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In re Compensation of Hoffnagle

Court of Appeals of Oregon

April 19, 2017

In the Matter of the Compensation of William W. Hoffnagle, Claimant.
v.
William W. HOFFNAGLE, Respondent. SHEARER'S FOODS, Petitioner,

          Argued and Submitted February 9, 2016

         Workers' Compensation Board 1301384

          Jerald P. Keene argued the cause for petitioner. With him on the briefs was Oregon Workers' Compensation Institute, LLC.

          Julene M. Quinn argued the cause and fled the brief for respondent.

          Before Ortega, Presiding Judge, and Lagesen, Judge, and Garrett, Judge.

         Case summary: Employer seeks judicial review of an order of the Workers' Compensation Board that set aside employer's denial of claimant's conditions. The Board determined that, within a letter denying a new injury, the employer also accepted a new condition for an earlier injury. On review, employer contends that the Board's order is fawed because the letter at issue was solely a denial of a new injury, and not an acceptance of anything. Held: The Board did not err. Whether a condition was accepted is a question of fact that is reviewed deferentially under the "substantial evidence" standard, which includes substantial reason. Substantial evidence supports the Board's determination that the letter at issue served more than one function, operating as a denial of a new injury claim but an acceptance of a new condition associated with the original injury.

         Affirmed.

          GARRETT, J.

         The question in this case is whether the Workers' Compensation Board erred when it concluded that employer accepted a condition concerning an original injury in the context of a letter denying a new injury. Employer argues that the board's reasoning is flawed because the letter at issue was clearly, unambiguously, and exclusively a denial- not an acceptance of anything. We conclude that, under the circumstances, the board could reasonably disagree. Accordingly, we affirm.

         We take the facts from the board's September 3, 2014, order on reconsideration. Claimant slipped and fell at work on June 7, 2012. On August 1, 2012, employer accepted a claim for a left hip strain. Several weeks later, on September 10, claimant was working when he felt a pop and a sharp pain in his lower back. Claimant filed a claim for a new injury (lower back strain) as well as a "Form 827" reporting an aggravation of his June 2012 injury.

         In late September, claimant had a telephone conversation with employer's claims adjuster, who said that employer would be issuing a denial of the new injury but that it "would not matter" because claimant would receive benefits under his June 2012 injury. Employer sent a letter on October 1, 2012, that stated:

"You filed a claim for a lower back injury that occurred on 9/10/12 while you were employed with [employer]. After careful review of the information in our file, it does not appear that you sustained a new injury on that date. Rather, the current condition appears to relate to your prior injury that occurred 6112. Thus, we hereby issue a denial of the new injury. All benefits will be paid on your prior claim.'"

(Emphasis added.)

         The October 2012 letter also included the statement of hearing rights that is required for a denial under OAR 438-005-0055(1). It did not include the information required for notices of ...


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