Giltner v. SAIF

529 P.3d 986, 325 Or. App. 566
Court of Appeals of Oregon·Decided April 26, 2023·No. A176021·Published·Cited by 1 cases

Opinion

Argued and submitted October 25, 2022, affirmed April 26, petition for review denied September 14, 2023 (371 Or 333)

In the Matter of the Compensation of Vern E. Giltner, Claimant.

Vern E. GILTNER,

Petitioner,

v.

SAIF CORPORATION

and Dirt & Aggregate Interchange Inc., Respondents.

Workers’ Compensation Board 2001930; A176021

529 P3d 986

Claimant seeks judicial review of an order of the Workers’ Compensation Board (board), which determined that the insurer was not required to immediately make a lump sum payment of permanent partial disability benefits (PPD). Held: The board correctly construed ORS 656.230(1), which provides that when a worker requests a lump sum payment of PPD, the insurer shall make the payment unless an exception applies. Here, the second exception applied, because the claimant requested a lump sum payment before the award became final by operation of law, which occurred 60 days after issuance of the notice of closure. As a result, the board was not required to immediately make the payment. The statute’s text, and the legislative history of the 2007 amendments to the statute, support the board’s construction of ORS 656.230(1).

Affirmed.

Jodie Anne Phillips Polich argued the cause for petitioner . Also on the reply brief was Law Offices of Jodie Anne Phillips Polich, P. C.

Michelle L. Shaffer argued the cause and filed the brief for respondents.

Before Shorr, Presiding Judge, and Mooney, Judge, and Pagán, Judge.

PAGÁN, J. Affirmed.

Cite as 325 Or App 566 (2023) 567

PAGÁN, J.

Claimant seeks judicial review of an order of the Workers’ Compensation Board (board) determining that the SAIF Corporation (SAIF) was not required to make a lump sum payment of permanent partial disability (PPD) pursuant to ORS 656.230(1).1 That statute addresses four circumstances when an insurer is not required to make a lump sum payment. We agree with SAIF that the board correctly interpreted the statute when it concluded that, even though claimant had waived his right to appeal the adequacy of the award, SAIF was not required to make a lump sum payment until expiration of the time to appeal the notice of closure. Accordingly, we affirm.

The relevant facts are procedural. In response to claimant’s workers’ compensation claim, SAIF mailed a notice of closure on March 20, 2020, awarding claimant PPD in the amount of $28,602.84. The notice stated that claimant was entitled to 34 percent loss of the whole person for impairment to his hearing. The date of injury was approximately seven years earlier, on April 10, 2013.

Under ORS 656.268(5)(e), the insurer has seven days from the date of the notice of closure to request reconsideration and the worker has 60 days to do so. SAIF did not request reconsideration of the award. Instead, on March 31, 2020, SAIF issued a letter specifying the monthly payment schedule for the award and enclosing the first payment. On April 6, claimant applied for approval of a lump sum payment , and he waived his right to appeal the adequacy of the award. On April 8, SAIF denied the request, because the award had not become final by operation of law. On April 14, 1 ORS 656.230 provides: “(1) When a worker has been awarded compensation for permanent partial disability, and the worker requests payment of all or part of the award in a lump sum payment, the insurer shall make the payment requested unless the:

“(a) Worker has not waived the right to appeal the adequacy of the award; “(b) Award has not become final by operation of law; “(c) Payment of compensation has been stayed pending a request for hearing or review under ORS 656.313; or “(d) Worker is enrolled and actively engaged in training according to rules adopted pursuant to ORS 656.340 and 656.726.”

568 Giltner v. SAIF

claimant requested a hearing on SAIF’s denial of his request for a lump sum payment. SAIF made a second monthly payment around the end of April and paid the remainder of claimant’s award in full on May 20, the sixty-first day after the notice of closure.

After a hearing on SAIF’s denial of claimant’s request for a lump sum payment, an administrative law judge (ALJ) decided in claimant’s favor. Interpreting and applying ORS 656.230(1) and OAR 436-060-0060(1),2 the ALJ determined that when claimant waived his right to appeal the adequacy of the award, and once SAIF’s seven- day window to request reconsideration had expired, the notice of closure became final by operation of law. According to the ALJ, “final by operation of law” meant “the expiration of both parties’ rights to appeal—which could be accomplished by the passage of sixty days, or the passage of seven days coupled with claimant’s waiver of his right to challenge the adequacy of the award. SAIF’s refusal to pay claimant’s permanent disability as a lump sum until May 20, 2020, forty-four days after SAIF received claimant’s request, was unreasonable.” The ALJ assessed a 25 percent penalty against SAIF and awarded claimant $4,797 in attorney fees.

SAIF appealed the ALJ’s order. The board reversed.

Interpreting ORS 656.230(1), the board determined that claimant’s waiver of his right to appeal the adequacy of the award did not automatically render the award final by operation of law, because “SAIF could have validly rescinded its closure notice and reclosed the claim, pursuant to OAR 436-030-0023,” and claimant “could still request reconsideration and allege that his claim was prematurely closed, a 2 OAR 436-060-0060(1) provides, in part: “The insurer may only deny the request for lump sum payment if any of the following apply:

“(a) The worker has not waived the right to appeal the adequacy of the award;

“(b) The award has not become final by operation of law; “(c) The payment of compensation has been stayed pending a request for hearing or review under ORS 656.313; or “(d) The worker is enrolled and actively engaged in an authorized training plan under OAR 436-120.”

Cite as 325 Or App 566 (2023) 569

finding which could result in an order rescinding the Notice of Closure and its permanent disability award.” Under those circumstances, the board determined that SAIF was not required to immediately make the lump sum payment. The board reversed the penalty and attorney fee award. Claimant now seeks our review of the board’s order.

“We review the board’s statutory interpretation for errors of law.” Baker v. Liberty Northwest Ins. Corp., 257 Or App 205, 210, 305 P3d 139, rev den, 354 Or 597 (2013) (citing ORS 183.482(8)(a)(B)). We attempt to discern the meaning of the statute intended by the legislature, examining the text in context and any relevant legislative history. State v. Gaines, 346 Or 160, 171-72, 206 P3d 1042 (2009). When interpreting the board’s administrative rules, “[w]e will defer to the board’s plausible interpretation of its own rule, including an interpretation made in the course of applying the rule, if it is not inconsistent with the text of the rule, its context, or any other source of law.” McGuire v. SAIF, 317 Or App 629, 634-35, 507 P3d 317, rev den, 370 Or 197 (2022).

ORS 656.230(1), the statute at issue, states that the insurer shall make a requested lump sum payment of PPD “unless” certain circumstances apply. The related administrative code provision, OAR 436-060-0060(1), provides that the insurer may deny a request for a lump sum payment of PPD “if any” of those same four conditions applies. The conditions include when the worker “has not waived the right to appeal the adequacy of the award,” and when the award “has not become final by operation of law.” ORS 656.230 (1)(a), (b); OAR 436-060-0060(1)(a), (b).

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Giltner v. SAIF, 529 P.3d 986, 325 Or. App. 566 (Or. Ct. App. 2023).

529 P.3d 986 (Giltner v. SAIF) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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