Mario Arriaga v. Department of Labor & Industries

CourtCourt of Appeals of Washington
DecidedSeptember 30, 2014
Docket32287-4
StatusPublished

This text of Mario Arriaga v. Department of Labor & Industries (Mario Arriaga v. Department of Labor & Industries) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mario Arriaga v. Department of Labor & Industries, (Wash. Ct. App. 2014).

Opinion

FILED

SEPTEMBER 30,2014

In the Office of the Clerk of Court

WA State Court'of Appeals, Division III

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION THREE

MARIO ARRIAGA, ) No. 32287-4-111 ) Appellant, ) ) v. ) PUBLISHED OPINION ) DEPARTIMENTOFLABORAND ) INDUSTRIES OF THE STATE OF ) WASHINGTON, ) ) Respondent. )

LAWRENCE-BERREY,1. - When a final industrial insurance order, decision, or

award is based upon a medical determination, a physician is deemed an interested party.

In such a case, the Department of Labor and Industries (Department) must provide notice

of the order, decision, or award both to the physician and the claimant. Failure to provide

notice tolls the 60-day appeal period. At issue here is whether a segregation order was

communicated to a claimant's physician when the physician did not see the order because

of a breakdown in mail handling procedures in his office. We hold that the order was

communicated to the physician because the Department properly mailed it to the

physician's office, and it was actually delivered to the physician's office. We, therefore, No. 32287-4-III

Arriaga v. Dep't ofLabor & Indus.

affirm the decision of the trial court, which barred the claimant's untimely appeal of the

segregation order.

FACTS

Mario Arriaga injured his right upper arm, face, and scalp while employed at

Oakville Forest Products, Inc. The Department allowed a claim for an industrial injury in

December 2005. Justin Sherfey, M.D., D.O., an orthopedic surgeon and osteopathic

physician who treats injured workers, became Mr. Arriaga's attending physician.

On October 29,2008, the Department issued an order segregating a cervical disc

degenerative condition from Mr. Arriaga's claim. The order stated, "[t]he Department of

Labor and Industries is not responsible for the condition diagnosed as: cervical disck [sic]

degenerative, determined by medical evidence to be unrelated to the industrial injury for

which this claim was filed." Board Record (BR) at 28. It is undisputed that the

Department mailed the order to the claimant and also to Dr. Sherfey'S office on October

29,2008. It also is uncontested that Dr. Sherfey's office received a copy of the order on

October 31,2008. However, as will be detailed below, Dr. Sherfey apparently was

unaware of the order until 2010.

Mr. Arriaga sought legal help with his claim in April 2010. The Department

closed Mr. Arriaga's claim on November 23,2010. In December 2010, someone from

No. 32287-4-III

Mr. Arriaga's attorney's office contacted Dr. Sherfey about Mr. Arriaga's claim. After

discovering the segregation order, Dr. Sherfey protested on Mr. Arriaga's behalf. The

Department affirmed the order, stating that it would not reconsider it because the protest

was untimely. Mr. Arriaga appealed to the Board of Industrial Insurance Appeals

(Board), which granted the appeal to review the timeliness of Dr. Sherfey's protest.

In his deposition, Dr. Sherfey explained that he functions as the attending

physician for injured workers and is, therefore, familiar with the rules and regulations of

the Department. His office has about 40 employees and he sees 40 to 45 patients per day.

Dr. Sherfey's practice includes a department that manages paperwork, including getting

authorizations, coordinating depositions, coordinating independent exams, and reviewing

"some of those records." Sherfey Dep. at 23. As to his intraoffice mail handling

procedures, Dr. Sherfey explained, "[t]ypically we have a protocol in place that either a

hard copy is placed in a mailbox for me or I receive an electronic notification of a new

document that I then either have to initial on the hard copy or I have to electronically sign

in the medical re90rd." Sherfey Dep. at 12. Dr. Sherfey stated that he reviewed mail

throughout the day, but admitted that he is not necessarily given all the documents that are

addressed to him.

Arriaga v. Dep 't ofLabor & Indus.

Dr. Sherfey testified that for mail to be "communicated" to him, "[i]t would have

to be appropriately received by the medical records or again our L & I management

. department. It would then have to be properly routed to me for review .... [A]fter that it

would have to be properly inserted into the medical record." Sherfey Dep. at 16. Dr.

Sherfey conceded that some documents are scanned without his "direct visualization."

Sherfey Dep. at 21. He stated that a person in the medical records department decides

whether a document is sufficiently important for his review. He explained, "[w]e have no

standard protocol in place, except typically paperwork that involves the patient is

supposed to come across the physician's desk." Sherfey Dep. at 23.

Somewhere in this process, the October 29 order never made it to Dr. Sherfey'S

desk. Dr. Sherfey explained that he had not initialed it, which suggested to him that he

had not reviewed it. Although the order had been in Mr. Arriaga's file since 2008, Dr.

Sherfey could not recall reviewing it until nearly two years later when Mr. Arriaga's

attorney brought it to his attention. He stated that if he had reviewed the order in 2008, he

"[l]ikely" would have responded with a letter indicating an additional evaluation was

needed in regard to the diagnosis. Sherfey Dep. at 15.

Mr. Arriaga ultimately appealed the order in January 2011. However, the

Department refused to reconsider the order "because the protest was not received within

No. 32287-4-III Arriaga v. Dep 'f ofLabor & Indus.

the 60 day time limitation" ofRCW 51.52.060(l)(a). BR at 24. The Board accepted

review of the appeal concerning the timeliness of Dr. Sherfey's protest of the segregation

order. Upon review, it also dismissed the appeal as untimely, finding:

[Mr. Arriaga's] attending physician acknowledges that he did not protest the October 29,2008 Notice of Decision within 60 days of the date it was communicated to his medical office, as he was unaware of the existence of the document until sometime in 2010. The timely filing of a protest or appeal is a statutorily imposed jurisdictional limitation upon every claimant's ability to get relief from a Department order and upon the Board's authority to hear an appeal. There is simply no legal precedent for excusing Mr. Arriaga from performing his statutory duty to file a timely protest or appeal. The result does not change even though he relied upon his attending physician to monitor correspondence from the Department of Labor & Industries.

BR at 18.

Mr. Arriaga appealed to the Thurston County Superior Court, which also dismissed

his appeal as untimely, finding that Dr. Sherfey received a copy of the Department's order

on October 31, 2008, and that he did not protest the order within 60 days of its receipt. In

its oral ruling, the court stated, "[m]y take on this is that the statute that requires

communication was met when this order was clearly conveyed to the physician's office."

Report of Proceedings (RP) at 18. It elaborated:

It is my take that "communication" means that it was received as addressed, that is to the physician.

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