Burkholder v. State Accident Insurance Fund

502 P.2d 1394, 11 Or. App. 334, 1972 Ore. App. LEXIS 685
CourtCourt of Appeals of Oregon
DecidedNovember 17, 1972
Docket375-901
StatusPublished
Cited by8 cases

This text of 502 P.2d 1394 (Burkholder v. State Accident Insurance Fund) 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
Burkholder v. State Accident Insurance Fund, 502 P.2d 1394, 11 Or. App. 334, 1972 Ore. App. LEXIS 685 (Or. Ct. App. 1972).

Opinion

FOLEY, J.

The State Accident Insurance Fund appeals from an order of the circuit court directing that a hearing be allowed claimant on his claim for a compensable injury. The principal question to be decided is whether *336 the claimant filed a timely request for a hearing by the Workmen’s Compensation Board after the Fund denied his claim for benefits under the Workmen’s Compensation Act. A second issue involves whether the trial court properly awarded attorney fees to claimant’s attorney.

The Fund mailed a notice on December 8, 1969, stating that claimant’s claim was denied. Pursuant to ORS 656.262 (6), that notice of denial stated the reasons for the denial and set out the procedure by which claimant might request a hearing by the Workmen’s Compensation Board. The problem in this matter arises from the fact that the notice of denial was mailed to claimant at an address at which claimant had never lived nor received mail. No explanation was given at the hearing for this mistake, nor was it established what ultimately became of the errant notice.

Claimant testified that he first learned that his claim had been denied when he telephoned a Mrs. Wilma Davidson at SAIF to inquire as to the status of his claim. This conversation took place “[a] couple of days” prior to January 14,1970. Claimant testified that he could not remember whether Mrs. Davidson informed him of the procedure to follow to request a hearing on his claim, but he believed that she told him to file the request with SAIF.

On January 14, 1970 claimant submitted a re *337 quest for a hearing by the Workmen’s Compensation Board to the State Accident Insurance Fund. This request was received by SAIF on January 16. In a letter dated January 26, 1970 Mrs. Davidson of SAIF informed claimant through his attorneys that his hearing request must be filed directly with the Workmen’s Compensation Board rather than with SAIF. Although this latter letter was dated January 26, claimant’s attorney testified that it was not received by him until March 8 or March 10.

On January 25, 1970, and again on February 8, 1970, claimant’s attorney wrote to Mrs. Davidson at SAIF requesting a report as to the status of claimant’s request for a hearing. On February 13,1970, Mr. W. F. Hall of SAIF wrote to claimant’s attorney. That letter suggested that “you refer your request for a hearing directly to the Workmen’s Compensation Board * * and enclosed a copy of the denial of claimant’s claim for counsel’s records.

On February 21,1970 claimant’s attorney wrote the following letter to the Workmen’s Compensation Board:

“RE: Gary Burkholder
“Gentlemen:
“Would you kindly advise me of prospective date for hearing the above captioned matter.
“Previous correspondence was with Mrs. Wilma Davidson and of recent date, Mr. W. F. Hall.”

On February 25, 1970, Mr. H. W. Plunkett, Assistant Administrator of the Compliance Division of the Workmen’s Compensation Board, wrote to claimant’s attorney as follows:

“We are in receipt of your letter of February *338 21, 1970 requesting information on a prospective hearing date.
“Our records do not show that a request for hearing has been filed with the Board by or on behalf of one Gary Burkholder.
“There is a record of three separate claims, and it would be necessary that we have not only a qualified request, but also the particular injury and issue in question.”

Thereafter, the only correspondence between the parties was: (1) A letter dated June 30, 1970 from claimant’s attorney to the Workmen’s Compensation Board informing the Board of claimant’s address after his release from the hospital; and (2) a letter dated July 2,1970 from the Workmen’s Compensation Board to claimant’s attorney stating, in pertinent part:

“The request for hearing which you submitted is acknowledged.
(Í# * * * * 3?

The State Accident Insurance Fund contends that claimant did not file a timely request for hearing as required by ORS 656.262 (6) and ORS 656.319 (2). ORS 656.262 (6) provides:

“If the State Accident Insurance Fund, the direct responsibility employer itself or its insurance carrier qualified under subsection (1) of ORS 656.405 or any other duly authorized agent of such employer for such purpose on record with the Workmen’s Compensation Board denies a claim for compensation, written notice of such denial, stating the reason for the denial, and informing the workman of hearing rights under ORS 656.283, shall be given to the claimant. A copy of the notice of denial shall be mailed to the board, and to the contributing employer by the fund. The workman may request a hearing on the denial at any time within 60 days after the mailing of the notice of denial.”

*339 OES 656.319 (2) provides':

“Notwithstanding the provisions of subsection (1) of this section:
“(a) With respect to objection by a claimant to denial of a claim for compensation under OES 656.262, a hearing thereon shall not be granted and the claim shall not be enforceable unless (A) a request for hearing is filed not later than the 60th day after the claimant was notified of the denial or (B) the request is filed not later than the 180th day after notification of denial and the claimant establishes at a hearing that there was good cause for failure to file the request by the 60th day after notification of denial.
* # * #

In Norton v. Compensation Department, 252 Or 75, 448 P2d 382 (1968), the Oregon Supreme Court held that, in a normal situation, the claimant is required to request the hearing within 60 days after the notice of denial was mailed. However, the court explicitly recognized that extenuating circumstances such as those present in the case at bar might require a different result:

“It is, of course, conceivable that the mailing of the notice of denial will not bring notice of the denial to the workman within 60 days after the denial or will not bring notice within a reasonably substantial time after the mailing, all through no fault of the workman.

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Related

Wright v. Bekins Moving and Storage Co.
775 P.2d 857 (Court of Appeals of Oregon, 1989)
Sekermestrovich v. State Accident Insurance Fund
573 P.2d 275 (Oregon Supreme Court, 1977)
Zandbergen v. Johnson
544 P.2d 587 (Court of Appeals of Oregon, 1976)
Schneider v. Emanuel Hospital
532 P.2d 1146 (Court of Appeals of Oregon, 1975)
Billings v. Crouse
522 P.2d 1401 (Court of Appeals of Oregon, 1974)
Burkholder v. State Accident Insurance Fund
522 P.2d 497 (Court of Appeals of Oregon, 1974)

Cite This Page — Counsel Stack

Bluebook (online)
502 P.2d 1394, 11 Or. App. 334, 1972 Ore. App. LEXIS 685, Counsel Stack Legal Research, https://law.counselstack.com/opinion/burkholder-v-state-accident-insurance-fund-orctapp-1972.