SAIF Corp. v. Tull

832 P.2d 1271, 113 Or. App. 449, 1992 Ore. App. LEXIS 1138
CourtCourt of Appeals of Oregon
DecidedJune 10, 1992
DocketWCB 88-17674; CA A68781
StatusPublished
Cited by13 cases

This text of 832 P.2d 1271 (SAIF Corp. v. Tull) 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
SAIF Corp. v. Tull, 832 P.2d 1271, 113 Or. App. 449, 1992 Ore. App. LEXIS 1138 (Or. Ct. App. 1992).

Opinions

[451]*451EDMONDS, J.

SAIF seeks judicial review of a Workers’ Compensation Board order that held claimant’s bilateral carpal tunnel syndrome compensable. We affirm.

SAIF makes multiple assignments of error. It first contends that the Board erred in refusing to remand the case to the referee for admission of evidence about when it mailed a 1988 denial letter to claimant. Remand by the Board to a referee for additional evidence is a matter of discretion. Muffett v. SAIF, 58 Or App 684, 687, 650 P2d 139 (1982). SAIF argues that its failure to submit the exhibits before or during the hearing was due to claimant’s failure to comply with the Board’s rule requiring specification of issues. See OAR 438-06-031. However, at the beginning of the hearing, SAIF was aware that compensability was at issue. Moreover, at the hearing, SAIF requested that the record be held open for submission of certain additional exhibits, and the request was granted. Approximately one month after the record was closed, SAIF made another attempt to supplement the record. Because SAIF had already had the opportunity to submit its evidence, the Board did not abuse its discretion when it denied the second request.

SAIF next argues that the Board erred in “concluding that SAIF had the burden of proving that claimant’s request for hearing was not timely filed.” The Board found that the record did not indicate when claimant was given notice of SAIF’s denial. In Madewell v. Salvation Army, 49 Or App 713, 716, 620 P2d 953 (1980), we held that, when an employer fails to offer proof of when a letter denying a claimant’s claim was mailed, the claimant’s request for hearing will be treated as timely. The holding in Madewell controls this issue. The Board did not err.

SAIF next argues that the Board erred when it concluded that there was no evidence in the record as to when SAIF’s denial letter was mailed. SAIF offered evidence of a dated letter as evidence of when SAIF’s denial letter was mailed. SAIF relies on OEC Sll(n)1 for the presumption that [452]*452“the ordinary course of business has been followed” and asserts that, “therefore, it must be presumed that the ordinary course of business for a workers’ compensation insurer during the period at issue was to mail a denial within 60 days of when it was written.” In Madewell, we held:

“While there is a presumption that a writing is truly dated, and that a letter directed and mailed was received in the regular course of the mail, there is no presumption that a letter is mailed on the day it is dated or on the date it was written. * * * Respondent has not put on any evidence to show the filing of the claim was untimely. We thus treat the claim as timely and proceed to the merits.” 49 Or App at 716. (Footnotes and citations omitted.)

Again, Madewell controls, and the Board did not err.

SAIF also argues that the Board erred in concluding that SAIF’s original acceptance of claimant’s claim for “somantic [sic] dysfunction” included an undiagnosed carpal tunnel syndrome. The Board found that

“SAIF accepted the claim after receiving an 801 form its claims representative had prepared and submitted on behalf of claimant. That acceptance encompassed the disease causing those symptoms, which turned out to be carpal tunnel syndrome. SAIF may not now avoid responsibility for that condition. Bauman v. SAIF, 295 Or 788[, 670 P2d 1027] (1983); SAIF v. Abbott, 103 Or App 49[, 796 P2d 378 (1990)].”

SAIF points out that we granted reconsideration in SAIF v. Abbott, 107 Or App 53, 810 P2d 878 (1991), and remanded it to the Board. However, we remanded because the Board had not reviewed the proper record. Here, the Board reviewed the proper record and properly applied the rule of Bauman v. SAIF, supra, that is, once an employer accepts a claim under ORS 656.262(6),2 it may not subsequently deny compensability.

[453]*453The dissent would hold that SAIF did not accept claimant’s claim, because it did not send a written notice of acceptance to claimant. See ORS 656.262(6). The dissent reaches an issue that is not framed by SAIF’s assignment of error; moreover, SAIF does not make the argument on which the dissent relies to hold that there was no acceptance. Also, the dissent’s analysis is wrong. It relies on Johnson v. Spectra Physics, 303 Or 49, 733 P2d 1367 (1987), Stevenson v. Blue Cross of Oregon, 108 Or App 247, 251, 814 P2d 185 (1991), and EBI Ins. Co. v. CNA Insurance, 95 Or App 448, 451, 769 P2d 789 (1989), in support of its position.

In Johnson, the Supreme Court reaffirmed that Bauman v. SAIF, supra, applies only to “specifically” or “officially” accepted claims. 303 Or at 55. The issue was whether the employer’s denial of the claimant’s carpal tunnel syndrome was precluded by its earlier acceptance of the claimant’s back injury. The court said:

“ORS 656.262(6) requires that an insurer or self-insured employer furnish the claimant with ‘(w)ritten notice of acceptance or denial of a claim * * * within 60[3] days after the employer has notice or knowledge of the claim.’ An insurer must accept a particular claim in writing, and subsequently deny that particular claim after the 60 days prescribed by ORS 656.262(6) have elapsed, before Bauman applies.” 303 Or at 56.

The court then concluded that “an insurer’s failure to respond to a claim or one aspect of a claim is neither acceptance nor denial.” 303 Or at 58. Whether furnishing a notice to a claimant was a necessary element for an “acceptance” to occur under ORS 656.262(6) was not the issue.

[454]*454In Stevenson, the Board held that SAIF had not accepted a claim, even though a SAIF employee had placed a check in the “accepted” box on the claimant’s 801 form. The form was a claim for tendinitis and a skin rash; SAIF sent a notice to the claimant that it had accepted only the skin rash. The claimant argued that the notation on the form was an acceptance of both conditions. We rejected that argument. We said:

“The Board found that SAIF had not accepted the tendinitis claim, and there is substantial evidence to support that finding.” 108 Or App at 252. (Emphasis supplied.)

In EBI Ins. Co., the claimant argued that the employer had accepted his new injury claim when it filed a report with the Workers’ Compensation division on a form that said “claim originally denied, now accepted.” Two days after filing the report, the employer filed another report explaining that the notation in the earlier report that stated “claim originally denied, now accepted” was a clerical error. On the basis of testimony of a witness, the Board found that the earlier report was not intended to be an acceptance.

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SAIF Corp. v. Tull
832 P.2d 1271 (Court of Appeals of Oregon, 1992)

Cite This Page — Counsel Stack

Bluebook (online)
832 P.2d 1271, 113 Or. App. 449, 1992 Ore. App. LEXIS 1138, Counsel Stack Legal Research, https://law.counselstack.com/opinion/saif-corp-v-tull-orctapp-1992.