Vega v. Express Services

927 P.2d 1106, 144 Or. App. 602, 1996 Ore. App. LEXIS 1764
CourtCourt of Appeals of Oregon
DecidedNovember 27, 1996
DocketWCB No. 93-08731; CA A86290
StatusPublished
Cited by2 cases

This text of 927 P.2d 1106 (Vega v. Express Services) 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
Vega v. Express Services, 927 P.2d 1106, 144 Or. App. 602, 1996 Ore. App. LEXIS 1764 (Or. Ct. App. 1996).

Opinion

DEITS, P. J.

Claimant seeks review of a Workers’ Compensation Board order holding that employer, American International Adjustment Company, was not required to comply with that portion of a reconsideration order that required employer to pay $6,405 in permanent partial disability (PPD) compensation. ORS 656.298. Employer cross-petitions the Board’s assessment of penalties for failure to pay the entire $6,405 award. ORS 656.298. We affirm on the petition and reverse on the cross-petition.

Claimant injured his right knee and employer accepted a claim for the injury in 1991. In November 1992, a notice of closure was issued and claimant was awarded seven percent PPD of the right leg, which amounted to $3,202.50. Employer paid that amount to claimant. In May 1993, claimant requested reconsideration and appointment of a medical arbiter. On July 21, 1993, after receiving the medical arbiter’s report, the department issued an order on reconsideration providing that:

“THE TOTAL SCHEDULED AWARD TO DATE FOR THE FOLLOWING BODY PART(S) IS:
“14 PERCENT EQUAL TO 21 DEGREES FOR RIGHT LEG (KNEE)
iijjt ‡ ‡ ‡ ‡
“THE INSURER IS ORDERED TO PAY THE WORKER AN AWARD OF $6,405.00. THIS IS IN ADDITION TO ANY PREVIOUS AWARDS.”

On July 26th, claimant filed a request for a hearing with the Hearings Division on the reconsideration order. On that same date, the department was contacted by employer and asked to clarify the order on reconsideration. Employer paid an additional $3,202.50 pursuant to the July 21 order, but pointed out to the department that while the order increased the award by seven percent, which would entitle claimant to an additional $3,202.50, the order provided that employer was to pay claimant an additional $6,405. That would give claimant a total award of $9,607.50. Employer [605]*605was told by department staff that the order would be corrected. On August 4, 1993, the department issued an amended order clarifying the order as requested by employer.

After the hearing, on January 14, 1994, the administrative law judge (ALJ) issued an order that set aside the department’s August 4 amended order on the ground that, under the applicable administrative rule, OAR 456-30-008(1), the department lacked authority to correct the order after a request for a hearing on the reconsideration order was received by the department. The ALJ also concluded, however, that claimant was substantively entitled only to a total award of 14 percent, and therefore, held that the order on reconsideration should be corrected to award only an additional $3,202.50. In addition, the ALJ imposed a 25 percent penalty against employer under ORS 656.262(10)1 on the ground that employer had unreasonably failed to pay the amount ordered in the July 21 reconsideration order. Both claimant and employer requested Board review of the ALJ’s order. The Board affirmed the order from which claimant and employer now seek review.

Claimant argues that the Board erred in concluding that employer was not obligated to pay claimant an additional $6,405, the amount ordered by the department in its July 21 order. He asserts that if employer disagreed with the order, it was required to file a timely request for a hearing on the order or seek abatement of the order rather than unilaterally deciding not to comply with it. Employer responds that claimant was never statutorily or substantively entitled to the overpayment and, consequently, under our decision in Lebanon Plywood v. Seiber, 113 Or App 651, 833 P2d 1367 (1992), the Board was correct that it had no authority to order employer to pay an additional $6,405, of which $3,202.50 would clearly be an overpayment of compensation.

[606]*606We agree with the Board that our decision in Seiber is controlling here and that employer is not obligated to pay claimant the disputed $3,202.50. In Seiber, the employer did not pay temporary disability benefits to the claimant after his medically stationary date pending claim closure. The employer thereby avoided the overpayment that normally is incurred as a result of the delay in the administrative closure of the case. Id. at 653. The Board concluded that the employer had to pay temporary disability benefits from the medically stationary date to the date of claim closure even though that would result in an overpayment because these payments were “ ‘procedural’ overpayments [,]” to which claimant was entitled. Id. at 653-54.

On review, we held that the payments that the employer withheld for the period following the claimant’s medically stationary date were not an entitlement but rather were “a consequence of the administrative process of claim closure[.]” Id. at 654. Thus, we concluded that the Board had no authority to impose an overpayment that the claimant was not entitled to receive. Id. We noted then that the proper manner to ensure compliance and to prevent employers from unreasonably delaying or refusing to pay temporary disability benefits is to impose penalties. Id.

Claimant argues that Seiber is distinguishable because it involved a procedural “entitlement” as opposed to a substantive entitlement. Claimant contends that this case is controlled by the decisions in Roseburg Forest Products v. McDonald, 116 Or App 448, 841 P2d 697 (1992), and Georgia-Pacific Corp. v. Piwowar, 305 Or 494, 753 P2d 948 (1988), in which the claimants were found to have a substantive entitlement to the benefits in dispute. Although claimant acknowledges that, in this case, the amount that the July 21 order required employer to pay is a mistake, he asserts that he has a substantive entitlement to the $6,405 included in the department’s order on reconsideration. He argues that his entitlement is “created by the mere existence of a valid Order awarding a specific amount of compensation, whether the amount awarded was based upon an erroneous calculation or not.”

[607]*607We do not agree that the erroneous order creates a substantive entitlement to the extra compensation. These circumstances are different from those in the cases on which claimant relies and from those in Anodizing, Inc. v. Heath, 129 Or App 352, 879 P2d 218 (1994), in which we also held that the claimant had an entitlement to the disputed benefits. In that case, the employer sought review of the order on reconsideration under ORS 656.313(1). Under the version of the statute applicable at that time, during the pendency of judicial review, the employer was required to continue to pay benefits.2 The employer did not do so. We held that, despite the fact that the employer prevailed on review of claimant’s award, the payments in that case were not “overpayments” because the claimant was substantively entitled under the statute, ORS 656.313

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Santos v. Caryall Transport
954 P.2d 187 (Court of Appeals of Oregon, 1998)
Atchley v. GTE Metal Erectors
945 P.2d 557 (Court of Appeals of Oregon, 1997)

Cite This Page — Counsel Stack

Bluebook (online)
927 P.2d 1106, 144 Or. App. 602, 1996 Ore. App. LEXIS 1764, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vega-v-express-services-orctapp-1996.