Court Opinion

ID: 9786557
Source: CourtListenerOpinion
Date Created: 2023-08-30 23:57:54.780741+00
Date Added: 2024-06-11T07:36:46.404936
License: Public Domain

EDMONDS, J.,
dissenting.
The issue in this case is whether claimant is entitled to an attorney fee under ORS 656.386(1) when he was *524successful in overturning SAIF’s denial for his alleged noncooperation with the investigation of this claim while the claim was pending but before the claim has been finally determined to be compensable. The issue is one of statutory interpretation in which we seek to discern whether the legislature intended that attorney fees be awarded under those circumstances. We first examine the text and the context of the statute.
ORS 656.386(1) provides, in relevant part:
“(a) In all cases involving denied claims where a claimant finally prevails against the denial in an appeal to the Court of Appeals or petition for review to the Supreme Court, the court shall allow a reasonable attorney fee to the claimant’s attorney. In such cases involving denied claims where the claimant prevails finally in a hearing before an Administrative Law Judge or in a review by the Workers’ Compensation Board, then the Administrative Law Judge or board shall allow a reasonable attorney fee. In such cases involving denied claims where an attorney is instrumental in obtaining a rescission of the denial prior to a decision by the Administrative Law Judge, a reasonable attorney fee shall be allowed.
“(b) For purposes of this section, a ‘denied claim’ is:
“(A) A claim for compensation which an insurer or self-insured employer refuses to pay on the express ground that the injury or condition for which compensation is claimed is not compensable or otherwise does not give rise to an entitlement to any compensation.”
Based on the above language, the majority holds that a “denied claim” within the meaning of the statute includes denials because of noncooperation by claimants. The majority adopts the Workers’ Compensation Board’s reasoning that a noncooperation denial is a “denied claim” because such a denial “otherwise does not give rise to an entitlement to any compensation” within the meaning of ORS 656.386(1)(b)(A). 192 Or App at 513. The effect of the majority’s holding is that claimant is entitled to an attorney fee under the statute even though his claim has yet to be processed to determine its compensability and even though it may be eventually determined that his claim is not compensable or that the employer is not responsible for it.
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The words “denied claim” in ORS 656.386(1) are not ambiguous when read in context with the other words of the Workers’ Compensation Act. The key phrases in the statute are “[i]n such cases involving denied claims where the claimant finally prevails in a hearing,” “[a] claim for compensation which an insurer or self-insured employer refuses to pay on the express ground that the injury or condition for which compensation is claimed is not compensable,” and “[a] claim for compensation which an insured or self-insured employer refuses to pay on the express ground that the injury or condition for which compensation is claimed * * * otherwise does not give rise to an entitlement to any compensation.” Some of the words in those phrases are defined in ORS 656.005, some have ordinary meanings, and some have a meaning as defined by ORS 656.386(1).
The word “ ‘[c]laim’ means a written request for compensation from a subject worker or someone on the worker’s behalf, or any compensable injury of which a subject employer has notice or knowledge.” ORS 656.005(6). A “compensable injury” is an injury “arising out of and in the course of employment * * * subject to the following limitations. * * *” ORS 656.005(7)(a). The limitations on compensability include situations where the injury arguably occurs within the course and scope of employment but the claim is not compensable for other reasons. An example of when a work-related injury or condition is not compensable for another reason is when it is not the major contributing cause of a consequential condition, ORS 656.005(7)(a)(A), or when it is not the major contributing cause of a combined condition, ORS 656.005(7)(a)(B). See also ORS 656.005(7)(b) (describing circumstances in which an otherwise compensable claim is noncompensable). In addition to the above kinds of limitations on compensation, there are also statutory limitations on compensability and on the responsibility for a compensable injury, even when the initial injury or condition is compensable. For instance, under ORS 656.273, an injured worker is entitled to additional compensation for a worsened condition resulting from the initial compensable injury only if the major contributing cause of the worsened condition is the injury or condition that occurred within the course and scope of employment. Additionally, a worker may not be entitled to *526compensation from a particular employer even though the injury or condition is determined to be compensable. Those kinds of denials are based on a lack of responsibility for a compensable injury. See, e.g., ORS 656.307; ORS 656.308.
All of the above statutes provide context for discerning the legislature’s intent with regard to the language of ORS 656.386(1), the statute at issue in this case. In general, the statute authorizes the recovery of attorney fees after a worker has finally prevailed over the denial of a claim. The statute first tells us that, “[i]n such cases involving denied claims where the claimant finally prevails in a hearing before an Administrative Law Judge or in a review by the Workers Compensation Board,” the claimant shall be allowed a reasonable attorney fee. That phrase constitutes the grant of authority for the award of attorney fees under the statute. The word “claims” in the phrase refers to claims as defined by ORS 656.005(6). A “claim” therefore is a “written request for compensation from a subject worker.” The words “finally prevails in a hearing” when used with the word “claims” tell us that a claimant must prevail finally on a request for compensation. Prevailing temporarily in the processing of a claim where there is yet to be a decision on the merits regarding compensation does not satisfy the requirement of the statute. In fact, prevailing temporarily under such circumstances is the antithesis of prevailing “finally” on a request for compensation.
Also, the legislature chose to specifically define the words “denied claim” in the above phrase in ORS 656.386(1). The fact that the legislature chose to define those words with regard to the authority to grant attorney fees under the statute rather than to use them as they are ordinarily understood in the context of ORS 656.005(6) is of special significance. Because the word “claim” is statutorily defined and the word “denied,” which modifies it, has an ordinary meaning, the fact that the legislature undertook to define those words especially for ORS 656.386(1) suggests strongly that the legislature did not intend those words to be understood in their generic sense nor intend that the denial of a claim for any reason fall within the rubric of the statute. If the legislature had intended the words “denied claim” to have their ordinary meaning, it would not have been necessary to promulgate special definitions for the purposes of the statute.
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In giving the words “denied claim” in ORS 656.386(1) a specialized meaning for purposes of the statute, the legislature divided the universe of “denied claims” into two worlds.1 First, a “denied claim” is defined as a claim on which the claimant prevails finally after the employer or self-insured employer refuses to pay on the express ground that the injury or condition is not compensable. ORS 656.005(7)(a)(A) defines a “compensable injury” in terms of work relatedness; that is, an injury must arise out of and in the course of employment to be compensable. Here, claimant does not contend that SAIF’s noncooperation denial was based on a contention that his injury did not arise out of and in the course of his employment or that the denial was on the basis that the claim was not otherwise compensable.
The alternative definition of a “denied claim” for purposes of ORS 656.386(1) provides that a “denied claim” is a “claim for compensation which an insurer or self-insured employer refuses to pay on the express ground that the injury or condition for which compensation is claimed * * * otherwise does not give rise to an entitlement to any compensation.” The key words in the phrase are “otherwise,” “does not give rise to,” and “entitlement.” The word “otherwise” means “in a different way or manner.” Webster’s Third New Int’l Dictionary 1598 (unabridged ed 1993). The word operates in the sentence to differentiate the phrase that follows, “does not give rise to an entitlement to compensation,” from the previous phrase regarding denials that are based on the lack of compensability. The creation of a defined category of “denied claims” separate from the category of denials based on lack of compensation is further evidence of an intent by the legislature to define “denied claims” in a way that does not embrace denials of claims for all kinds of reasons. In other words, the structure of the statute tells us that the legislature has undertaken to divide “denied claims” into two categories: those kinds of denied claims that fall into either of the alternative definitions of the statute trigger an award of attorney fees, while those kinds of denials that fall into neither of the prescribed categories do not give rise to an award of attorney fees.
*528The focus of the second, alternative definition of a “denied claim” in the statute is on rulings that “give rise to an entitlement to compensation” rather than on compensability. ORS 656.386(1)(b)(A). The ordinary meaning of the words “give rise to” is to “bring about: PRODUCE, OCCASION.” Webster’s at 960. Similarly, the ordinary meaning of the word “entitlement” is “the condition of being entitled: RIGHT; specif: the right to benefits under the state employment-compensation laws or federal old-age and survivors insurance.” Id. at 758.
When the above words are read with the remainder of the language in the statute, they communicate the following thoughts. First, a claimant must prevail finally on a denied claim. Second, the words “denied claim” have a limited meaning for purposes of ORS 656.386(1), as distinguished from a generic meaning. Third, those limitations include those denials that are based on a lack of compensability and those denials that are based on a lack of entitlement to compensation. Fourth, to be entitled to attorney fees under the second, alternative definition of a “denied claim” in the statute, a claimant must prevail finally in a manner that brings about, produces or occasions an entitlement to compensation. In the context of the Workers’ Compensation Act, a clear example of prevailing finally over a denial that gives rise to an entitlement to compensation is when a denial of responsibility for a compensable injury is made under ORS 656.308 and is thereafter overcome by the claimant. In contrast, the overturning of a denial based on a lack of cooperation does not bring about an entitlement to compensation. Rather, it puts the claimant in the position of being able to litigate compensability and/or responsibility. A correct analysis based on the text and context of ORS 656.386(1) need go no further in this case. Claimant, who has yet to prevail on the merits of his claim has not finally prevailed over a denied claim in a way that gives rise to an entitlement to compensation.
The majority holds otherwise, but its position is not faithful to the language in the statute for a couple of reasons. First, the majority’s decision permits a claimant to prevail over a noncooperation denial, be awarded attorney fees as a result, and then lose on the issue of compensability. In effect, *529the majority must reason that when a claim for an allegedly compensable injury or condition sets in motion a sequence of interim procedural events that could lead to a determination of compensability or an entitlement to compensation, and when the claimant “finally prevails” regarding one of those interim events, then the claimant has prevailed finally within the meaning of the statute. But that interpretation does not give effect to the import of the words in the statute that the claimant must finally prevail on a request for compensation. Such a claimant has only temporarily prevailed in an interim proceeding during the pendency of the adjudication of the request for compensation. Second, the majority, in order for its interpretation to be correct, must construe the phrase “give rise to an entitlement to any compensation” as meaning that a claimant is entitled to attorney fees when he or she finally prevails in a hearing that precedes the determination of an entitlement to compensability. But, again, that interpretation is at odds with the ordinary meaning of the phrase, which requires a ruling that brings about or produces the final right to an “entitlement” to compensation.
There should be no doubt about the meaning of ORS 686.386(1) when the statutorily defined language in the statute is read with its words that have ordinary meaning. But if such doubt exists, the Supreme Court has previously interpreted the statute contrary to the majority’s construction. When the Supreme Court interprets a statute, that interpretation becomes a part of the statute as if it were written into the law at the time of its enactment. Holcomb v. Sunderland, 321 Or 99, 105, 894 P2d 457 (1995). It follows that, unless a statute so interpreted is subsequently amended to change the meaning of the statute, the Supreme Court’s interpretation remains viable and controlling.
In Greenslitt v. City of Lake Oswego, 305 Or 530, 533-34, 754 P2d 570 (1988), the Supreme Court considered an earlier version of ORS 686.386(1). In that case, SAIF initially denied the claimant’s claim. At a hearing on SAIF’s denial, the referee held that the claimant’s claim was compensable, remanded the claim to SAIF for acceptance, and awarded the claimant attorney fees. SAIF timely requested that the board review the referee’s order. The board reduced the award of attorney fees and otherwise affirmed the referee’s order. The *530Supreme Court, in considering the claimant’s assertion that the board lacked authority to reduce the attorney fee award, reviewed the requirements of ORS 656.386(1):
“(1) the claimant must initiate the hearing process by requesting review from an order or decision denying the claim; (2) the claimant must prevail finally on the issue of compensation * * *; and (3) the decision of the referee, board or court in which the claimant prevails finally must be from an earlier decision or order denying, rather than allowing, the claim for compensation.”
Greenslitt, 305 Or at 533-34 (citing Shoulders v. SAIF, 300 Or 606, 611-12, 716 P2d 751 (1986)) (emphasis in Greenslitt). The court, clarifying the meaning of the second requirement, held that “[a] claimant ‘prevails finally5 before a forum if that forum holds in the claimant’s favor on the issue of the claimant’s right to workers’ compensation and that determination is not appealed within the time allowed by statute.” Greenslitt, 305 Or at 534. The court concluded that, because SAIF timely appealed the referee’s ruling, the claimant had not yet finally prevailed, and the board therefore had authority to reduce the attorney fee award. In other words, the Greenslitt court interpreted the “finally prevail! ]” language in ORS 656.386(1) to require that the claimant prevail on “the merits of his workers’ compensation claim, leaving only attorney fees in dispute.” Id. That interpretation continues to be in effect under the language of the present statute unless the legislature subsequently changed the statute to have a different meaning. Under the holding in Greenslitt, claimant in this case has not “finally prevailfed]” on the merits of his claim.
The majority argues, however, that Greenslitt is no longer controlling authority because the legislature amended ORS 656.386(1) in 1995.2 According to the majority, when the legislature undertook to define the words “denied claim” in the statute in 1995, that definition resulted in the Greenslitt court’s holding being no longer applicable. But that assertion *531is not supported by the structure or the import of the changes to the statute that were made in 1995.3
The 1995 amendments to ORS 656.386(1) were part of a major revision of the Workers’ Compensation Act. Before referring to the specific revisions regarding ORS 656.386(1), it is informative to consider the structure of the amendments as a whole. For instance, the 1995 amendments also amended ORS 656.005(7)(a)(B). That amendment provided as follows:
“(B) If [a] an otherwise compensable injury combines at any time with a preexisting [disease or] condition to cause or prolong disability or a need for treatment, the [resultant] combined condition is compensable only if, so long as and to the extent that the otherwise compensable injury is [and remains] the major contributing cause of the disability of the combined condition or the major contributing cause of the need for treatment of the combined condition.”
Or Laws 1995, ch 332, § 1 (deletions in italics, new language in boldface). The use of the word “otherwise” in the amendments to ORS 656.005(7)(a)(B) is illustrative of how the legislature used the word “otherwise” in chapter 332 to create the structure of when an employer is responsible and when an employer is not responsible for a work-related injury or condition. ORS 656.005(7)(a)(B) is an example of that kind of *532structure. An employer is responsible for a combined work-related and preexisting condition only when the work-related injury or condition is the major contributing cause of the combined condition. Otherwise, an employer has no liability under such circumstances for what was initially a work-related injury or condition.
By undertaking to define specifically what constitutes a “denied claim” for purposes of ORS 656.386(1) in the 1995 amendments, it appears that the legislature followed a structure similar to the one it used by regarding employer liability for work-related injuries. The legislature divided work-related claims into classes of compensable and noncompensable claims for purposes of employer liability; it also divided “denied claims” for purposes of ORS 656.386(1) into classes of denied claims for which attorney fees may or may not be awarded. Employer liability for a “compensable” claim depends on the claimant finally prevailing on the issue of compensability and/or responsibility in a series of administrative and judicial review steps. Similarly, employer liability for attorney fees depends on the claimant, at the completion of the available procedural steps, finally prevailing over a denied claim (as defined). In other words, the common predicate for employer liability for compensable claims and for an award of attorney fees against an employer is the same throughout the amendments: the claimant must finally prevail. In light of the structure of the act as a whole, it makes sense that the legislature would not have intended for a claimant to recover attorney fees until the claimant had prevailed on the issue of the liability of the employer. To interpret the amendment in Oregon Laws 1995, chapter 332, section 43 to have changed the rule of Greenslitt and to have enlarged the entitlement to attorney fees to circumstances where the claimant has not finally prevailed on the issue of compensation is to ignore the structure of the 1995 amendments to the Workers’ Compensation Act as a whole.
There is, however, another, less subtle reason why the majority’s reliance on the 1995 amendments as an implicit repeal of the holding of the Greenslitt court is wrong. No language in the 1995 amendments to the statute changed the court’s interpretation; rather, the legislature left intact the language in the statute that prompted the Greenslitt *533court to conclude that a claimant must “finally prevail” on the merits of the claim before attorney fees could be awarded. Rather than deleting those words, the bill deleted the phrase, “[i]n all cases involving accidental injuries,” and substituted in its place, the phrase, “[i]n all cases involving denied claims.” Or Laws 1995, ch 332, § 43.4 Under the prior statute, the recovery of attorney fees was authorized in “all cases involving accidental injuries where a claimant finally prevails * * * from an order or decision denying the claim for compensation.” The phrase “from an order or decision denying the claim for compensation” in the prior statute operated to identify the nature of the legal action over which the claimant was required to prevail before attorney fees could be recovered. By adding to the statute the words “denied claims” and deleting the words “from an order or decision denying the claim for compensation” from the statute, the legislature continued to express its intention about the nature of the legal action that could trigger an award of attorney fees. Had the legislature done nothing more at that point, the argument that the legislature intended to change the statute as interpreted by the Greenslitt court would be more tenable, because the statute, as amended, could have applied to all denials. It could follow then that a decision on the merits of the claim was not a prerequisite to an award of attorney fees. But the legislature chose additionally to define the words “denied claims” in terms of compensability and entitlement to compensation. By narrowing the definition of a “denied claim” to rulings that determined the merits of a claim (compensability or entitlement to compensation), the legislature necessarily reiterated, in its own words, the interpretation previously given to the statute by the Greenslitt court. The majority fails to adequately explain why the legislature would have left the words “prevails finally” in the statute if it had actually intended to change the meaning of the statute as interpreted by the Greenslitt court.
The version of ORS 656.386(1) applicable to this case tracks the above language added in 1995. Under the current version of the statute, a claimant must “finally prevail [ ]” *534over the denial of the claimant’s request for compensation. To trigger liability for attorney fees, the overturned denial must have been on the basis that the claim was not compensable or on the basis that claimant was not otherwise entitled to compensation. Whether the statute is interpreted on its face or whether the Greenslitt court’s interpretation is followed, the result is the same. A denial based on lack of cooperation with an investigation is not the kind of denial that brings about a decision on the merits of the claim. Claimant is not entitled to attorney fees unless he finally prevails on the merits.5
For those reasons, I dissent.
Linder and Schuman, JJ., join in this dissent.

 In that sense, ORS 656.386(1) tracks the conceptual framework found elsewhere in the Workers’ Compensation Act where compensability and responsibility for otherwise compensable injuries are treated separately.

 A survey of the overall trend of Oregon Laws 1995, chapter 332 creates doubt that the legislature intended to expand the scope of the existing law regarding the entitlement of claimants to attorney fees merely because a claimant prevailed in an interim proceeding. If anything, the legislature appeared to be aiming in the opposite direction.

 The changes made by the 1995 amendment to ORS 656.386 appear as follows. Although the majority correctly notes that the legislature amended the statute by wholesale deletion and addition in 1995, the statute did not change as much as the majority suggests. Words present in both statutes are noted in plain text. Words present in the earlier version but not the current version of the statute are noted in italics. Additions to the statute made in 1995 are noted in boldface.
“In all cases involving [accidental injuries] denied claims where a claimant finally prevails against the denial in an appeal to the Court of Appeals or petition for review to the Supreme Court [from an order or decision denying the claim for compensation], the court shall allow a reasonable attorney fee to the claimant’s attorney. * * * For purposes of this section a ‘denied claim’ is a claim for compensation which an insurer or self-insured employer refuses to pay on the express ground that the injury or condition for which compensation is claimed is not compensable or otherwise does not give rise to an entitled to any compensation. A denied claim shall not be presumed or implied from an insurer’s or self-insured employer’s failure to pay compensation for a previously accepted injury or condition in timely fashion.”
Or Laws 1995, ch 332, § 43.

 My research of the legislative history of the 1995 amendments does not reveal any discussion by the legislature that would suggest an intent to legislatively overrule the holding in Greenslitt.

 The majority says that, when a compensable injury combines with a preexisting condition but is not the major contributing cause of the combined condition, the combined condition is not compensable. 192 Or App at 514 n 5.1 agree. But that observation, correct as it is, begs the question before us. The issue is whether the legislature intended a claimant to recover attorney fees before finally prevailing on the issue of compensability or on an issue that gives rise to an entitlement to compensation. If the majority means to say that the denial of a combined or consequential condition is the kind of denial that qualifies for the first category of “denied claims,” rather than for the second category of denied claims, as defined by ORS 656.386(1), then, for the sake of argument, I agree. It could be that the legislature intended the first classification of denials in the statute to include denials based on the lack of work-relatedness as well as on limitations on compensability and the second class of denials to be based only on the lack of responsibility. I have found no legislative history that resolves that issue, but it makes no difference to the correct interpretation of the legislature’s intent regarding the issue in this case. A denial based on lack of cooperation cannot logically fall into either classification of a “denied claim” for purposes of ORS 656.386(1) because a claimant does not finally prevail on the issue of compensability or on an issue giving rise to an entitlement to compensation when he or she overcomes a denial based on lack of cooperation.