Meza v. Bruce Packing Co.

63 P.3d 1193, 186 Or. App. 452, 2003 Ore. App. LEXIS 263
CourtCourt of Appeals of Oregon
DecidedFebruary 19, 2003
Docket99-09292; A113613
StatusPublished
Cited by2 cases

This text of 63 P.3d 1193 (Meza v. Bruce Packing Co.) 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
Meza v. Bruce Packing Co., 63 P.3d 1193, 186 Or. App. 452, 2003 Ore. App. LEXIS 263 (Or. Ct. App. 2003).

Opinions

KISTLER, J.

The Workers’ Compensation Board found that claimant had agreed that, if she lacked good cause for failing to file a timely request for a hearing from insurer’s written denial, her claims would be dismissed. Finding no good cause, the board dismissed her claims. Claimant petitions for review, and we affirm.

On September 12, 1997, claimant filed a request for compensation with insurer, alleging that she was having hand, wrist, and back problems. Insurer accepted some claims and denied others. Two claims were processed to closure, and claimant was awarded no permanent partial disability (PPD) compensation. Claimant requested reconsideration of the determination order. The order on reconsideration affirmed that claimant was not entitled to PPD, and an administrative law judge (ALJ) affirmed that order on July 21,1999.

On July 30, 1999, claimant’s attorney requested that insurer accept additional claims for “thoracic, lumbar and sacral disc injuries, including bulges, herniations, radiculopathies, including herniation of T7-8 disc.” Sometime before October 6, 1999, claimant obtained new counsel, who “re-asked [sic] the insurer to accept specific cervical and thoracic conditions.” Insurer did not respond, and, on November 18, 1999, claimant’s attorney requested a hearing on insurer’s de facto denial.

The hearing was rescheduled several times. On March 27, 2000, insurer issued a formal denial reaffirming its acceptance of some claims and denying others. When the denial was issued, claimant was not represented. The denial stated that claimant could seek assistance from the State of Oregon Ombudsman’s office. It provided that she must file a request for a hearing on the denial within 60 days. It added that, “[i]f you do not file a request within 60 days, you will lose any right you may have to compensation unless you can show good cause for delay beyond 60 days.” Finally, the denial advised claimant of her right to an attorney.

Claimant received the denial on March 29, 2000. Because of claimant’s difficulties with English, she asked her [455]*455son “who can ‘speak English perfectly well’ to interpret the denial letter to her.” After receiving the letter, claimant spoke with several attorneys but was not successful in obtaining representation. Claimant also showed the letter to her brother, who speaks English. According to claimant, neither her son nor her brother explained the denial letter correctly to her.

During this time, the board notified claimant that a hearing on the de facto denial had been set for July 5, 2000. That hearing was postponed and rescheduled for September 12, 2000. Claimant obtained counsel, who advised the board on July 20, 2000, that she should be substituted as the attorney of record for claimant. On September 12,2000, claimant’s new counsel appeared at the hearing on the de facto denial and filed a request for a hearing on the March 27, 2000, denial. Claimant’s request for a hearing was filed more than 60 but fewer than 180 days after the March 27, 2000, denial.

At the hearing, the ALJ recited his understanding that the parties'had agreed to bifurcate the hearing: They would begin with the question whether claimant had good cause for failing to file a timely request for a hearing on the March 27, 2000, denial. If claimant lacked good cause, the entire matter would be dismissed. See ORS 656.319(1)(b).1 If claimant had good cause, then the parties would hold a hearing on the merits of claimant’s claims. Claimant did not disagree with the ALJ’s recitation of the parties’ understanding, and they introduced evidence on the issue of good cause.

In his opinion and order, the ALJ noted that there were two grounds for good cause — claimant’s reliance on a [456]*456family member to interpret the letter for her and her misunderstanding of the status of the denial. As to the first, the AU reasoned that “a worker, who does not speak English, and relies upon a family member to interpret an in-coming denial, does not demonstrate good cause in the event the family member misinterprets or misunderstands the importance and the legal effect of said denial.” As to the second, the ALJ explained:

“Claimant’s attorney pointed out that a major issue is because of on-going Notices of Hearing, claimant clearly (mis)understood that her hearing would be reset on the same issues which had prevailed at the initial hearing and, therefore, claimant did not need to file another request for hearing, thereby obviating any necessity to call the Ombudsman.
“In regards to claimant’s confusion regarding the legal posture of the case, of interest is Mary [M.] Schultz, 45 Van Natta 393 [(1993)], in which case that worker thought that her receipt of interim compensation proved that the claim had been accepted and, therefore, no formal request for hearing on the denial needed to be filed.
“Unfortunately for claimant, her totally understandable confusion regarding the status and on-going effect of the March 27, 2000 denial does not demonstrate ‘good cause’ for failing to timely file a written request for hearing on said denial.”

The ALJ concluded that claimant lacked good cause for failing to file within 60 days, and, “[a]s a result, the currently pending request for [a] hearing is a nullity and must be dismissed because of lack of jurisdiction.”

Before the board, claimant argued that, even if she did not have good cause for failing to file a request for a hearing on the March 27, 2000, denial, the ALJ erred in saying that he lacked jurisdiction to decide her pending request for a hearing on the de facto denial. Claimant reasoned that the board’s jurisdiction over her request for a hearing on the de facto denial was independent of its jurisdiction over her request for a hearing on the March 27, 2000, denial. Alternatively, claimant argued that, even if the board’s jurisdiction depended on whether she had good cause for failing to file a timely request for a hearing on the March 27, 2000, [457]*457denial, she was understandably confused about the status of the proceedings.

The board found that, when the parties were before the ALJ, they had agreed that, if claimant did not have good cause for failing to file a request for a hearing on the March 27, 2000, denial, all her claims would be dismissed. The board noted that the ALJ had recited the terms of the parties’ agreement and that claimant had not disagreed with the ALJ’s recitation. The board reasoned:

“Having reviewed the ‘pre-testimony' discussions, we are persuaded that the parties agreed that litigation of compensability issues was dependent on the outcome of the timeliness issue. Thus, we find that any compensability issues raised by the November 1999 hearing request concerning a ‘de facto’ denial were subsumed by the subsequent formal written denial of March 27, 2000.”

The board then agreed with the “ALJ’s reasoning that claimant did not establish ‘good cause’ for [her] failure to timely request a hearing from [the March 27, 2000] denial” and affirmed the ALJ’s order dismissing all of claimant’s claims.

On review, claimant raises three assignments of error. We begin with the third assignment.

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Cite This Page — Counsel Stack

Bluebook (online)
63 P.3d 1193, 186 Or. App. 452, 2003 Ore. App. LEXIS 263, Counsel Stack Legal Research, https://law.counselstack.com/opinion/meza-v-bruce-packing-co-orctapp-2003.