Title: Morales v. SAIF

State: oregon

Issuer: Oregon Supreme Court

Document:

FILED:  December 15, 2005
IN THE SUPREME COURT OF THE STATE OF OREGON
In the Matter of the Compensation of
Robert M. Morales, Claimant.
ROBERT M. MORALES,
Petitioner on Review,
v.
SAIF CORPORATION
and BRING RECYCLING,
Respondents on Review.
(WCB 02-07850; CA A122935; SC S52119)
En Banc
On review from the Court of Appeals.*
Argued and submitted September 9, 2005.
Christopher D. Moore, of Malagon, Moore & Jensen, Eugene,
argued the cause and filed the brief for petitioner on review.
Jerome P. Larkin, SAIF Corporation, Salem, argued the cause
and filed the brief for respondents on review.
DE MUNIZ, J.
The decision of the Court of Appeals and the order of the
Workers' Compensation Board are affirmed.
*Judicial review from final order of the Workers'  
Compensation Board. 196 Or App 693, 103 P3d 654 (2004).
DE MUNIZ, J.
The issue in this workers' compensation case is whether
ORS 656.325(5)(b) entitled claimant's former employer to cease
paying benefits for temporary total disability and to begin
paying benefits for temporary partial disability when claimant's
attending physician approved work in a modified job that the
former employer would have offered claimant if claimant had not
been terminated for violating a work rule.  We conclude that the
statute authorized the payment changes at issue in this case and,
therefore, affirm the order of the Workers' Compensation Board
(board) and the decision of the Court of Appeals. 
We take the procedural history and facts from the Court
of Appeals opinion:
"In 1997, claimant suffered a shoulder injury at work,
which employer accepted as nondisabling.  Claimant
returned to his job without time loss.  In 1998,
employer terminated claimant's employment for a
violation of work rules.  Claimant began working for a
different employer, Foss Furniture Clinic (Foss). 
Meanwhile, in 2000, employer implemented a written
policy to assist workers to return to work after an
injury by offering modified work.
"In 2002, claimant's shoulder condition became
worse and he was unable to continue working at Foss. 
He has not returned to work since that time.  In July
2002, employer accepted an aggravation claim relating
to the shoulder injury and reclassified the original
claim as disabling.  Employer began paying benefits for
temporary total disability as of September 19, 2002. 
Claimant had surgery on his shoulder on September 23,
2002, and his attending physician released him for
modified work on September 30, 2002.  On October 9,
2002, the attending physician approved a modified job
that employer would have offered to claimant as of
October 14, 2002, had he remained employed.  In
response to the physician's release, employer ceased
payment of temporary total disability as of October 14. 
The board upheld employer's termination of benefits
[under ORS 656.325(5)(b) set out post], and claimant
seeks judicial review.  The only question on review is
whether employer was authorized to cease paying
temporary total disability benefits."
Morales v. SAIF Corp., 196 Or App 693, 695, 103 P3d 654 (2004).
On appeal, claimant argued that (1) ORS 656.325(5)(b)
does not apply to aggravation claims; (2) even if ORS
656.325(5)(b) were applicable, the statute's provisions had not
been satisfied because claimant's termination had not occurred
while his aggravation claim was pending; and (3) employer did not
have a written return-to-work policy in effect at the time of
that termination.  The Court of Appeals, however, affirmed the
board's termination of claimant's temporary total disability
benefits.  The Court of Appeals reasoned that, although claimant
could not return to work for employer because employer had
terminated him, employer nevertheless had satisfied the
requirements of ORS 565.325(5)(b) by (1) creating a job modified
to accommodate claimant's injury; (2) implementing a written
policy of offering such modified work to injured workers; and (3)
receiving approval from claimant's physician regarding claimant's
ability to do that modified work.  Morales, 196 Or App at 699. 
We subsequently allowed claimant's petition for review
to examine the legislature's intent in enacting ORS
656.325(5)(b).  On review, claimant reasserts the arguments that
he presented to the board and the Court of Appeals, which
question the meaning and applicability of ORS 656.325(5)(b),
which provides:
"If the worker has been terminated for violation
of work rules or other disciplinary reasons, the
insurer or self-insured employer shall cease payments
pursuant to ORS 656.210 and commence payments pursuant
to ORS 656.212 when the attending physician or nurse
practitioner authorized to provide medical services
under ORS 656.245 approves employment in a modified job
that would have been offered to the worker if the
worker had remained employed, provided that the
employer has a written policy of offering modified work
to injured workers."
We begin our analysis with claimant's assertion that
the Court of Appeals and the board "erroneously applied ORS
656.325(5)(b) to an accepted aggravation claim, denying
[claimant] the protection of temporary disability benefits
afforded by the workers' compensation statutes."  Claimant
contends that an aggravation claim is not subject to ORS 656.325
because an aggravation claim is a separate and independent claim
governed by ORS 656.273, (1) which does not refer to or
incorporate ORS 656.325.  
In support of that contention, claimant initially
argues that this court's decision in Buddenberg v. Southcoast
Lumber, 316 Or 180, 850 P2d 360 (1993), established that "ORS
656.325 does not apply to aggravation claims because they are new
claims in their own right, independent of the prior adjudicated
claim."  Claimant's reliance on Buddenberg is misplaced.  
In Buddenberg, this court held that "a claim for
aggravation independently fits the definition of a 'claim,'" 316
Or at 183 n 1.  However, the court also concluded that
entitlement to benefits for an aggravation claim depends "on how
the claimants's circumstances fit within the provisions of the
Worker's Compensation Law governing that particular claim."  Id.
at 186.  Here, the Court of Appeals in applying Buddenberg,
reasoned that, "although an aggravation claim is a separate
claim, the general provisions of the Workers' Compensation Law
regarding the availability of and limitations on particular types
of benefits apply to aggravation claims."  Morales, 196 Or App at
700.  
The Court of Appeals cited correctly this court's
statement in Buddenberg in rejecting claimant's argument. 
However, in Buddenberg this court did not analyze ORS
656.325(5)(b) under the now-familiar methodology for construing
statutes that this court summarized in PGE v. Bureau of Labor and
Industries, 317 Or 606, 859 P2d 1143 (1993).  This case presents
the opportunity to do so.  Under that methodology, we first
examine the text of the statute, in context, in an effort to
discern the intent of the legislature.  Id. at 610.  If the
meaning of the statute is clear at that level of analysis, then
further inquiry is unnecessary.  Id. at 611. 
The text of ORS 656.325(5)(b) does not indicate
explicitly whether its provisions are applicable or inapplicable
to aggravation claims.  However, the statute applies to
"payments" made under ORS 656.210 and ORS 656.212, and does not
specifically exclude payments for aggravations claims.  If the
legislature had intended to exempt aggravation claims from ORS
656.325(5)(b), it could have included an exclusionary
preamble. (2)  No such preamble exists, and in interpreting a
statute, this court will not insert what the legislature has
omitted.  ORS 174.010.  The legislature's omission of any
exemptions  demonstrates that the legislature intended the
provisions of ORS 656.325(5)(b) to have plenary effect. 
Furthermore, in determining the statute's
applicability, we also must consider previous decisions of this
court interpreting ORS 656.325(5).  In Cutright v. Weyerhaeuser,
299 Or 290, 702 P2d 403 (1985), the court determined that 
"[a]s applied to aggravation claims, [former ORS
656.325(5) (1983)] dictates that a worker receiving
[temporary total disability] benefits must not refuse
wage earning employment prior to the aggravation claim
determination if the worker is capable of working. 
Thus, a claimant who has retired from the labor market
cannot qualify for [temporary total disability]
benefits because of the claimant's decision to refuse
further wage earning employment."
Id. at 300.  In the 20 years following the Cutright decision, the
legislature has not amended the text of ORS 656.325(5) to
restrict its application to initial claims only or otherwise
explicitly made the statute inapplicable to aggravation
claims. (3)  For the reasons described above, we conclude that
the legislature intended that temporary total disability benefits
deriving from an aggravation claim be subject to termination in
the circumstances set forth in ORS 656.325(5)(b).
Claimant next argues that, even if ORS 656.325 applies
to aggravation claims generally, the statute is "reasonably
susceptible to more than one meaning."  Claimant contends that
the statute does not clearly indicate when its provisions are
triggered.  Claimant argues that ORS 656.325(5)(b) applies only
if termination occurred during the aggravation claim and a
written return-to-work policy was in effect at the time of that
termination.  As claimant interprets ORS 656.325(5)(b), employer
failed to satisfy either of those requirements.  
Claimant further argues that his claim is new and
independent, separate from the initial claim, and that this court
should analyze it based on present circumstances and not on
events that preceded it.  As claimant views it, his 1998
termination should have no bearing on whether he is entitled to
benefits under the current aggravation claim, and he should not
be "punished" for an event that occurred at a prior employment.  
In essence, claimant relies on the underlying purpose
of the Workers' Compensation Law, which is to "restore the
injured worker physically and economically to a self-sufficient
status in an expeditious manner and to the greatest extent
practicable[.]"  ORS 656.012(2)(c).  Claimant argues that
"interpreting ORS 656.325(5) to include workers * * * who have
remained in the workforce and have worked successfully for later
employers and then suffer an aggravation of their compensable
condition, frustrates the Workers' Compensation Law's policies
and punishes the employee for an earlier alleged work rule
violation."  Claimant's policy argument is reasonable, and it
parallels the stated purposes of the Workers' Compensation Act. 
Furthermore, claimant is correct that ORS 656.325(5)(b) applies
"[i]f a worker has been terminated for violation of work rules or
other disciplinary reasons" and does not state explicitly by whom
the worker must have been terminated.  
However, the text of ORS 656.325(5)(b) indicates only
that it applies if the employer-at-injury terminated the
claimant, and it does not address any subsequent employment.  ORS
656.325(5)(b) provides that, if a worker has been terminated, and
"the attending physician * * * approves employment in a modified
job that would have been offered to the worker if the worker had
remained employed," then the employer is permitted to cease
payment of temporary total disability and commence payment of
temporary partial disability.  (Emphasis added.)  The employer
permitted to reduce payments under the statute is the employer-at-injury, and the hypothetical modified job is a job that would
have been offered by the employer-at-injury had the claimant
remained employed by the employer-at-injury.  As we view it, the
text allows for no other interpretation. 
Claimant also argues that ORS 656.325(5)(b) applies
only if the injured worker is receiving temporary total
disability benefits at the time of termination.  ORS 656.325(5)
provides that "[t]he insurer or self-insured employer shall cease
[temporary total disability] payments and commence [temporary
partial disability] payments when the attending physician * * *
approves employment in a modified job that would have been
offered to the worker if the worker had remained employed."  ORS
656.325(5) unambiguously conditions both the obligation to stop
paying temporary total disability and the obligation to begin
paying temporary partial disability on the attending physician's
approval of employment in a modified job.  The text of the
statute does not support claimant's interpretation, because it
requires only that the termination of employment precede the
physician's approval of a modified job
Finally, claimant contends that ORS 656.325(5)(b)
requires the employer to have the written policy in place at the
time of termination, not merely at the time that the physician
approves the modified job.  We disagree.  The statute refers to a
hypothetical job, which would have been offered had the claimant
not been terminated.  Here, employer's policy was in effect both
at the time that the aggravation of the injury occurred and at
the time that the attending physician approved employment in a
modified job.  Under ORS 656.325(5)(b), the obligation to have a
return-to-work policy is satisfied if the employer has that
policy in place at the time the worker's attending physician
approves a modified job. 
Based on the foregoing, we conclude that employer
satisfied the requirements under ORS 656.325(5)(b) and was
authorized to cease paying temporary total disability benefits
and commence reduced temporary partial disability benefits
payments.
The decision of the Court of Appeals and the order of
the Workers' Compensation Board are affirmed.
1. ORS 656.273(1)(a) and (b) provides: 
"After the last award or arrangement of compensation, an injured worker is
entitled to additional compensation for worsened conditions resulting from the
original injury. A worsened condition resulting from the original injury is
established by medical evidence of an actual worsening of the compensable
condition supported by objective findings. However, if the major contributing
cause of the worsened condition is an injury not occurring within the course and
scope of employment, the worsening is not compensable. A worsened condition is
not established by either or both of the following:
"(a) The worker's absence from work for any given amount of time as a
result of the worker's condition from the original injury; or
"(b) Inpatient treatment of the worker at a hospital for the worker's
condition from the original injury."
2. An example of such a preamble can be found in ORS
656.325(5)(a), which provides, in part:
"Except as provided by ORS 656.268(4)(c) and (10),
an insurer * * * shall cease making payments pursuant
to ORS 656.210 and shall commence making payment of
such amounts as are due pursuant to ORS 565.212 when an
injured worker refuses wage earning employment prior to
claim determination * * *." 
3. In 1995, the legislature amended ORS 656.325(5), renumbering
that provision as ORS 656.325(5)(a) and adding two new
paragraphs.  In so doing, the legislature chose to incorporate
the text of former ORS 656.325(5) (1983) as the entirety of
subparagraph (5)(a).  Therefore, the legislature demonstrated an
intent to extend the circumstances in which an injured worker
becomes entitled to temporary partial disability as opposed to
temporary total disability to both paragraphs (5)(b) and (c).