Hibbs v. Sedwick CMS (A180289)

340 Or. App. 431
Court of Appeals of Oregon·Decided May 14, 2025·No. A180289·Published·Cited by 3 cases

Opinion

No. 422 May 14, 2025 431

IN THE COURT OF APPEALS OF THE STATE OF OREGON

In the Matter of the Compensation of James Hibbs, Claimant. James HIBBS,

Petitioner,

v.

SEDGWICK CMS,

and Cascade Tissue Group Sales Respondents.

Workers’ Compensation Board 2105190; A180289

Argued and submitted April 15, 2025. Julene M. Quinn argued the cause and filed the briefs for petitioner.

Katherine M. Caldwell argued the cause and filed the brief for respondents.

Before Tookey, Presiding Judge, Kamins, Judge, and Jacquot, Judge.

TOOKEY, P. J. Affirmed.

432 Hibbs v. Sedwick CMS (A180289)

TOOKEY, P. J. This case is one of two cases decided today in which we consider the division of jurisdiction between the Workers’ Compensation Board (the board), on the one hand, and the Director of the Department of Consumer and Business Services (the director), on the other.1 In this case, claimant seeks judicial review of a final order of the board, which affirmed an order transferring to the director claimant’s request for a hearing on what claimant describes as an “improperly requested independent medical examination [(IME)] by the insurer under ORS 656.325(1)(a) and related penalties and attorney fees.” Claimant asserts that the board erred “in determining that it did not have jurisdiction over a dispute under ORS 656.325 that involved whether an insurer improperly requested more than three [IMEs] without first notifying and obtaining authorization from the director.”

The issue in this case is the meaning of ORS 656.325(6), which provides that “[a]ny party may request a hearing on any dispute under this section pursuant to ORS 656.283.” ORS 656.283(1), in turn, provides that “any party or the Director of the Department of Consumer and Business

1 The other case is Hibbs v. Sedgewick CMS (A180280), 340 Or App 421, ___ P3d ___ (May 14, 2025), in which we conclude that the claimant’s request for the assessment of a penalty under ORS 656.262(11)(a) was under the jurisdiction of the director, not the board, when the request for the assessment stemmed from a “medical services dispute” that was also under the jurisdiction of the director.

Additionally, at the outset, we note that the parties, as well as the board’s order on review, frame this case as involving a matter of “jurisdiction,” although some of the relevant statutes use the word “authority” rather than “jurisdiction.” Compare, e.g., ORS 656.704(3)(a) (“For the purpose of determining the respective authority of the director and the board to conduct hearings, investigations and other proceedings under this chapter * * *.”), with ORS 656.262(11)(a) (“Notwithstanding any other provision of this chapter, the director shall have exclusive jurisdiction over proceedings regarding solely the assessment and payment of the additional amount and attorney fees described in this subsection.”).

In this opinion, we adopt the nomenclature used by the parties and the board, because it does not affect our analysis, but we express no opinion on whether that is the appropriate nomenclature, nor do we attempt to definitively define the difference between jurisdiction and authority in this context. Cf. Weyerhaeuser Co. v. Rich, 208 Or App 302, 304 n 1, 144 P3d 978, rev den, 342 Or 117 (2006) (“choos[ing]” to use the term “authority,” although the board and the administrative law judge used the term “jurisdiction,” but refraining from the “attempt to definitively define either”).

Cite as 340 Or App 431 (2025) 433

Services may at any time request a hearing on any matter concerning a claim, except matters for which a procedure for resolving the dispute is provided in another statute, including ORS 656.704.”

As claimant sees it, ORS 656.325(6) “has an express statement providing the board with jurisdiction” over “any dispute” under ORS 656.325, such as the dispute concerning the allegedly improperly requested IME at issue in this case. Moreover, as claimant sees it, the board’s jurisdiction to hear disputes under ORS 656.325 does not depend on whether the dispute at issue is a “matter concerning a claim” or not. Cf. Mantle v. SAIF, 330 Or App 8, 14, 542 P3d 889 (2024) (“Generally speaking, under ORS 656.704, the board has review authority over matters concerning a claim, and the director has review authority over matters other than those concerning a claim.” (Internal quotation marks omitted)); see also ORS 656.704(3)(a) (“[M]atters concerning a claim under this chapter are those matters in which a worker’s right to receive compensation, or the amount thereof, are directly in issue.”).

Respondent, for its part, contends that ORS 656.325(6) did not confer jurisdiction on the board in this case, because this case “does not present a matter concerning a claim.” As respondent sees it, ORS 656.325(6) does not provide the board jurisdiction over “any dispute” under ORS 656.325, but only “any dispute” that the board could hear under ORS 656.283(1), which in respondent’s view are limited to “matters concerning a claim.”

Thus, as framed, this case requires us to determine whether, by operation of ORS 656.325(6), jurisdiction over a dispute under ORS 656.325 that does not involve “matters concerning a claim” properly lay with the director or with the board.2 For the reasons below, we conclude that juris-

2 As explained below, the board determined that the issues “claimant has raised are not ‘matters concerning a claim.’ ”

At oral argument, claimant stated that he “does not concede” that the issues he raised in this case are not “matter[s] concerning a claim,” although claimant also noted that that is “not what [he] rests [his] case on.”

We note that in his briefing on appeal, claimant did not assert that the board erred in determining that the issues claimant raised are not “matters concerning a claim.” Consequently, we do not analyze whether the board’s determination in this case that the issues claimant raised were not matters concerning a claim is correct. Colton and Colton, 297 Or App 532, 547-48, 443 P3d 1160 (2019) (“We do 434 Hibbs v. Sedwick CMS (A180289)

diction over such disputes properly lay with the director. Consequently, we affirm. I. HISTORICAL FACTS AND PROCEDURAL HISTORY The relevant facts are both few and undisputed.

Claimant received a November 18, 2021, letter from employer ’s insurer processing agent indicating that an IME was scheduled for December 2, 2021, and a November 22, 2021, letter from the same processing agent notifying him of the December 2, 2021, examination, and referring to it as a “mandatory closing” IME. Claimant requested a hearing before the board on December 10, asserting that the November 18, 2021, “IME notice was defective and unreasonable” and that the November 22, 2021, “mandatory closing IME notice was defective and unreasonable.” Claimant requested a penalty and penalty-based attorney fee for each defective notice. Employer and its processing agent maintained that “under the circumstances presented in this case, the IME notices were not defective or unreasonable, and that claimant has not shown an entitlement to a penalty or penalty-based attorney fee.”

An administrative law judge (ALJ) determined that the issues claimant raised were not “matters concerning a claim” and are “consequently under the [director’s] jurisdiction .” It transferred the matter to the director for resolution.

Claimant sought review of that order before the board. The board adopted and affirmed the ALJ’s order.

II. ANALYSIS

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Hibbs v. Sedwick CMS (A180289), 340 Or. App. 431 (Or. Ct. App. 2025).

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Hibbs v. Sedwick CMS (A180289)
340 Or. App. 431 (Court of Appeals of Oregon, 2025)