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In re Hopper

Court of Appeals of Oregon

September 10, 2014

In the Matter of the Compensation of Naomi R. Hopper, Claimant. NAOMI R. HOPPER, Petitioner,
v.
SAIF CORPORATION and JESME, INC. - MD SANDERS, Respondents

Argued and Submitted June 6, 2014

Workers' Compensation Board 1200309.

Julene M. Quinn argued the cause for petitioner. With her on the briefs was Kryger Alexander Carlson PC.

Holly C. O'Dell argued the cause and filed the brief for respondents.

Before Duncan, Presiding Judge, and Wollheim, Judge, and Lagesen, Judge.

OPINION

Page 531

[265 Or.App. 466] LAGESEN, J.

SAIF Corporation (SAIF) denied claimant's claim for workers' compensation benefits for failure to cooperate with its investigation of her claim after claimant did not comply with SAIF's multiple requests that she complete an interview with its investigator. The Workers' Compensation Board (the board) upheld that denial under ORS 656.262(15), determining that claimant failed to prove that her failure to cooperate was " for reasons beyond [her] control." ORS 656.262(15). On review of the board's order under ORS 656.298, we affirm, concluding that the board's decision rests on a correct interpretation of ORS 656.262 and is supported by substantial evidence.

I. BACKGROUND

Claimant injured her lower back at work in September 2011 and filed a claim for workers' compensation for the injury. Shortly after claimant filed the claim, SAIF sent claimant a letter explaining the claims process and informing claimant of her obligation under ORS 656.262(14) to cooperate with that process. Around the same time, SAIF contacted claimant by phone to alert her that she would need to make a statement about her claim to a SAIF investigator. Claimant did not take any affirmative steps to contact SAIF's investigator.

A few weeks later, on October 17, SAIF sent a letter to claimant stating that she had an appointment for an interview on October 21. Claimant did not attend the interview or otherwise contact SAIF. On November 2, SAIF sent a letter to the Workers' Compensation Division (WCD) of the Department of Consumer and Business Services and requested that claimant's benefits be suspended based on her failure to participate in an interview. That letter was copied to claimant. Two days later, on November 4, WCD sent claimant a letter by certified mail stating that her benefits would be suspended within five working days unless she cooperated

Page 532

with SAIF or demonstrated to WCD that her failure to cooperate with SAIF was reasonable. A member of claimant's household signed for the letter upon delivery, but claimant did not follow up with either WCD or SAIF.

[265 Or.App. 467] Four days later, on November 8, SAIF sent claimant a letter stating that she had 30 days from the date of WCD's November 4 letter to cooperate with its interview request, or claimant's claim would be denied. On November 16, claimant's benefits ...


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