FILED: March 17, 1999
In the Matter of the Compensation of
Kenneth P. Bundy, Claimant.
FRED MEYER, INC.,
Petitioner,
v.
KENNETH P. BUNDY and DEPARTMENT
OF CONSUMER AND BUSINESS SERVICES,
Respondents.
En banc
Judicial Review from Workers' Compensation Board.
Argued and submitted April 16, 1998; resubmitted en banc October 14, 1998.
Craig A. Staples argued the cause and filed the briefs for petitioner.
Roger Ousey argued the cause for respondent Kenneth P. Bundy. With him on the brief was Bischoff, Strooband & Ousey, P. C.
No appearance for respondent Department of Consumer and Business Services.
David L. Runner filed a brief amicus curiae for SAIF Corporation and Timber Products Company.
Deborah L. Sather, Tracy J. White, and Krishna Balasubramani filed a brief amicus curiae for Northwest Natural Gas, Precision Castparts Corp., Safeco Insurance Co., and Freightliner Corporation.
Before Deits, Chief Judge, and Edmonds, De Muniz, Landau, Haselton, Armstrong, Linder, Wollheim, Kistler, Judges, and Warren, Senior Judge.
EDMONDS, J.
Reversed and remanded for reconsideration.
Wollheim, J., dissenting.
EDMONDS, J.
Employer seeks review of a Workers' Compensation Board (Board) order ruling that claimant is entitled to temporary disability benefits as of May 11, 1993. We review for errors of law, ORS 656.298(7) and ORS 183.482(8), and reverse.
Claimant has a compensable right wrist condition. The claim was initially closed in 1992. In May 1993, claimant filed an aggravation claim and a request for surgery, which employer denied. The denial was set aside by the Hearings Division, and employer appealed to the Board, which affirmed. That order has become final. In May 1995, claimant requested temporary disability benefits. On May 24, 1995, claimant's attending physician authorized the payment of temporary partial disability (TPD) compensation from November 1992 through April 1995. Employer acknowledged receipt of the authorization, but paid no TPD. In August 1995, employer issued a notice of closure that was subsequently affirmed on reconsideration. The order awarded TPD from April 25, 1995 to August 3, 1995, the date that claimant had become medically stationary. Claimant requested a hearing on the order on reconsideration, arguing that he was entitled to TPD beginning on May 11, 1993, the date the aggravation claim was made. The Board agreed with claimant's argument, and employer seeks review.
Employer argues that:
"The 1995 Legislature determined, by enacting ORS
656.262(4)(g),[(1)] that an attending physician
may not retroactively establish
a claimant's entitlement to temporary disability benefits for any period
unless he has authorized the disability within 14 days of such period. The
Board majority erred in concluding that this provision applies only to an
employer's procedural obligation to pay temporary disability while a claim
is open and does not also govern the claimant's ability to establish
substantive entitlement to such benefits upon claim closure." (Internal
footnote omitted).
In response to employer's argument, claimant asserts:
"The changes made to Chapter 656 by Oregon Law 1995, Chapter
332 should not be retroactively applied to this claim. However, if the
provisions of Oregon Laws 1995, Chapter 332 are applicable, the 1995
revisions to ORS 656.262 did not eliminate the distinction between
procedural and substantive temporary disability. Even if the amendments
did abolish the distinction, the limitation on retroactive authorization does
not apply to the present case where the claimant had been seen by the
attending physician for several years. The legislature intended to prohibit
retroactive authorization for cases involving initial claims. In the present
case, the worker had seen his attending physician to obtain ongoing
treatment for the same condition for a period of five years."
The meaning of ORS 656.262(4)(g) is the focal point of the parties'
arguments. It provides:
"Temporary disability compensation is not due and payable pursuant
to ORS 656.268 after the worker's attending physician ceases to authorize
temporary disability or for any period of time not authorized by the
attending physician. No authorization of temporary disability compensation
by the attending physician under ORS 656.268 shall be effective to
retroactively authorize the payment of temporary disability more than 14
days prior to its issuance."
ORS 656.262(4)(g) was enacted by the Legislature in 1995. Senate Bill
369; Or Laws 1995, ch 332. ORS 656.262(4)(g) was enacted while this claim was in
litigation. Therefore, the amendment applies. Jensen v. Conagra, Inc., 152 Or App 449,
954 P2d 822 (1998);(2) Volk v. America West Airlines, 135 Or App 565, 899 P2d 746
(1995), rev den 322 Or 645 (1996).
The remaining issue in this case is whether ORS 656.262(4)(g) applies to
only procedural obligations to pay temporary disability while a claim is open, or whether
it also applies to the substantive entitlement to benefits at claim closure. The Board ruled
that ORS 656.262(4)(g) is only an additional requirement for the authorization of
procedural temporary disability compensation during an open claim. It reasoned that,
because the terms in the statute are in the present tense and thereby address the
contemporaneous payment of compensation while the claim is in open status, it follows
that the statute does not apply to awards of temporary disability made at the time of
closure. The Board noted that a claimant's entitlement to temporary disability benefits
under ORS 656.210 and ORS 656.212 was not amended in 1995 in any way that was
material to the meaning of ORS 656.262(4)(g) and that neither ORS 656.210 nor ORS
656.212 contains any language that limits a worker's substantive entitlement to temporary
disability to only those periods for which there has been contemporaneous authorization
by the attending physician. Based on that reasoning, the Board concluded that ORS
656.262(4)(g)'s restriction on the authorization of temporary disability benefits was
inapplicable to claimant's claim for substantive temporary disability benefits.
The pertinent statutes are reasonably susceptible to the construction given
to them by the Board. However, that conclusion does not end the inquiry. In interpreting
a statute, our task is to discern the intent of the legislature. ORS 174.020. The text of the
statutory provision itself is the starting point for interpretation because it is the best
evidence of the legislature's intent. We also consider the context of the statutory
provision at issue, which includes other provisions of the same statute and other related
statutes as well as rules of construction of the statutory text that bear directly on how to
read the text. If the legislature's intent is clear from such an inquiry, there is no need to go
further. It is with those rules in mind that we examine ORS 656.262(4)(g) to determine
whether the Board's interpretation is the only reasonable construction of the meaning of
ORS 656.262(4)(g).
On its face, ORS 656.262(4)(g) is not limited to benefits that are due and
payable during the time that the claim is open. The first sentence in the statute tells the
reader when temporary disability compensation is not due and payable; the second
sentence in the statute restricts the retroactive authorization of temporary disability
compensation to a time period of not more than 14 days. The fact that the verbs in the
statute are in the present tense does not negate the possibility that the statute also applies
to awards of time loss(3) made at claim closure. Whether time loss is awarded while a
claim is open or at closure will always be an act that occurs contemporaneously to the
overall processing of the claim. Moreover, the reference to ORS 656.268 in both
sentences is a reference to a statute that addresses the process of claim closure. Finally,
the fact that ORS 652.210 and ORS 656.212, statutes regarding the substantive
entitlement to temporary disability, remain unchanged is not determinative of the issue.
The legislature could well have intended that the requirements in those statutes remain
the same, while intending to superimpose upon them a limitation on the retroactive award
of such benefits. We conclude, based on the above examination, that the intent of the
legislature is not clear from the text and the context of ORS 656.262(4)(g).(4) In light of its
language, the legislature could have intended that the 14 day restriction on TPD apply to
both procedural and substantive time loss.
As a result of the purpose of the legislature not being clearly discernable
from the text and context of ORS 656.262(4)(g), we consider the legislative history
underlying the statute. Our review of the legislative history discloses that the changes in
ORS 656.268 were: "Intended to preclude a closure order from making a substantive
award of time loss benefits for any period of time during which procedurally the time loss
benefits were lawfully suspended or withheld or terminated." Tape recording, Joint
Meeting of Senate Committee on Labor and Government Operations and House
Committee on Labor, February 1, 1995, Tape 19A.
In addition, the following exchange took place at a legislative committee
meeting on Senate Bill 369:
"[Representative Kevin Mannix addressing Senator Randy Leonard]: You
were surprised, and I think even shocked, that it could be possible under the
act that a physician could do retroactive time loss. Senator, it happens.
And, we've been required to respond to it. And, we've been penalized for
not paying it -- periods of time during which the time loss might have been
monitored, the worker's medical condition might have been reported on, but
it wasn't. We end up getting a retroactive authorization for --I have seen
two years of time loss, I have seen more.
"[Senator]: Retroactive?
"[Jerry Keene]: Doctor says, I'm going back two years to authorize time loss
even though I haven't seen you. This says you can go back fourteen days.
"[Senator]: Just give me the example.
"[Keene]: Worker files a claim based on a recent visit to a physician and
says, I had this problem a couple of years ago * * * and doctor says, in my
opinion, this person couldn't work as of a year ago based on that condition
or injury.
"[Senator]: Evaluation today?
"[Keene cont.]: And I'm authorizing retroactive time loss. This section says
you can't do that more than fourteen days back. If somebody is that badly
off that they need time loss, they should see a physician to get authorization
for the time loss. And it's reasonable for someone who has been hurt--they
went home for a few days, they were in bed and weren't getting [doctor's
care]--to take a few days to get to the doctor so that's why the fourteen days
* * *.
"[Senator]: Actually that was clarified to me after I asked the questions.
Well, that kind of a situation--yes, you could get hurt and then later go to
the doctor and it could be a few days. So that actually made sense."
"* * * * *
"[Keene cont.]: This does not affect the time limit for making a claim. It
just affects how far back a doctor can give you time loss.
"[Senator]: For time loss. I see. Okay." Tape recording, Joint Meeting of
Senate Committee on Labor and Government Operations and House
Committee on Labor, February 17, 1995, Tape 48B.
Later, Mannix stated in support of the bill:
"* * * [T]here have been ludicrous situations where the worker doesn't go
to a physician for a couple of months on the initial claim, and the physician
said, oh yeah, I'll retroactively authorize time loss all the way back. This
makes it clear that you can only do that up to 14 days. If someone really
needed to be off work, they should be seeing an attending physician." Tape
Recording, House Committee on Labor, March 6, 1995, Tape 46A.
As indicated previously, ORS 656.268 addresses the process of claim
closure, including the procedure for determining awards of permanent disability,
termination of temporary total disability and the events that result in termination of
benefits. ORS 656.268(3) was amended as part of the 1995 changes. It now provides, in
pertinent part:
"(3) Temporary total disability benefits shall continue until
whichever of the following events first occurs:
"* * * * *
"(d) Any other event that causes temporary disability benefits to be
lawfully suspended, withheld or terminated under ORS 656.262(4) or other
provisions of this chapter."
As a result of the above amendment, temporary disability benefits are terminated not only
when the worker returns to work or is released to return to work, but upon the occurrence
of the events enumerated in ORS 656.262(4).(5) The incorporation of ORS 656.262(4)
events into ORS 656.268(3) as events that act to terminate the obligation to pay
temporary disability is a manifestation of the legislature's intention that closure orders be
precluded from awarding time loss benefits for any period of time during which there is
no procedural entitlement. Thus, the legislative history when read with the text and
context of the applicable statutes makes it clear that the reference in ORS 656.262(4)(g)
to ORS 656.268 was intended to limit the award of retroactive time loss to 14 days,
whether the claim was open or was pending closure.
The dissent contends that our decision in this case should be controlled by
our holdings in Shaw v. Rebholz, 152 Or App 328, 954 P2d 190 (1998) and Santos v.
Caryall Transport, 152 Or App 322, 954 P2d 187 (1998). In Shaw, the issue was
whether the employer could be ordered to make temporary partial disability payments
beyond the date that the claimant became medically stationary. The claimant contended
the Board was precluded from determining that he was not entitled to benefits after that
date because, in an earlier proceeding, it had concluded that the employer had improperly
terminated claimant's benefits. The Board concluded that ORS 656.268 as amended by
the 1995 legislature continues to address a claimant's entitlement to benefits awarded at
closure, and it ruled that claimant was not entitled to benefits beyond the date that he was
disabled. On review, we summarily rejected the claimant's argument that the distinction
between "substantive" and "procedural" entitlement had been legislatively overruled by
the 1995 legislature by citing to Santos.
In Santos, the issue was again whether an employer could be ordered to pay
temporary partial disability payments beyond the date that the claimant was medically
stationary. He argued that he was entitled to temporary disability benefits because
amended ORS 656.268 no longer provides for the termination of benefits at the time that
a claimant becomes medically stationary. He also argued that ORS 656.262(4)(g) could
not be applied to him retroactively. We did not decide the latter argument. Rather, we
cited a number of cases that had been decided since the 1995 amendments, and we
concluded that claimant's arguments were controlled by our holding in Lebanon Plywood
v. Seiber, 113 Or App 651, 833 P2d 1367 (1992). In that case, we held that the claimant's
substantive entitlement to temporary benefits ended on the medically stationary date, and
that the Board lacked the authority to order an employer to pay benefits beyond that date.
Our holdings in Santos and Shaw are not controlling.(6) Whether a claimant
is entitled to benefits after becoming medically stationary is not the issue. As to the award
of retroactive time loss, the legislature's intent is clear that ORS 656.262(4)(g) provides a
limitation on all awards of temporary disability under ORS 656.268. Under ORS
656.262(4)(g), the passage of time acts by operation of law to restrict the retroactive
authorization of time loss. Consequently, claimant's physician was without authority to
authorize temporary disability retroactively for a period of more than 14 days. We
conclude that the Board erred when it ruled that claimant was entitled to substantive
temporary disability from May 11, 1993, through April 24, 1995.(7)
Reversed and remanded for reconsideration.
WOLLHEIM, J., dissenting.
The majority opinion ignores case law that existed before the adoption of
ORS 656.262(4)(g) and case law after its adoption. The majority opinion acknowledges
that the Board's interpretation of the relevant statutes is reasonable. The Board's statutory
interpretation is not only reasonable, it is also the correct interpretation. For this reason, I
dissent.
The primary question is whether ORS 656.262(4)(g) abolished the
distinction between procedural and substantive temporary disability benefits. Although it
has its basis in the statutes, the "substantive/procedural" terminology is not found in ORS
chapter 656. The distinction has been described in case law. Lebanon Plywood v.
Seiber, 113 Or App 651, 833 P2d 1367 (1992). The substantive entitlement for
temporary total disability benefits is set forth in ORS 656.210, which provides that
"[w]hen the total disability is only temporary, the worker shall receive during the period
of that total disability compensation equal to 66-2/3 percent of wages * * *." Temporary
total disability benefits are awarded to replace lost wages due to a compensable temporary
disability. Cutwright v. Weyerhaeuser Co., 299 Or 290, 295, 702 P2d 403 (1985).
Substantive time loss is the temporary total disability award, which the injured worker is
entitled to receive at the time of closure by virtue of proof that the injured worker
experienced a period of temporary total disability before claim closure. SAIF v. Taylor,
126 Or App 658, 660-61, 870 P2d 245 (1994).
An injured worker's procedural entitlement to time loss is the temporary
total disability benefits that the employer or insurer is obligated to pay on an open claim
by virtue of the procedures of claim processing before the injured worker becomes
medically stationary. The ability to obtain payment of benefits for temporary total
disability while the claim is open is dependent on the satisfaction of a number of
conditions, most of which are set forth in ORS 656.262. In Atchley v. GTE Metal
Erectors, 149 Or App 581, 585, 945 P2d 557, rev den 326 Or 133 (1997), we said:
"[T]he general distinction between a substantive and procedural entitlement
is that a substantive benefit is one that is made explicit and unconditional by
statute, while a procedural benefit is conditional, arising solely from the
vagaries of claim processing."
A substantive award of temporary disability at the time of closure may
exceed or be less than the procedural time loss payments to which an injured worker was
entitled during the time when the claim was open. That is, an employer or insurer may be
required to pay additional time loss payments or may be entitled to an offset for any
overpaid time loss benefits. To this date, this court has not construed the condition for
payment of benefits for time loss, as set forth in ORS 656.262, as creating limitations on
the award of benefits to which the injured worker is entitled under ORS 656.210 at the
time of closure. This court has not held that a failure to carry out the procedures
necessary to obtain payment of temporary total disability benefits while a claim is open
bars an award for the entire period of disability at the time of closure.
I agree with the majority that we must first examine the text and context of
ORS 656.262(4)(g). PGE v. Bureau of Labor and Industries, 317 Or 606, 610, 859 P2d
1143 (1993); Deluxe Cabinet Works v. Messmer, 140 Or App 548, 553, 915 P2d 1053,
rev den 324 Or 305 (1996). I disagree with the majority in that I believe the text and
context of ORS 656.262(4)(g) support the Board's decision. Because I believe the
legislative intent is clear from the text and context of ORS 656.262(4)(g), I do not
consider the legislative history. A review of the relevant portions of ORS 656.262
follows.
ORS 656.262(4)(a) describes generally how benefits to time loss are paid,
with the first installment due "no later than the 14th day after the subject employer has
notice or knowledge of the claim, if the attending physician authorizes the payment of
temporary disability compensation." The initial payment of time loss benefits is due upon
authorization by the attending physician. With the exception of ORS 656.262(4)(f),
which relates to the compensability of medical services, each subsequent subparagraph of
subsection (4) relates to a circumstance affecting the payment of temporary total disability
benefits while the claim is open. ORS 656.262(4)(d) is the first subsection to speak about
"verification" of disability, as distinct from authorization of benefits. Temporary total
disability is not due and payable during the period of time where the attending physician's
verification of an inability to work has been requested but not received, unless the
claimant has been unable to receive treatment for reasons outside the claimant's
control.(8)
In Taylor, this court interpreted that subsection, then numbered (4)(b), and held that the
requirement for verification of disability is a procedural limitation on the payment of
benefits when the claim is open and does not alter the claimant's substantive entitlement
to an award of benefits for the entire period of disability. We said that even if medical
verification is not provided, as required under subsection (4)(d), and benefits are not due
and payable while the claim is open, the benefits to which the claimant is substantively
entitled become due and payable at the time of closure:
"As we held in Sandoval v. Crystal Pine, 118 Or App 640, 848 P2d 1224,
rev den 317 Or 272 (1993), the suspension of benefits pursuant to ORS
656.262(4)(b) due to the absence of medical verification of an inability to
work does not terminate the claimant's substantive entitlement to benefits.
The benefits to which the claimant is substantively entitled become due and
payable when the claim is closed." 126 Or App at 661.
Under ORS 656.262(4)(e), the claimant's failure to attend an appointment
with the attending physician may allow the employer or insurer to suspend the payment of
benefits. ORS 656.262(4)(f) does not concern the payment of time loss benefits.
Under ORS 656.262(4)(g), the disputed provision, no benefits are "due and
payable pursuant to ORS 656.268" after the attending physician ceases to authorize them
or for any period not authorized. Further, no authorization by a physician "under ORS
656.268" may retroactively authorize more than 14 days of benefits. From this brief
summary, it can be readily determined that ORS 656.262(4) is primarily about the
payment of benefits on an open claim, i.e., when payment must be made, when payment is
not due and payable, and when payment may be unilaterally suspended. As the statute's
repeated reference to the subject bears out, the legislature considers authorization of
benefits and verification of disability to be prerequisites to obtaining payment of
temporary disability benefits on an open claim. Authorization of benefits and verification
of disability, or the lack thereof, are determinative under ORS 656.262(4) for the purpose
of obtaining temporary disability benefits while a claim is open and before being
processed for claim closure. I presume that the legislature's use of "not due and payable"
and the unilateral suspension of benefits is intentional and, further, that the legislature
used different language because it intended different meanings. Dale v. Electrical Board,
109 Or App 613, 616, 820 P2d 868 (1991).
The process for awarding benefits on a claim at the time of closure, as
distinct from paying benefits for time loss before closure, is set forth in ORS 656.268.
See Fazzolari v. United Beer Distributors, 91 Or App 592, 595,
757 P2d 857, adhered to
93 Or App 103, 761 P2d 6, rev den 307 Or 236 (1988) (ORS 656.268
only deals with the
processing of claims). For example, ORS 656.268(5)(a) provides that when the
department receives the medical and vocational reports concerning an accepted disabling
injury claim, the claim shall be examined and "further compensation, including permanent
disability award, if any, [be] determined * * *." This implies that an injured worker may
be entitled to further compensation for temporary disability beyond what was due and
payable while the claim was open. ORS 656.268(13) provides:
"Any determination or notice of closure made under this section may
include necessary adjustments in compensation paid or payable prior to the
determination or notice of closure, including * * * crediting temporary
disability payments against current or future permanent or temporary
disability awards or payments and requiring the payment of temporary
disability payments which were payable but not paid."
Under ORS 656.268(15)(a), an employer or insurer may offset any compensation payable
to the worker to recover an overpayment from a claim with the same employer or insurer.
Each of the described subsections sets forth how an award of compensation, either an
additional or lesser amount, must be made in the closure order.
ORS 656.268(3) describes the circumstances under which temporary
disability benefits continue unless a specified event first occurs. ORS 656.268(3)
provides:
"Temporary total disability benefits shall continue until whichever of
the following events first occurs:
"(a) The worker returns to regular or modified employment;
"(b) The attending physician advises the worker and documents in
writing that the worker is released to return to regular employment;
"(c) The attending physician advises the worker and documents in
writing that the worker is released to return to modified employment, such
employment is offered in writing to the worker and the worker fails to begin
such employment; or
"(d) Any other event that causes temporary disability benefits to be
lawfully suspended, withheld or terminated under ORS 656.262(4) or other
provisions of this chapter."
Subsection (3)(d) refers to ORS 656.262(4) and authorizes a discontinuance of temporary
disability benefits based on "[a]ny other event that causes temporary disability benefits to
be lawfully suspended, withheld or terminated under ORS 656.262(4) * * *." However,
subsection (3)(d) does not include the language from ORS 656.262(4)(g) of "not due and
payable."
This court previously interpreted ORS 656.262(4)(g) not to require an
employer to pay the claimant more than two years of retroactive temporary disability
benefits while the claim was open. Jensen v. Conagra, Inc., 152 Or App 449, 954 P2d
822 (1998). We rejected the claimant's arguments that ORS 656.262(4)(g) did not apply
to open claims. Id. at 452-53.
ORS 656.262(4)(g), in turn, refers to ORS 656.268 in stating its
requirement for authorization of time loss. The question here is whether the requirement
for authorization of time loss applies for purposes of the award of benefits at the time of
closure and, if so, whether the limitation on retroactive authorization also applies to the
award of benefits.
ORS 656.262(4)(g) twice refers to ORS 656.268:
"Temporary disability compensation is not due and payable pursuant
to ORS 656.268 after the worker's attending physician ceases to authorize
temporary disability or for any period of time not authorized * * *. No
authorization * * * by the attending physician under ORS 656.268 shall be
effective to retroactively authorize the payment of temporary disability more
than 14 days prior to its issuance." (Emphasis added.)
The Board interpreted the references in ORS 656.262(4)(g) to ORS 656.268 to relate only
to ORS 656.268(3)(d), rather than to ORS 656.268 in its entirety. It held that the
limitations expressed in ORS 656.262(4)(g) are additional procedural restrictions on the
payment of time loss benefits while a claim is open, but that they do not restrict an award
of benefits at the time of closure. The majority disagrees.
The placement of ORS 656.262(4)(g) among the subparagraphs, which we
have previously held relate only to procedural limitations on the payment of time loss
benefits, supports claimant's and the Board's interpretation. To adopt the majority's
interpretation would be a significant departure from prior statutes and our case law
interpreting them. Taylor; Sandoval; Fazzolari; Vip's Restaurant v. Krause, 89 Or App
214, 748 P2d 164, adhered to 91 Or App 472, 756 P2d 47, rev den 306 Or 414 (1988). I
am unwilling to assume that the legislature intended such a departure without very clear
statutory language that it did so.
The language of ORS 656.268(4)(g) does not support the majority's
interpretation. The first sentence of subsection (4)(g) is expressly limited to temporary
disability benefits not due and payable "pursuant to ORS 656.268." That statute is only a
procedural statute. Fazzolari, 91 Or App at 595. Because temporary disability benefits
suspended under the first sentence of subsection (4)(g) are, by definition, being paid
pursuant to ORS 656.268, this sentence is limited to the procedural entitlement to
temporary disability benefits. The second sentence of subsection (4)(g) expressly refers
to an attending physician's authorization of temporary disability benefits "under ORS
656.268." The explicit reference to ORS 656.268 limits the application of this sentence
of (4)(g) to the procedural entitlement of temporary benefits while the claim is open. I
cannot ignore the legislature's explicit reference to ORS 656.268 by omitting what the
legislature inserted. ORS 174.010. Thus, like the first sentence, the second sentence of
subsection (4)(g) is also limited to the procedural entitlement to temporary disability
benefits.
The distinction between procedural and substantive benefits applies only to
temporary disability benefits. There are no procedural permanent disability benefits, no
procedural medical benefits, nor procedural vocational assistance benefits. Under the
majority's reading of ORS 656.262(4)(g), the distinction between procedural and
substantive temporary disability benefits no longer exists. No employer or insurer would
ever be required to pay temporary benefits more than 14 days before the attending
physician's authorization.
To reach this result, the majority overrules our recent decisions in both
Shaw v. Rebholtz, 152 Or App 328, 954 P2d 190 (1998), and Santos v. Carryall
Transport, 152 Or App 322, 954 P2d 187 (1998). Essential to the decision in Shaw, this
court had to determine whether the legislature abolished the distinction between
procedural and substantive benefits:
"Claimant insists that the distinction between his entitlement to
temporary disability benefits during the pendency of the open claim and his
entitlement to the benefits at closure relies on a distinction between
'substantive' and 'procedural' entitlements that has been legislatively
overruled. We have rejected that argument." 152 Or App at 333.
In Santos, the issue was whether the employer was required to pay time loss
benefits after the claimant was medically stationary. 152 Or App 322. The claimant
argued that the amendments to ORS 656.268(3) were the only authority for the unilateral
termination of time loss benefits and that because being medically stationary was not one
of the statutory grounds for the unilateral termination of time loss benefits, the claimant
was entitled to such benefits until the claim was closed. Id. at 325. We rejected the
claimant's arguments and held that the distinction between procedural and substantive
entitlements was not changed by either the 1990 or the 1995 amendments to ORS chapter
656. Id. at 327.
The majority is correct that the holdings in Santos and Shaw are not directly
on point. ___ Or App at ___ (slip opinion at 11). The majority and I disagree about the
effect of this decision on Santos and Shaw. Essential to both decisions was that this court
held the distinction between substantive and procedural entitlement to temporary
disability benefits was not abolished by either the 1990 nor the 1995 amendments to ORS
chapter 656. However, the majority here holds that the 1995 amendments to ORS
656.262(4)(g) abolished the distinction between substantive and procedural temporary
disability benefits.
In summary, both sentences of ORS 656.262(4)(g) explicitly refer to ORS
656.268, the statute for processing and closing a claim. ORS 656.268 refers to
procedural, not substantive, temporary disability benefits. Accordingly, I would hold that
ORS 656.262(4)(g) applies only to procedural entitlement to temporary disability benefits.
Here, the award of temporary disability benefits was substantive, and the Board's order
was proper.
There is another reason to affirm the Board: stare decisis. The rule of stare
decisis was discussed by the Supreme Court in Multnomah County v. Sliker, 10 Or 65, 66
(1881):
"[T]he rule is said to be almost universal that in construing statutes and the
constitution, [the courts] adhere to the doctrine of stare decisis [even
though a different conclusion might be reached] * * * unless error is plainly
shown to exist * * *."
This language was recently relied on by Judge Edmonds, dissenting in Newell v. Weston,
156 Or App 371, 383, ___ P2d ____ (1998). The majority opinion ignores the rule of
stare decisis and overrules two recent decisions by this court. I do not believe the
majority has established that plain error exists. I fear this decision undermines an
important policy of the appellate courts of this state: to afford certainty to the
administration of justice. The changing of the goal posts by judicial fiat can only lead to
uncertainty in the law and encourage litigants to question settled law. Nor can it be said
that the law concerning ORS 656.262(4)(g) is even settled. Perhaps another litigant will
raise this issue again, and this court, perhaps with different members, will reexamine this
statute and decide that Santos and Shaw were correctly decided. Such changes do not
promote the rule of stare decisis, nor do they promote the administration of justice.
Because I would affirm the Board's decision, it would be necessary to reach
employer's second assignment of error. Employer asserted that the Board erred in
determining that claimant was disabled during the period in question. I would hold that
the Board's determination is supported by substantial evidence.
I dissent.
De Muniz and Armstrong, JJ., join in this dissent.
1. During the time in question, the statute was numbered ORS 656.262(4)(f). In
1997, ORS 656.262(4)(f) (1995) was renumbered to ORS 656.262(4)(g). Or Laws 1997, ch 639,
§ 7. We refer to it by its current number.
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2. We held in Jensen that ORS 656.262(4)(g) applied retroactively to existing
claims and that the statute, "creates a limit on the amount of retroactive benefits to which
claimant is entitled, i.e., two weeks. That limit, defining as it does a claimant's rights, is
substantive." 152 Or App at 453.
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3. For purposes of this opinion and in the legislative history, "time loss" is a term
encompassed in the term "temporary disability" compensation or TPD.
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4. Apparently, the dissent would hold that when the legislature used ORS 656.268 in the language of ORS 656.262(4)(g), it really meant to say "ORS 656.268(3)(d)." Presumably, the legislature knows how to specifically incorporate a subsection of a statute into another statute. If the legislature had intended ORS 656.262(4)(g) to incorporate only ORS 656.268(3)(d), it would have said so.
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5. ORS 656.268(3) provides in its entirety:
"(3) Temporary total disability benefits shall continue until whichever of the following events first occurs:
"(a) The worker returns to regular or modified employment;
"(b) The attending physician advises the worker and documents in writing that the worker is released to return to regular employment;
"(c) The attending physician advises the worker and documents in writing that the worker is released to return to modified employment, such employment is offered in writing to the worker and the worker fails to begin such employment; or
"(d) Any other event that causes temporary disability benefits to be lawfully suspended, withheld or terminated under ORS 656.262(4) or other provisions of this chapter."
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6. The legislature makes law by enacting new statutes. When it acts, our task is to interpret what the legislature has done by giving effect to the legislature's intention. It is beyond our authority to create law based on a statute that is different from what the legislature intended. ORS 174.010; ORS 174.020. Although the dissent believes that essential to the determinations in the decisions in Santos and Shaw was a distinction between substantive and procedural entitlement to temporary disability benefits, neither opinion expressly considers the legislature's intent in that regard. Moreover, our prior case law is of no consequence when the legislature acts anew, as it did here. Because of the 1995 amendment to ORS 656.262, the rule of stare decisis is inapplicable. The dissent's analysis based on those precedents necessarily fails in the light of the ambiguity of ORS 656.262(4)(g), which requires us to discern the legislature's intent from the legislative history underlying the amendment.
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7. Employer paid temporary loss benefits after April 24, 1995.
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8. Explicit in ORS 656.262(4)(d) is the provision that the claimant may be entitled to temporary disability benefits that were not due and payable if the claimant can later establish that no treatment was received for reasons beyond the claimant's control. Implicit in this subsection is that the claimant can later establish that fact when the claim is closed and the claimant is awarded temporary disability benefits. Under the majority's analysis, a claimant would not be entitled to later receive time loss benefits even if it was established that the reason the claimant was unable to receive treatment was outside the claimant's control. Thus, the majority's analysis renders subsection (4)(d) nugatory.
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