Tattoo v. Barrett Business Service

847 P.2d 872, 118 Or. App. 348, 1993 Ore. App. LEXIS 202
CourtCourt of Appeals of Oregon
DecidedFebruary 24, 1993
DocketWCB 90-08503; CA A74765
StatusPublished
Cited by10 cases

This text of 847 P.2d 872 (Tattoo v. Barrett Business Service) 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
Tattoo v. Barrett Business Service, 847 P.2d 872, 118 Or. App. 348, 1993 Ore. App. LEXIS 202 (Or. Ct. App. 1993).

Opinion

*350 EDMONDS, J.

Claimant seeks review of an order of the Workers’ Compensation Board that set aside the referee’s award of attorney fees and a penalty, that reinstated and upheld employer’s denials of temporary total disability and of chiropractic treatment, and that reversed the referee’s award of unscheduled permanent disability. We affirm.

The Board found that claimant injured his lower back on August 1, 1989. He filed a claim for a lumbosacral sprain, which employer accepted. After months of chiropractic therapy failed to relieve claimant’s back pain, his treating physician performed an MRI test. The test revealed abnormalities that preexisted claimant’s industrial injury.

On April 3, 1990, employer issued this denial:

“Studies * * * indicate that you are suffering from a spleen condition which is not causally related to your industrial injury on August 1, 1989 * * *. Those studies also indicate that you do not have discitis or osteomyelitis, which are conditions that also would be unrelated * * *.
“Therefore, * * * [we] must respectfully deny your request for temporary total disability as your condition for which you may he disabled is not causally related to your industrial injury * * *.
“We will continue to monitor your claim relating to the accepted lumbosacral strain for benefits due.”

Claimant requested a hearing on that denial on April 18, 1990.

On May 30, 1990, employer denied claimant’s request for payment of chiropractic care:

“Medical information received to date indicates that current chiropractic care is not reasonable and necessary, and does not result from the August 1, 1989 lumbosacral strain injury * * *. Therefore, [we] must respectfully deny current chiropractic care.”

Claimant supplemented his earlier hearing request to also challenge this denial.

On July 5, 1990, a determination order awarded claimant temporary disability benefits through February 19, 1990, and 8 percent unscheduled permanent disability. *351 Employer’s request for reconsideration of that determination order was denied, because claimant’s request for hearing on the denial of chiropractic treatment was pending. Claimant requested a hearing seeking permanent partial disability benefits in addition to those awarded by the determination order. Employer mailed its cross request for a hearing on the determination order on Friday, August 3, 1990. The request was received by the Board on Monday, August 6, 1990. The hearing was held on October 22, 1990, and the record was closed on December 7, 1990.

First, claimant argues that the Board erred when it applied the 1990 amendments to the Workers’ Compensation Act to the issue regarding employer’s denial of chiropractic treatment, because claimant requested a hearing in April, 1990, and the amendments did not become effective until July 1, 1990. However, the amendments provide that the former law is not applicable unless a request for hearing was made before May 1, 1990, and the hearing convened before July 1, 1990. 1 See Astoria Plywood v. Culp, 115 Or App 737, 840 P2d 99 (1992). The hearing in this case was convened on October 22, 1990. The Board properly applied the 1990 amendments.

Second, claimant argues that the May denial of chiropractic care was impermissibly prospective. See Evanite Fiber Corp. v. Striplin, 99 Or App 353, 781 P2d 1262 (1989). The Board ruled that employer’s denial was not prospective. The denial is for “current chiropractic care.” However, claimant points to testimony at the hearing by employer’s claims examiner in which she said that she meant the denial to cover past treatment and treatment into the future and that she did not believe it would be necessary to issue subsequent denials for future treatment.

We hold that- employers are bound by the express language of their denials and the testimony of the claims *352 examiner here is irrelevant. Our previous decisions about whether a denial is prospective in nature are consistent with this proposition. See Boise Cascade Corp. v. Hasslen, 108 Or App 605, 816 P2d 1181 (1991); Green Thumb, Inc. v. Basl, 106 Or App 98, 806 P2d 186 (1991); Evanite Fiber Corp. v. Striplin, supra. If we were to hold to the contrary, an employer could change what it had expressly said in a denial to the detriment of all parties who have relied on the language. The Board did not err.

Third, claimant argues that the Board erred when it held that employer’s failure to pay the temporary disability benefits within 30 days of the determination order was not unreasonable. Claimant seeks a penalty and/or award of attorney fees under ORS 656.210(10)(a) or ORS 656.382(1). The Board held that, because the 30th day from July 5,1990, was August 4,1990, and employer had mailed its request for hearing on Friday, August 3, 1990, it was reasonable for employer to believe that it had properly appealed the determination order and that it was not required to pay the benefits that had been ordered.

Before the 1990 amendments to the Workers’ Compensation Law, ORS 656.313(1), the filing of an appeal did not stay payment of compensation. ORS 656.313(l)(a) now provides, in part:

“Filing by an employer or the insurer of a request for hearing on a reconsideration order or a request for board review or court appeal stays payment of the compensation appealed except for:
‘ ‘ (A) Temporary disability benefits that accrue from the date of the order appealed from until closure under ORS 656.268, or until the order appealed from is itself reversed, whichever event first occurs; and
“(B) Permanent total disability benefits that accrue from the date of the order appealed from until the order appealed from is reversed.”

Claimant argues, and the Board agreed, that ORS 656.313(l)(a) is inapplicable, because no reconsideration order was issued in this matter. However, as the Board noted, employer was faced with an array of temporary administrative rules to interpret in order to decide whether it could withhold payment. OAR 436-60-150(1) said that benefits *353 falling due on a weekend were payable on the working day before the weekend. However, OAR 436-60-150(6)(c) provided that permanent disability benefits were due no later than the 30th day

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Bluebook (online)
847 P.2d 872, 118 Or. App. 348, 1993 Ore. App. LEXIS 202, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tattoo-v-barrett-business-service-orctapp-1993.