Landriscina v. Raygo-Wagner

632 P.2d 1281, 53 Or. App. 558, 1981 Ore. App. LEXIS 3216
CourtCourt of Appeals of Oregon
DecidedAugust 24, 1981
DocketNo. 79-1775, CA 19195
StatusPublished
Cited by2 cases

This text of 632 P.2d 1281 (Landriscina v. Raygo-Wagner) 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
Landriscina v. Raygo-Wagner, 632 P.2d 1281, 53 Or. App. 558, 1981 Ore. App. LEXIS 3216 (Or. Ct. App. 1981).

Opinion

RICHARDSON, P. J.

Claimant appeals an order of the Workers’ Compensation Board determining that he had waived his right to contest a determination order by accepting a lump sum payment of the award. ORS 656.304. Claimant also contends that if he has not waived his right to contest the award, he is entitled to permanent total disability benefits. The referee determined there was no waiver and that claimant was permanently and totally disabled. The Board reversed the referee’s order regarding waiver and did not discuss the merits of claimant’s disability claim. We reverse and remand.

Claimant is presently 60 years old. He was bom on the Isle of Rhodes and lived in Italy until 1962, when he immigrated to the United States. He had some formal education beyond the high school level in Italy, but the extent of that education is difficult to discern. He apparently speaks English quite well and has an elementary ability to read and write English.

Claimant sustained a compensable injury to his back on April 17, 1975, while employed by Raygo-Wagner, which was insured by United Pacific Insurance Company (United Pacific). He received medical treatment, including surgery, and ultimately a determination order was issued on November 3, 1978, awarding him 35 percent unscheduled disability. Immediately after receiving the determination order, claimant called William Slater, a disability determination specialist for the Evaluation Division of the Workers’ Compensation Department. Claimant told Slater he disagreed with the award and that current medical reports showed he was permanently disabled. Slater informed claimant that he did not have the current medical reports and that if claimant sent in the reports his claim would be reevaluated. Claimant’s doctors submitted several additional medical reports to the Evaluation Division, and the Division began the process of reconsideration.

United Pacific, upon receiving the determination order, mailed the first monthly check for the award to claimant early in November, 1978. Claimant called the claims manager for United Pacific on November 13, 1978, and indicated that he disagreed with the award and did not [561]*561want to accept the monthly checks. The claims manager informed him that by accepting and cashing the monthly checks he did not waive his right to contest the award.1 There was no discussion regarding a lump stun payment.

On November 21, 1978, claimant called United Pacific and requested forms in order to obtain a lump sum payment of his award. There was no discussion regarding the effect of accepting a lump sum payment. Claimant completed the forms with the assistance of his ex-wife and returned them to United Pacific on November 27, 1978. The application form contained the following statement in the same size type as the balance of the form:

"I further understand that I will have waived my right to a hearing on this award by applying for and accepting an advance lump sum payment. * * *.”2

United Pacific submitted the forms to the Compliance Division of the Workers’ Compensation Department for approval pursuant to ORS 656.230.

Jean Howard, Claims Examiner for the Compliance Division, received claimant’s application for lump sum payment and found it inadequate. On December 1, 1978, she wrote to claimant requesting additional information regarding the reasons for the request. Claimant responded in a letter of December 7,1978, that he wanted the money to pay off his mortgage.

Howard had gone on vacation prior to the time claimant’s response was received in the Compliance Division. Her supervisor, Wanda Meithof, reviewed the file and approved the application. Meithof testified that she assumed Howard had completed investigation of the application and that she was not aware at the time that the [562]*562Evaluation Division was in the process of reconsidering the initial determination. She stated that if she had had that information, she would not have approved the lump sum payment because it would have been contrary to Department regulations. The approved request was transmitted to United Pacific on December 19, 1978, and a check for the total amount of the award was sent to claimant the next day. He deposited the check in his bank account.

Shortly after depositing the check, claimant became aware that acceptance of the lump sum award assertedly prevented him from contesting the determination order. On December 26, 1978, he called the claims manager for United Pacific and told him he had been deceived by United Pacific regarding his right to dispute the award and would return the lump sum payment. The following day he went to the United Pacific claims office and gave the claims manager his personal check for the amount of the lump sum payment. That check was returned to claimant the next day.

On January 10, 1979, claimant was informed by the Evaluation Division that because he had accepted the lump sum payment, the original award could no longer be reevaluated. He requested a hearing and again tendered the amount of the lump sum award.

The issue in this case is the application of ORS 656.304 to the facts of the case. That statute provides:

"A claimant may accept and cash any check given in payment of any award or compensation without affecting his right to a hearing, except that the right of hearing on any award shall be waived by acceptance of a lump sum award by a claimant where such lump sum award was granted on his own application under ORS 656.230. * * *”

ORS 656.230 states:

"(1) Where a worker has been awarded compensation for permanent partial disability, and the award has become final by operation of law or waiver of the right to appeal its adequacy, the director may, in the director’s discretion, upon the worker’s application order all or any part of the remaining unpaid award to be paid to him in a lump sum. Any remaining balance shall be paid pursuant to ORS 656.216.
«*****”

[563]*563The Director of the Workers’ Compensation Department is given discretion to approve or disapprove an application for lump stun payment of an award. In carrying out this function, the Department has promulgated rules setting forth guidelines and criteria regarding the exercise of discretion. OAR 436-53-005, which was in effect at the time claimant submitted his application, provided:

"(1) A worker who has been awarded permanent partial disability compensation may apply to the Compliance Division for an order directing the paying agency to pay all or part of his remaining unpaid award to him in a lump sum, if the worker was injured after October 4, 1973. The applicant shall state the part of the award that he wishes to be paid in a lump sum and the reasons for his request.

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Bluebook (online)
632 P.2d 1281, 53 Or. App. 558, 1981 Ore. App. LEXIS 3216, Counsel Stack Legal Research, https://law.counselstack.com/opinion/landriscina-v-raygo-wagner-orctapp-1981.