MacDonald v. Safeway Stores, Inc.

741 P.2d 521, 87 Or. App. 86, 1987 Ore. App. LEXIS 4253
CourtCourt of Appeals of Oregon
DecidedAugust 26, 1987
DocketWCB 84-03634, 84-03635; CA A41681
StatusPublished

This text of 741 P.2d 521 (MacDonald v. Safeway Stores, Inc.) 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
MacDonald v. Safeway Stores, Inc., 741 P.2d 521, 87 Or. App. 86, 1987 Ore. App. LEXIS 4253 (Or. Ct. App. 1987).

Opinion

VAN HOOMISSEN, J.

Claimant seeks review of a Workers’ Compensation Board order which reversed the referee’s order setting aside employer’s notice of claim closure and awarding penalties and attorney fees. He contends that the Board erred in concluding that the referee did not have jurisdiction to review the claim closure or, in the alternative, that he did not prove an aggravation. On de novo review, ORS 656.298, we affirm.

Claimant sustained a compensable low back injury on May 24, 1983, while working for employer as a grocery clerk. On June 3, Dr. Boyd, claimant’s treating physician, released him for “limited duty” for a period of two weeks. He returned to Boyd’s office on June 16 and was seen by Dr. Bross, who was filling in for Boyd. Bross reported that claimant was “gradually improving,” prescribed physical therapy and encouraged him to cut down on his work schedule.

Claimant wanted to see a back specialist. The Lane County Medical Society referred him to Dr. Abel, who examined claimant on August 4. Abel did not refer claimant to a specialist, but instead referred him for physical therapy and released him for modified work limited to four days per week. Abel scheduled another appointment for August 18; however, claimant did not return.

Employer’s insurer requested a closing examination. Claimant saw Boyd on September 1. Boyd recommended physical therapy and prescribed anti-inflamation medicine. He referred claimant to Dr. Tearse, a neurologist, who found that claimant’s low back strain was “resolving satisfactorily.” He scheduled him for physical therapy and for a follow-up examination with Boyd.

On October 8, Abel submitted a Form 828, indicating that claimant had not been in for a follow-up examination and that he had been medically stationary with no permanent impairment on August 4, the date of his last visit. On October 18, the insurer issued a Notice of Closure on the low back claim. On March 30,1984, claimant requested a hearing on the closure.

In February, 1984, claimant sustained a new industrial injury to his right knee. On May 3, he saw Boyd, who noted that claimant’s back condition would bother him as long [89]*89as his knee was bothering him. Boyd saw claimant on June 29 and noted that he had made little improvement and that he might have a herniated disc. He was allowed only limited duty work. On December 21, claimant saw Dr. Gorman, a chiropractor, who concluded that he was not medically stationary and that permanent impairment could not be determined. Gorman also treated him for cervical and thoracic conditions.

On April 18,1985, the insurer denied the an aggravation claim; it also denied responsibility for the cervical and thoracic conditions. It refused to pay Gorman. Claimant requested a hearing on the denial. Gorman later reported that the cervical and thoracic conditions were a result of the low back condition and that there was no additional charge for treating those conditions in addition to the charge for the low back condition. The insurer again refused to pay Gorman.

After concluding that he had jurisdiction, the referee set aside the closure. He further found that employer was unreasonable in closing the claim and awarded penalties and attorney fees. Finally, he concluded that employer was unreasonable in refusing to pay Gorman and awarded additional penalties and attorney fees. On review, the Board concluded that the referee did not have jurisdiction over the closure issue and denied the alternative aggravation claim. It upheld the referee’s decision with respect to the refusal to pay Gorman and upheld the penalty and attorney fee, but did not allow attorney fees for prevailing before the Board on that issue.

Claimant first contends that the Board erred in concluding that the referee did not have jurisdiction over the closure issue. He argues that the right to seek a determination order in these circumstances is in addition to the right to request a hearing at any time on any matter. ORS 656.283(1). He relies on Logue v. SAIF, 43 Or App 991, 607 P2d 750 (1979). Employer argues that the referee did not have jurisdiction, because ORS 656.268(3) requires a claimant to seek a determination order before seeking a hearing on a closure and that claimant’s remedy was clearly spelled out to him in the Notice of Closure. It also argues that Logue does not change the result, because in that case a determination order had been issued, and the issue was whether reconsideration was required before requesting a hearing.

ORS 656.268(3) provides, in relevant part:

[90]*90“When the medical reports indicate to the insurer or self-insured employer that the worker’s condition has become medically stationary and the insurer or self-insured employer decides that the claim is disabling but without permanent disability, the claim may be closed, without the issuance of a determination order by the Evaluation Division. The insurer or self-insured employer shall issue a notice of closure of such a claim to the worker and to the Workers’ Compensation Department. The notice must inform the worker of the decision that no permanent disability results from the injury; of the amount and duration of temporary total disability compensation; of the right of the worker to request a determination order from the Evaluation Division within one year of the date of the notice of claim closure; of the aggravation rights; and of such other information as the director may require. Within one year of the date of the notice of such a claim closure, a determination order subsequently shall be issued on the claim at the request of the claimant * * *.”

ORS 656.283(1) provides:

“Subject to subsection (2) of this section and ORS 656.319, any party or the director may at any time request a hearing on any question concerning a claim.”

ORS 656.319(4) provides:

“With respect to objections to a determination under ORS 656.268(3), a hearing on such objections shall not be granted unless a request for hearing is filed within one year after the copies of the determination were mailed to the parties.”

Before the 1979 statutory amendments, the Evaluation Division determined all claim closures involving any type of disability. Insurers could close only time-loss only claims. In 1979, the legislature modified the procedure to allow insurers and self-insured employers to close all temporary disability claims. See Minutes, Senate Committee on Labor, Consumer and Business Affairs, April 3, 1979, 4-6, 15. That procedure allows insurers and self-insured employers to close a claim without a prior determination order.

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Related

Matter of Compensation of Bahler
652 P.2d 875 (Court of Appeals of Oregon, 1982)
Mobley v. State Accident Insurance Fund
648 P.2d 1357 (Court of Appeals of Oregon, 1982)
Saxton v. SAIF Corp.
723 P.2d 355 (Court of Appeals of Oregon, 1986)
Logue v. State Accident Insurance Fund
607 P.2d 750 (Court of Appeals of Oregon, 1979)

Cite This Page — Counsel Stack

Bluebook (online)
741 P.2d 521, 87 Or. App. 86, 1987 Ore. App. LEXIS 4253, Counsel Stack Legal Research, https://law.counselstack.com/opinion/macdonald-v-safeway-stores-inc-orctapp-1987.