicting Gambee and putting responsibility back on Freightliner. He also noted that his “intraoperative findings with the mild degenerative changes would be consistent with a more remote injury.” In a letter dated September 16,1998, Barrett rescinded acceptance of the claim, issued the “back-up” denial and claimed that Freightliner bore the responsibility.

Claimant at this point had an injury that both employers agreed was compensable, but for which both denied responsibility. He sought review of both denials. An administrative law judge (AU) found that Barrett’s back-up denial of the claim was not based on later obtained evidence, *149 set aside Barrett’s back-up denial of responsibility, affirmed Freightliner’s denial of responsibility, and assessed a penalty against Barrett. Barrett appealed to the Board, which reversed on the penalty assessment but affirmed the AU’s conclusion that Barrett bore responsibility for claimant’s injury. Barrett seeks judicial review.

The legislative assembly enacted the so-called “backup” denial provision of ORS 656.262(6)(a) in order to address the problem of “nervous denials,” that is, allegedly unwarranted denials issued by employers who feared that, once they had accepted a claim, they would be unable to revoke acceptance even if they later discovered evidence indicating that the claim was not compensable or that they were not responsible for it. CNA Ins. Co. v. Magnuson, 119 Or App 282, 285, 850 P2d 396 (1993).

ORS 656.262(6)(a) provides, in pertinent part:

“If the insurer or self-insured employer accepts a claim in good faith * * * and later obtains evidence that the claim is not compensable or evidence that the insurer or self-insured employer is not responsible for the claim, the insurer or self-insured employer may revoke the claim acceptance and issue a formal notice of claim denial [.]”

In order to review the Board’s order, we must first determine what “later obtained evidence” is and then determine whether Barrett’s denial relied on it. Evidence obtained after issuance of the denial is, of course, irrelevant; such evidence could not have affected the denial and is therefore immaterial.

We have examined the phrase ‘later obtained evidence” in several cases. In CNA Ins. Co., an employer accepted a claim before ORS 656.262 was amended to permit back-up denials. After the amendment, the employer solicited and received a “new” letter from the claimant’s physician confirming the physician’s earlier theory that the claim was not compensable. CNA Ins. Co., 119 Or App at 284. The Board held that the “new” letter was not “later obtained evidence.” We agreed:

“The legislature intended that evidence warranting a retroactive denial ‘come about’ after the insurer’s original *150 acceptance. We agree * * * that the statute requires new material, i.e., something other than the evidence that the insurer had at the time of the initial acceptance.

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Bluebook (online)
35 P.3d 1055, 178 Or. App. 145, 2001 Ore. App. LEXIS 1761, Counsel Stack Legal Research, https://law.counselstack.com/opinion/barrett-business-services-inc-v-stewart-orctapp-2001.