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Board must reconsider missed deadline for comp hearing

A man who missed his workers compensation hearing request deadline may have his case reconsidered, an Oregon appellate court held Wednesday. 

 

In Matter of the Compensation of Goodwin v. NBC Universal Media, a three-judge panel of the Court of Appeals of Oregon in Salem unanimously reversed and remanded an Oregon Workers Compensation Board’s decision barring a worker’s claim as untimely.

The worker was employed as a painter for NBC Universal when, in August 2012, he fell from the lift gate of a truck on to his back while holding an air compressor. He reported the injury, and an on-site medic gave him over-the-counter medication and heat packs, but he did not file a claim at that time.

On July 24, 2013, he was lifting a heavy piece of plywood on set when he felt a snap or pinch in his neck, pain between his shoulder blades and numbness in his left arm. He filed a workers compensation claim, and a doctor determined that he had two disk protrusions. He was awarded permanent partial disability by the employer, who closed the claim, but the worker requested reconsideration of the notice of closure.

During this process, the worker did not attend the required medical arbiter examination, and the state’s workers compensation division issued a notice suspending his benefits and reconsideration, later upheld the notice of closure.

The worker, however, continued to suffer symptoms and had surgery for degenerative disc disease. He asked for a new/omitted medical condition to be included, and the workers comp insurer arranged for an independent medical examination in Portland, Oregon. However, the worker had since move to Oklahoma and did not attend.

As a result, his claim was denied for a lack of sufficient information to determine whether the additional symptoms and conditions were work related, and under Oregon law, he had 60 days from the mailing of that denial letter to request a hearing. He mailed a letter to the sanctions unit of Oregon’s workers comp division describing his issues, asking for help, but did not explicitly mention the denial or request a hearing. An ombudsman spoke to the worker by phone on what would have been the 60th day past the mailing of the rejection and confirmed that the worker did intend in the letter to request a hearing. He sent a second letter shortly after that conversation, but it also didn’t explicitly state his request for a hearing.

The board held that he failed to request his hearing within the required 60-day time frame and that he failed to show he had “good cause” for missing the mailing deadline.

The worker appealed, and the appellate court reversed and remanded the board’s decision. While the appellate court agreed with the board that the letters may not have constituted a sufficient request for hearing, the ombudsman’s information stating the worker’s intention to appeal the denial or request a hearing coupled with the letters constituted a request for hearing, the court said.

The worker, who also has dyslexia and cannot read or write, and his father had both testified that he did not understand the procedural significance of the various notices, or the requirements for requesting a hearing.

Although the ombudsman did not deliver the letters until after the 60-day deadline, the appellate court held that the worker had good cause, noting that he did send his first letter “well within the 60-day period for requesting a hearing” and that the unclarity of requesting a hearing was due to “his lack of sophistication and confusion, due to the many procedures that were in process.”

The court, therefore, reversed and remanded the case to the board to reconsider whether, in light of the circumstances, the worker’s “mistakes and inadvertence” constituted good cause.

Attorneys in the case did not immediately respond to requests for comment.