Opinion

Fleming v. SAIF

  • 302 Or. App. 543
  • 461 P.3d 261
Court
Court of Appeals of Oregon
Filed
Mar 4, 2020
Status
Published
On the bench
Lagesen
Cited by
2 cases
Authority
More cited than 46.5%

disagreeing with the dissent- ing opinion’s view on that point

How later courts described this case

  • disagreeing with the dissent- ing opinion’s view on that point

Written by the judges who cited it.

The opinion

543

Argued and submitted April 5, 2019, reversed and remanded March 4, 2020

In the Matter of the Compensation of

Lloyd R. Fleming, Claimant.

Lloyd R. FLEMING,

Petitioner,

v.

SAIF CORPORATION

and Treske Precision Machining,

Respondents.

Workers’ Compensation Board

1504074; A165693

461 P3d 261

Claimant seeks judicial review of an order of the Workers’ Compensation

Board affirming respondent SAIF’s denial of claimant’s occupational dis-

ease claim for a right shoulder condition. The board concluded that claimant’s

prior disputed claim settlement (DCS) under ORS 656.289(4) with his previous

employer, in which he stipulated that his shoulder condition was not compensably

related to his work for that employer, precluded him from contending, against

the employer in this case, that that employment contributed to his claimed occu-

pational disease. Claimant argues that his DCS with a previous employer does

not preclude him from asserting, in the context of a claim against his subse-

quent employer, that that employment contributed to his claimed occupational

disease. Held: ORS 656.289(4) does not state or imply that a DCS with a previous

employer, as a matter of law, precludes a claimant from litigating the role that

previous employment may have played in determining the compensability of a

subsequent claim against an employer not bound by a DCS with that claimant.

The board erred in concluding otherwise.

Reversed and remanded.

Julene M. Quinn argued the cause and filed the briefs for

petitioner.

Julie Masters argued the cause and filed the brief for

respondents.

Before Lagesen, Presiding Judge, and DeVore, Judge, and

James, Judge.

LAGESEN, P. J.

Reversed and remanded.

DeVore, J., dissenting.

544 Fleming v. SAIF

LAGESEN, P. J.

Claimant seeks judicial review of an order of the

Workers’ Compensation Board. In that order, the board

affirmed respondent SAIF’s denial of his occupational dis-

ease claim for a right shoulder condition. The board con-

cluded, applying Gilkey v. SAIF, 113 Or App 314, 832 P2d

1252, rev den, 314 Or 573 (1992), that claimant’s prior dis-

puted claim settlement (DCS) under ORS 656.289(4) with

his previous employer, in which he stipulated that his shoul-

der condition was not compensably related to his work for

that employer, precluded him from contending, in this pro-

ceeding involving an occupational disease claim against a

different employer, that that employment contributed to his

claimed occupational disease. On review, claimant argues

that the board’s interpretation of Gilkey is incorrect and

that the board erred when it concluded that claimant’s DCS

with respect to the claim against his prior employer pre-

cluded him from asserting, in this proceeding, that his pre-

vious work contributed to his claimed occupational disease

in his right shoulder. We agree with claimant and, there-

fore, reverse and remand to the board.

The dispositive facts in this case are not in dispute.

Claimant worked as a saw fitter for Simonds International

from 2010 to 2013. His primary responsibilities included

grinding large band saws and rolling out welds, all of which

put considerable pressure on his arms. In 2012, claimant

began experiencing significant pain whenever he would

raise or lower his right arm. He visited his doctor, who diag-

nosed him with a full thickness partial tear of his right

rotator cuff. Claimant filed for workers’ compensation and

Simonds’s insurer, Liberty Northwest Insurance Company,

accepted the claim. Claimant underwent several weeks

of treatment during which the condition improved signifi-

cantly. In February 2013, claimant was released back to

regular full duty with no permanent limitations.

In November 2013, claimant left his job with

Simonds to work for Treske Precision Machining. He worked

at this job without difficulty until July 2014, when the pain

in his shoulder returned. Claimant returned to see his doc-

tor again, who discovered that his condition had worsened to

Cite as 302 Or App 543 (2020) 545

a full thickness rotator cuff tear. Claimant requested that

Liberty, as Simonds’s insurer, accept the full thickness tear

as a worsening of the rotator cuff tear accepted by Liberty

in 2012. In evaluating claimant’s request, Liberty scheduled

an insurer-arranged medical examination (IME) of claim-

ant. After examining claimant, the IME doctor concluded

that claimant’s current rotator cuff tear was the result of a

condition that was preexisting at the time of his 2012 rota-

tor cuff injury. For that reason, Liberty denied claimant’s

claim for a worsening of the 2012 condition.

Claimant nonetheless underwent surgery to repair

his rotator cuff and sought review of Liberty’s denial.

However, before a hearing was held in claimant’s case,

claimant and Simonds, acting through Liberty, agreed to

settle the case by DCS under the authority of ORS 656.289.

The DCS recited the competing contentions of claimant

and Liberty regarding claimant’s rotator cuff tear that

“[e]ach party has substantial evidence to support its factual

allegations,” that there was a “bona fide dispute between

the claimant and [Liberty],” and that “[t]he parties have

agreed to compromise and settle the denied claim under

the provisions of ORS 656.289(4).” Under the terms of the

DCS, claimant received $25,000 in exchange for allowing

Liberty’s denial of his worsening claim to remain in force.

The DCS also provided that claimant agrees that the “legal

effect” of the settlement would be “the same as if the claim-

ant admitted and agreed to the accuracy of the contentions

of [Liberty]” recited in the agreement.

Shortly after entering into the DCS, claimant ini-

tiated the occupational disease claim at issue in this case

against his current employer, Treske, insured by SAIF.

Claimant asserted that, although working conditions at

Treske were not the major contributing cause of his injury,

Treske was still liable for his current rotator cuff condition

by virtue of the “last injurious exposure rule” (LIER), appli-

cable to occupational disease claims under Inkley v. Forest

Fiber Products Co., 288 Or 337, 605 P2d 1175 (1980). As had

Liberty, SAIF scheduled an IME of claimant. Just as before,

the examining doctor concluded that claimant’s work condi-

tions were not the major cause of his full thickness rotator

cuff tear. As a result, SAIF too denied claimant’s claim.

546 Fleming v. SAIF

Claimant requested a hearing before an adminis-

trative law judge (ALJ), who upheld SAIF’s denial of the

claim. The ALJ held that, under Gilkey, 113 Or App 314,

claimant’s DCS with Liberty as a matter of law operated

to preclude him from contending that his employment with

Simonds was a cause of his current rotator cuff condition.

That, according to the ALJ, meant that claimant’s right

shoulder condition had to be treated as a preexisting con-

dition for purposes of his claim and that claimant had to

“prove that his work at Treske was the major contributing

cause of the combined condition and pathological worsening

of his right shoulder condition.” Because the medical evi-

dence submitted by claimant did not address that point at

all, the ALJ concluded that claimant had not met his burden

of proof and affirmed SAIF’s denial.

Claimant sought review by the Worker’s Compensa-

tion Board, which adopted and affirmed the ALJ’s order. On

review before the board, claimant argued that the DCS that

he entered into to resolve his prior claim against Simonds

did not preclude him from asserting, in the context of the

instant claim, that his employment at Simonds contributed

to his claimed occupational disease. Gilkey, he argued, is

distinguishable because, in that case, the claimant’s prior

DCS and subsequent claim involved the same employer.

Here, claimant’s prior DCS involved a different employer

from the one he now asserts a subsequent claim against.

Instead, claimant asserted that Ahlberg v. SAIF, 199 Or

App 271, 111 P3d 778 (2005), controls. Ahlberg provides that,

under the LIER, a worker’s compensation claimant can rely

on “any and all working conditions” to establish compensa-

bility of his current injury. Id. at 276 (emphasis in original).

SAIF, Treske’s insurer on the claim, argued in response that

the ALJ correctly decided that Gilkey controls.

The board ultimately adopted the ALJ’s opinion

and order, employing largely the same reasoning. The board

rejected claimant’s attempt to distinguish Gilkey, explain-

ing that, in its view, Gilkey did not turn on the fact that

the prior DCS and subsequent claim both involved the same

employer. Instead, the board understood Gilkey to turn on

the express wording of the DCS at issue. The board explained

Cite as 302 Or App 543 (2020) 547

that here, just as in Gilkey, claimant “expressly stipulated

and agreed that his then-current right shoulder conditions

(which included the current claimed conditions) were not

related or attributable to his employment exposure (includ-

ing his work injury and work activities) with Simonds and

were due, instead, to nonwork-related causes or subsequent

injuries or work activities.” (Emphasis in original.) Those

stipulations, even though they were included in a settlement

agreement to which Treske was not a party, were stipu-

lations that bound claimant on his claim against Treske.

Claimant sought judicial review of the board’s decision.

The legal effect of a DCS under ORS 656.289(4) on

a subsequent claim against a different employer presents a

question of law, so we review for legal error. ORS 183.482(8).

As an initial matter, the board erred when it con-

cluded that Gilkey stands for the proposition that a DCS

under ORS 656.289(4) binds a claimant in the context of a

different claim against a different employer. That is because

that issue was not presented in Gilkey. At issue in Gilkey

was the legal effect of a DCS in the context of the claimant’s

subsequent claim against the same employer and the same

insurer. We were not asked to address, and did not address,

the extent to which a nonparty to a DCS might rely on it

to resolve factual issues in the context of a subsequent pro-

ceeding. To answer that question, we must interpret ORS

656.289(4) by examining its text in context. See State v.

Couch, 341 Or 610, 617, 147 P3d 322 (2006).

ORS 656.289(4) provides:

“(a) Notwithstanding ORS 656.236, in any case where

there is a bona fide dispute over compensability of a claim,

the parties may, with the approval of an Administrative

Law Judge, the board or the court, by agreement make

such disposition of the claim as is considered reasonable.

“(b) Insurers or self-insured employers who are parties

to an approved disputed claim settlement under this sub-

section shall not be joined as parties in subsequent pro-

ceedings under this chapter to determine responsibility for

payment for claim conditions for which settlement has been

made.

548 Fleming v. SAIF

“(c) Notwithstanding ORS 656.005(21), as used in

this subsection, ‘party’ does not include a noncomplying

employer, except where a noncomplying employer has sub-

mitted a disputed claim settlement with a claimant for

approval before the claim has been referred to an assigned

claims agent by the director. Upon approval of the disputed

claim settlement, the Administrative Law Judge, the board

or the court shall mail to the director a copy of the disputed

claim settlement.”

The text of paragraph (b) speaks directly to the legal

effect of a DCS in a subsequent proceeding addressing a con-

dition addressed by the settlement. That effect, the statute

explains, is that insurers or self-insured employers “who are

parties” to a DCS “shall not be joined as parties in subse-

quent proceedings under this chapter to determine respon-

sibility for payment for claim conditions for which settlement

has been made.” That text clarifies that the legal effect of a

DCS is to resolve an insurer’s or employer’s responsibility

to the claimant for payment with respect to a claim condi-

tion that has been settled; once an insurer or self-insured

employer has entered into a DCS, it can no longer be made

to participate in any subsequent proceeding about the con-

dition or conditions resolved by the DCS, and can no longer

be made to pay for the condition or conditions. The text of

the statute, notably, does not state or imply that the effect of

a DCS goes beyond that to resolve as a factual matter for the

purposes of a subsequent proceeding what role employment

with the relevant insured or self-insured employers might

have played in the claimed condition. Indeed, the statutory

text’s explicit contemplation of the possibility of subsequent

proceedings in which the settling self-insured employer or

insurer’s responsibility would otherwise be at issue tends to

suggest that the legislature anticipated that a DCS would

not conclusively resolve factual issues for the purposes of

such proceedings. Had the legislature intended for the legal

effect of a DCS in subsequent proceedings to go beyond what

it expressly stated in ORS 656.289(4)(b), we think that it

would have said so expressly.1

1

We have reviewed the legislative history of ORS 656.289. The legislature

did not address explicitly the issue presented by this case, but we see no indi-

cation that the legislature intended that a DCS would be legally binding on a

claimant in subsequent proceedings involving nonparties to the DCS.

Cite as 302 Or App 543 (2020) 549

The dissenting opinion reaches a contrary conclu-

sion, but its analysis rests on several manifest fault lines.

First, the opinion strays from the basis of the board’s order,

the arguments presented to us, and, perhaps most saliently,

our case law. In Gilkey, we held squarely that a DCS does

not give rise to claim preclusion or issue preclusion. Gilkey,

113 Or App at 317. Contrary to the dissenting opinion’s sug-

gestion, that holding in Gilkey was not dictum. The board

in Gilkey had relied on principles of preclusion, and we

were explaining that the board erred in doing so, though

we ultimately concluded that we could affirm on an alterna-

tive basis identified by the board. Id. And, in this case, the

board did not purport to apply preclusion principles, neither

party disputes the nature of Gilkey’s holding, and neither

party asks us to overrule that preclusion holding. Second,

the opinion relies on a conclusory and questionable reading

of ORS 656.289(4) to the extent that it suggests that the

board’s fairness review of a DCS effectively converts the DCS

into an order of the board; it is far from a foregone conclu-

sion that fairness review converts a private settlement into

a board order. Third, the dissenting opinion draws authority

from treatise passages that do not, on their face, bear much

resemblance to Oregon’s statutory workers’ compensation

scheme and, therefore, do not provide insight into the pol-

icy choices made by the Oregon legislature in enacting that

scheme. For these reasons, the opinion ultimately does not

answer the core question presented by this case: Did the leg-

islature intend for a DCS entered into under ORS 656.289

to be binding in a subsequent proceeding between a party to

the agreement and a nonparty?

For those reasons, the board erred when it con-

cluded that claimant’s DCS, as a matter of law, precluded

him from litigating the role his employment with Simonds

may have played in the shoulder condition on which his

occupational disease claim against Treske is founded.2 We

therefore reverse and remand.

Reversed and remanded.

2

The parties have not addressed the extent to which stipulations in a DCS

may be entered into evidence in a subsequent proceeding against a nonparty to

the DCS, and we express no opinion on the issue.

550 Fleming v. SAIF

DeVORE, J., dissenting.

This workers’ compensation case presents an open

question whether the stipulated facts in a disputed claim

settlement (DCS), approved by the Workers’ Compensation

Board in a prior claim, should be recognized as prior deter-

minations of the board when claimant disclaims those stip-

ulated facts in a new claim against his next employer. The

question can be posed, contemplating two very different pos-

sibilities. When claimant makes a claim against the subse-

quent employer based on the same medical history, should

the board regard the prior DCS stipulations to be irrelevant

to the subsequent claim, akin to terms of a private settle-

ment with a third party? Or, are those stipulations to be

regarded as public determinations of ultimate fact that were

approved by the board so as to be binding on claimant in

both the prior, settled claim and the current, subsequent

claim?

The majority decides that the board erred by regard-

ing claimant’s stipulations in the prior DCS as binding on

claimant in this subsequent claim. Looking at the same

statutes and case law, I am not persuaded that the board

erred. Looking at the context of the workers’ compensation

system, I suspect that the answer should be that, because

the stipulations are the bases for the board’s approval of a

DCS with the prior employer done within the context of the

workers’ compensation system, they are determinations of

the board as to those stipulated facts for purposes of claim-

ant’s claims against the both settled and subsequent employ-

ers. Regardless which answer prevails today, the question

presented deserves more attention even if only from the

exploration of the question in this opinion. The question may

deserve attention from the practicing bar or a supervising

legislature.

FACTS

From 2010 through part of 2013, claimant worked

for his prior employer, Simonds International Corporation

(Simonds). In July 2012, he had a nondisabling shoulder

strain, which was accepted by Liberty, Simonds’s insurer. In

February 2013, claimant was released with no permanent

limitations.

Cite as 302 Or App 543 (2020) 551

In November, 2013, claimant began working with

Treske Precision Machining, Inc. (Treske). In July 2014, he

experienced right shoulder symptoms.

In January 2015, he filed a claim against former

employer Simonds and Liberty for a new medical condition

or an aggravation of his July 2012 injury. In March 2015,

Liberty issued a partial denial. Claimant sought review

and, in the meantime, underwent surgery for his rotator

cuff condition.

In June 2015, claimant, Simonds, and Liberty

entered into a disputed claim settlement. As required by

rule, the DCS recounted the conflicting contentions of the

parties. See OAR 438-009-0010 (quoted later). Among the

contentions, claimant had asserted that the current condi-

tions were compensable conditions arising out of the July

2012 work activities. In reply, Liberty had asserted that the

previously accepted right shoulder strain had been resolved

without the need for further medical treatment and was

no longer the material contributing cause of disability or a

need for treatment. After detailing the current conditions,

Liberty made further allegations that would become the

basis of the parties’ stipulations to resolve the claim. Liberty

alleged that

“claimant’s current conditions * * * are not, in any way or

degree of contribution, the result or consequence of claim-

ant’s on the job injury of July 20, 2012, nor materially

related to his work activities with Simonds International

Corp. The conditions * * * are due to non-compensable, pre-

existing conditions, and / or due to a new injury or subse-

quent work activities neither caused nor worsened by claim-

ant’s on the job injury of July 20, 2012. * * * [T]he denied

conditions * * * are not medically or legally attributable to

the claimant’s employment with Simonds International

Corp. under Oregon’s compensability standards.”

(Emphasis added.) The terms of the DCS specified that

“[t]he claimant understands and stipulates that the

denial entered in this case shall be construed to include the

contentions of First Liberty Insurance Corporation as set

forth above, and that the denial issued, including the con-

tentions of First Liberty Insurance Corporation as set forth

552 Fleming v. SAIF

above, shall forever remain in full force and effect, and that

the execution of this document shall constitute a full and

final waiver of the claimant’s right to challenge or appeal

from the denial, and the claimant stipulates and agrees that

the legal effect of this settlement shall be the same as if the

claimant admitted and agreed to the accuracy of the con-

tentions of First Liberty Insurance Corporation as set forth

above.”1

(Emphasis added.) Administrative rule did not require that,

in order to achieve settlement, claimant must admit or stip-

ulate to Simonds’s statement of the ultimate facts. See ORS

656.289(2) (DCS with board approval); OAR 438-009-0010

(required terms of a DCS).2

In exchange for his agreement to the terms of the

DCS, Liberty agreed to pay his medical bills to date, plus

$25,000.3 The parties agreed that the amounts paid were

accepted “in full settlement of all issues raised or which

could have been raised on or before the date of this agree-

ment.” The DCS explained that,

1

The document provided that claimant retained all rights he may have

for medical services under ORS 656.245, aggravation under ORS 656.273, own

motion proceedings under ORS 656.278, and vocational assistance under ORS

656.340, but the document did not provide that claimant retained rights involv-

ing a later claim for occupational disease under ORS 656.802.

2

In relevant part, OAR 438-009-0010 requires:

“(2) A disputed claim settlement shall recite, at a minimum:

“(a) The date and nature of the claim;

“(b) That the claim has been denied and the date of the denial;

“(c) That a bona fide dispute as to the compensability of all or part of

the claim exists and that the parties have agreed to compromise and settle

all or part of the denied and disputed claim under the provisions of ORS

656.289(4);

“(d) The factual allegations and legal positions in support of the claim;

“(e) The factual allegations and legal positions in support of the denial of

the claim;

“(f) That each of the parties has substantial evidence to support the fac-

tual allegations of that party;

“(g) A list of medical service providers who shall receive reimbursement

in accordance with ORS 656.313(4), including the specific amount each pro-

vider shall be reimbursed, * * *; and

“(h) The terms of the settlement, including the specific date on which

those terms were agreed.”

3

He agreed that those payments were “compensation for the consequences of

impairment which claimant anticipates will affect him for the rest of his life.”

Cite as 302 Or App 543 (2020) 553

“[f]or purposes of this agreement ‘issues raised or which

could have been raised’ includes any and all claims for new

medical conditions arising out of the claimed condition and

identified or diagnosed in the medical record to date.”

The DCS provided that

“[c]laimant agrees that by signing this Disputed Claims

Settlement agreement, claimant waives his right to file a

claim for any other condition associated with or arising out

of his denied claim, or to file a claim for civil remedies aris-

ing out of the denied claim under ORS 656.019.”

(Emphasis added.) Finally, the DCS provided that it was

not binding unless, and until, it was approved by an admin-

istrative law judge (ALJ) or the board. In July 2015, the

DCS was approved by the board.

The day after claimant signed the DCS, he filed the

present claim for his shoulder condition against Treske, his

subsequent employer, and SAIF, its insurer based upon the

same medical records. He now contended that this shoul-

der condition was the result of an occupational disease and

that his work exposure with both employers—Simonds and

Treske—should be considered. By taking that approach, he

sought to avoid needing to prove that working conditions

at Treske were the major contributing cause of his injury;

instead, he would only need to prove that Treske’s work was

the “last injurious exposure,” making Treske fully liable for

his shoulder condition. See Inkley v. Forest Fiber Products

Co., 288 Or 337, 342-43, 605 P2d 1175 (1980) (last injurious

exposure rule).

SAIF denied the claim. An ALJ upheld the denial,

treating the DCS as determining that work with Simonds

made no contribution to the conditions, pursuant to our

decision in Gilkey v. SAIF, 113 Or App 314, 832 P2d 1252,

rev den, 314 Or 573 (1992). With work for only one, not two

employers at issue, the ALJ concluded that claimant’s proof

did not establish that work with Treske was the major con-

tributing cause of a combined condition or worsening of

the diseased under ORS 656.802(2). On review, the board

agreed, emphasized the particular terms of the DCS in this

case, and affirmed the ALJ’s conclusion.

554 Fleming v. SAIF

MAJORITY OPINION

The majority opinion concludes that the board erred

in relying on Gilkey. The majority recognizes that Gilkey

involved a claim that followed a DCS, but the majority

observes that the case involved a subsequent claim against

the same employer and not a case with a claim against a sub-

sequent employer. For that reason, the majority determines

that Gilkey provides no answer. To the majority, Gilkey begs

the question. As a result, the majority turns to the autho-

rizing statute that describes a DCS. ORS 656.289(4)(a)

provides:

“Notwithstanding ORS 656.236, in any case where

there is a bona fide dispute over compensability of a claim,

the parties may, with the approval of an Administrative

Law Judge, the board or the court, by agreement make

such disposition of the claim as is considered reasonable.”

In the next paragraph of the statute, the majority finds an

answer implied on the basis that nothing more is written in

that paragraph. ORS 656.289(4)(b) provides:

“Insurers or self-insured employers who are parties to

an approved disputed claim settlement under this subsec-

tion shall not be joined as parties in subsequent proceed-

ings under this chapter to determine responsibility for pay-

ment for claim conditions for which settlement has been

made.”

The majority appropriately observes that ORS 656.289(4)(b)

provides that insurers or self-insured employers cannot be

sued again after settlement. Without more said in text, the

majority infers that, because the provision says nothing

about the effect of a DCS on a subsequent claim against

another employer, the provision necessarily implies that the

legislature “anticipated that a DCS would not conclusively

resolve factual issues for the purposes of such proceedings.”

302 Or App at 548. Essentially, the majority infers that a

DCS has no further significance for a claimant, despite the

fact that the subsequent claim includes the same record. In a

footnote, the majority candidly reports that its review found

nothing in legislative history to shed light on the intent of

the provision as concerns related claims against subsequent

employers.

Cite as 302 Or App 543 (2020) 555

In my opinion, it is ORS 656.289(4) that provides

no answer. It begs the question. The provision merely says

that, after insurers or self-insured employers have been par-

ties to a DCS, they “shall not be joined as parties in subse-

quent proceedings.” Essentially, the provision says that “a

settlement is a settlement” and says nothing more. Given

those terms, the provision implies nothing about the present

question. Yet, the majority infers that, because the legisla-

ture said that much, the legislature somehow “anticipated”

that a DCS should have no other effect. I believe that such

an inference of legislative intention is, not only unsupported

by legislative records, it is not implicit in textual silence. As

to silence in a statute, we know that our first rule of con-

struction is not to insert what has not been written. ORS

174.010.4

If legislative history does show something, it is that

ORS 656.289(4)(b) was intended to provide that “a settle-

ment is a settlement.” That itself is significant because it

says nothing more. The provision was added in 1995 with

Senate Bill (SB) 369. Or Laws 1995, ch 332, § 35. The bill

summary explained simply that the amendment “states

that once a worker and insurer have agreed on a disputed

claim settlement, the insurer cannot be compelled to attend

future hearings on the claim.” Exhibit A, Senate Committee

on Labor and Government Operations, SB 369, Jan 30, 1995

(bill summary). Later, the staff summary explained that

ORS 656.289(4)(b) “[e]liminates [any] requirement to appear

at hearing on [an] issue which has been settled.” Exhibit F,

Senate Committee on Labor and Government Operations,

SB 369, Feb 8, 1995 (statement of Staff Original Measure

Effects and Amendment Effects). It added “that once a

worker and insurer have agreed on a disputed claim set-

tlement, the insurer cannot be compelled to attend future

hearings on the claim.” Id. The legislative record confirms

that the only thing the legislature contemplated was that a

4

The familiar admonishment of ORS 174.010 says:

“In the construction of a statute, the office of the judge is simply to ascer-

tain and declare what is, in terms or in substance, contained therein, not to

insert what has been omitted, or to omit what has been inserted; and where

there are several provisions or particulars such construction is, if possible, to

be adopted as will give effect to all.”

556 Fleming v. SAIF

DCS binds the parties. Because that is so, there is no reason

to imagine that the legislature “anticipated” anything else.

Silence in legislative materials, like silence in statutory text,

does not support the majority’s answer. Without something

better, the majority’s construction of the statute—based on

its thin inference of intention—is unreasonable.

SETTLEMENTS IN WORKERS’ COMPENSATON

Rather than take guidance from silence, the court

should take guidance from the significance of settlement

within the workers’ compensation system, two signposts

in case law, issue preclusion, and a reflection on the conse-

quences of the majority’s answer. I address those topics in

turn.

Settlements in workers’ compensation are not—at

least not necessarily—merely private settlements between

private parties with no other significance to the system.

If we were to think of a compensation claim as merely a

private, personal, adversary money claim against the par-

ticular employer, then we could go on to conclude, as some

do, that settlements can freely occur without public over-

sight, protection of the settling worker, or significance to be

accorded later to settlement stipulations. See 13 Larson’s

Workers’ Compensation Law § 132.04[1] (rev ed 2019) (refer-

ring to a Kansas decision). The leading treatise comments:

“What this overlooks is that the entire compensation

system has been set up and paid for, not by the parties,

but by the public. The public has ultimately borne the cost

of compensation protection in the price of the product, and

it has done so for the specific purpose of avoiding having

the disabled victims of industry thrown on private charity

or public relief. * * * [T]he employer and employee have no

private right to thwart this objective by agreeing between

them on a disposition of the claim that may, by giving the

worker less than this amount, make the worker a potential

public burden. The public interest is also thwarted when

the employer and employee agree to a settlement which

unnecessarily increases the cost of the product by giving

the worker more than is due.”

Id. If we begin with that basic understanding, then we can

begin to find an answer to the question presented. It is an

Cite as 302 Or App 543 (2020) 557

answer that takes its guidance from how settlements of

workers’ compensation claims occur.

Under ORS 656.289(4), a DCS can occur only with

approval of an ALJ, the Workers’ Compensation Board, or a

court. That is significant. The familiar treatise explains:

“If the statute requires that a settlement have

Commission approval, a settlement lacking such approval

amounts to nothing more than a voluntary payment of com-

pensation. * * * [I]t does not rise to an ‘award’ upon which

procedures for reopening can be based, nor is it a waiver of

the right to controvert the claim.”

13 Larson’s Workers’ Compensation Law § 132.06[1] (rev

ed 2019). The effect of board approval becomes significant.

Larson’s states:

“If the settlement is approved, it takes on the quality of

an award, and the parties can no more back out of it than

any other kind of award.”

Id. at § 132.06[2]. Another treatise adds:

“Since an approved settlement agreement is given the

effect of a workers’ compensation award, its determinations

are given collateral estoppel effect.”

3 Modern Workers Compensation § 300:16 (2019); see Drews

v. EBI Companies, 310 Or 134, 140-42, 795 P2d 531 (1990)

(issue preclusion applies to issues of fact or law in adminis-

trative proceedings).

This court has treated the determinations made

after the board has approved a DCS like any other award

or decision of the board. In Southwest Forest Industries v.

Archer, 109 Or App 349, 351, 819 P2d 748 (1991), the claim-

ant had entered into a DCS with an employer and insurer

after a dispute over a back injury and psychological issues.

In the language of his DCS, he agreed that the employer’s

contentions “shall be affirmed.” Id. at 352. He worked for a

subsequent employer and had ongoing back issues, but his

claim against the subsequent employer failed when assert-

ing a new condition. Id. As for his claim against the original

employer, the board determined that his claim for aggrava-

tion was meritorious. Id. We concluded, however, that the

board erred “as a matter of law” when it did not correctly

558 Fleming v. SAIF

apply the “settlement order.” Id. at 353. The DCS had upheld

the acceptance of some injury and the denial of the psychiat-

ric claim. Id. at 351-52. We observed, “The settlement order,

however, does much more than that.” Id. at 353. That DCS,

in its stipulations, had “affirmed” that the “back problems

were unrelated to his employment, had no physical origin

and were due to psychiatric and psychological problems.”

Id. We reversed and remanded. Id. In material part, we did

so because the agreed stipulations in the DCS operated as

determinations of the ultimate facts of the claim, like any

other decision of the board. See id.

Similarly, in Wasson v. Evanite Fiber Corp., 117

Or App 246, 248, 843 P2d 1004 (1992), the claimant and

employer entered into a DCS after claims of depression and

hip and back conditions. The board treated the determina-

tion in the DCS that her depression was not compensable as

dispositive, because it was the same condition denied in the

DCS. Id. We resolved the appeal in language that regarded

the DCS as a binding determination of ultimate facts like

any other decision. We concluded:

“Claimant also argues that, by not allowing her to

relitigate issues settled by the DCS, we are denying her

an opportunity to contest an issue that would be a viable

subject for an aggravation claim if it had been resolved

through litigation. However, the DCS was a final resolution

of the compensability dispute concerning her depression.

Absent a showing that the present psychological condition

is different from the original condition permitting relitigat-

ing would undermine the finality for which employer, and

claimant bargained.”

Id. (first emphasis added; second emphasis in original).

Although circumstances vary, we have routinely

regarded the factual determinations made in a DCS to be

dispositive. See International Paper Co. v. Pearson, 106 Or

App 121, 124, 806 P2d 189 (1991) (neither party disputes

that it may not relitigate issues resolved by the DCS; the

issue comes down to what, precisely, was resolved); Miller v.

Coast Packing Company, 84 Or App 83, 88-89, 733 P2d 97,

rev den, 303 Or 534 (1987) (DCS absolved second employer

of responsibility; claimant is bound by its determination);

Cite as 302 Or App 543 (2020) 559

Proctor v. SAIF, 68 Or App 333, 335, 681 P2d 161 (1984)

(claimant is bound by determination of DCS and can recover

only if he has developed a new condition). What is important

to observe about those cases is what they represent in the

workers’ compensation system. In those cases, a DCS is not

a mere release of a worker’s claim against an employer—

as if whatever may have been stipulated does not matter.

Rather, the DCS was an approved determination, accord-

ing to its stipulations as to the ultimate facts. Those factual

stipulations, if any, bound the claimant.

Like the majority, I recognize that these cases

happen to be examples of disputes that arose between the

claimant and the original employer who were parties to

a DCS. Unlike the majority, I emphasize that a DCS is a

unique form of settlement that takes place in the context

of the workers’ compensation system, that may or may not

contain stipulations about the ultimate facts, and that is

required to be approved by an ALJ or the board. To distin-

guish a DCS from a private party agreement that has no

other significance to a claimant or others, it helps to see that

a DCS is one of the more formal forms of settlement in the

workers’ compensation system. That is because the admin-

istrative regulation of settlement suggests that such formal

settlements have a broader significance in the workers’ com-

pensation system than a private settlement outside workers’

compensation.

In Simmons v. Lane Mass Transit District, 171 Or

App 268, 271-74, 15 P3d 568 (2000), we reviewed the three

types of formalized settlements in the workers’ compensa-

tion system. A DCS, as contemplated by ORS 656.298(4)(a),

is defined in OAR 438-009-0001(2) as a written agreement

by which the parties make a reasonable disposition of a

claim involving a bona fide dispute over the compensability

of a claim. Simmons, 171 Or App at 272. That is to say, a DCS

involves a claim that has been denied. Id. The rule “requires

the parties to provide information to the Board, along with

assurances that the claimant has been thoroughly informed

of the effect of the DCS, before the Board will approve it.” Id.

A claim disposition agreement (CDA), as contem-

plated in ORS 656.236, is defined in OAR 438-009-0001(1)

560 Fleming v. SAIF

as a written agreement in which a claimant releases rights,

an insurer, or a self-insured employer from obligations,

except for medical services. Unlike DCS, a CDA involves

an accepted claim. Simmons, 171 Or App at 272. Both

types of settlements are required to be written, require

that claimant be advised, and require that their provisions

are reviewed and approved by an ALJ or the board. ORS

656.289(4) (DCS); ORS 656.236(1) (CDA).

A third type of settlement is a “settlement stipula-

tion,” for situations that are not suited to a DCS or CDA.

Simmons, 171 Or at 273. A “settlement stipulation” need

not be written, may be made orally by stipulation, does not

require that claimant be advised of any specific information,

and sets no criteria for the ALJ’s approval. OAR 438-009-

0005; Simmons, 171 Or App at 273.

The common feature among all three forms of settle-

ments in the workers’ compensation system is that they are

not merely private settlements. They are not divorced from

the adjudicatory process of workers’ compensation. In par-

ticular, a DCS is a written disposition of a claim, concluding

in denial, that cannot be accomplished without warnings to

the claimant and cannot be effective without a decision of an

ALJ or the board that concurs in the disposition based on

the stipulations and other information provided.

Case law, recounted above, confirms that the dis-

position accomplished by a DCS is no less significant than

that of an award made by the board in a contested decision.

The only open question, presented by this case, is whether

an exception should be made to treat a DCS as anything less

than a decision of the board when claimant brings a claim—

here based on the same medical records—against a succes-

sive employer while attempting to deny his stipulations on

ultimate facts contained in a DCS approved by the board.

WHEN A DCS IS A STIPULATED JUDGMENT

If we return to the text of the statute, we are

reminded that a DCS is not a mere private settlement. It is

not outside the workers’ compensation system. We are told in

ORS 656.289(4)(a) that the parties may, “with the approval

of an Administrative Law Judge, the board or the court, by

Cite as 302 Or App 543 (2020) 561

agreement make such disposition of the claim as is considered

reasonable.” (Emphases added.) The “approval” and “consid-

ered reasonable” language means that no DCS is effective

unless and until an ALJ, the board, or a court approves.

The parties must agree that the DCS is reasonable, but stat-

ute does not delegate to the parties the ultimate decision

about what is reasonable. Instead, the statute requires that,

as here, the board must act to make the determinations

required. Under OAR 438-009-0010(2) and (7), the approval

process is based on the information required and the stipu-

lations reached. The statute and rule require that the board

engage in the claim, consider the conflicting allegations,

review stipulations on the merits, if any, and agree with the

parties’ proposed disposition. Under both statute and rule,

it is the board that must “consider” that the “disposition”

is reasonable. ORS 656.289(4); OAR 438-009-0010(7). To be

reasonable requires that the disposition be one permitted

by law, be consistent with the ultimate facts recited in any

stipulations reached, and be consonant with the workers’

compensation system. See, e.g., EBI Companies v. Freschette,

71 Or App 526, 531, 692 P2d 723 (1984), rev den, 298 Or

822 (1985) (holding that a DCS violated the statutory pro-

hibition against releases). The engagement of the board, in

reviewing any stipulations on the merits, makes the DCS a

determination of the board like any other determination in

any other award. Simply put, a DCS—particularly one with

factual stipulations on the merits—has no less significance

than a stipulated judgment. And, a stipulated judgment has

the same effect as judgment after a trial on the merits. See

Webber v. Olsen, 330 Or 189, 196, 998 P2d 666 (2000) (“A

stipulated judgment has the same effect as a judgment that

is entered after a trial on the merits of a claim.”).

From the cases reviewed above, we know that a

DCS is like a stipulated judgment. In Archer, the DCS did

“much more” than serve as a settlement agreement to make

a claim go away; it “affirmed” the factual determination

that the claimant’s back problems were “unrelated to his

employment.” 109 Or App at 353. In Wasson, the DCS estab-

lished with “finality” that the psychological condition had

already been determined not to be compensable. 117 Or App

at 248; see also Miller, 84 Or App at 88-89 (claimant bound

562 Fleming v. SAIF

by factual determination of responsibility); Proctor, 68 Or

App at 335 (claimant bound by prior determination of prior

condition). Although such cases involve claims against the

same employer, the cases are resolved on the basis of the

determinations of ultimate facts made in the DCS. Those

determinations are the public determinations made in the

sequence of a particular worker’s claims that may be ongo-

ing in a sequential manner of claims within the workers’

compensation system. If determinations are made—whether

by stipulation or contested claim—it makes no sense to treat

approved determinations of fact as binding on claimant only

as to a prior employer, but not binding on claimant as to the

same facts in the current claim as to a successive employer.

Our statute, administrative rule, and case law do not imply

that the approved, factual determinations in a DCS should

be ignored, deemed irrelevant, or assumed to be insignifi-

cant thereafter.5

As this court observed in International Paper Co.,

106 Or App at 124, the issue should not be whether the DCS

can resolve factual issues in a stipulated disposition. Instead,

“[t]he issue come down to what, precisely, was resolved by

the settlement.” (Emphases added.) In a case like this, that

question is: What, if anything, were the stipulated state-

ments of ultimate fact in the DCS at hand? As is apparent in

OAR 438-009-0010(2)(e), the parties do not need to go so far

as to agree to one set of ultimate facts. Instead, they could

simply recite their conflicting “factual allegations and legal

positions” and leave it at that. Or, in the alternative, they

may choose to stipulate to one set of ultimate facts in resolv-

ing a claim in a DCS. That choice rests with the parties. The

result of different choices is reflected in two cases that, like

signposts, point to very different results depending whether

parties included or omitted agreed stipulations of ultimate

facts in a DCS.

5

Taking the opposite view, the claimant here argues that, “while [the DCS]

binds claimant legally, it does not bind him factually to the employer’s conten-

tions.” He argues that, because he disputed the employer’s contentions, “claimant

may in the later claim and litigation against a different employer continue to

make the same [original] contentions.” Claimant, however, ignores that, after

the recital of conflicting contentions, he stipulated to the employer’s statements

of ultimate fact that declared the Simonds’s work exposure not to be a cause

of injury or need for treatment. He did stipulate “factually to the employer’s

contentions.”

Cite as 302 Or App 543 (2020) 563

In Gilkey, the ultimate facts determined in a prior

DCS proved dispositive. 113 Or App at 317. That claimant

suffered an initial hip injury that was compensable and even-

tually was closed. Id. at 316. Two years later, the claim was

reopened in contemplation of hip surgery for degenerative

changes. Id. SAIF denied compensability. Id. Nevertheless,

claimant and SAIF entered into a DCS that provided that

SAIF would pay $4,000. Id. It was agreed that the denial

would “remain in full force and effect” and that claimant

understood that there would be no future recourse for medi-

cal care or benefits arising out of the Workers’ Compensation

Act as a result of the degenerative hip disorders involving

congenital dysplasia of both hips or degenerative osteo-

arthritis of the left hip. Id. Four years later, claimant’s hip

pain increased and he filed an occupational disease claim

with SAIF and Liberty Northwest Insurance Corporation,

a successor insurer. Id. Both insurers denied the disease

claim. Id.

The board made four determinations: (1) that the

hip condition had worsened more than might be expected by

virtue of aging alone; (2) that the DCS had the effect of estab-

lishing that the degenerative hip condition as it existed on

the date of the DCS was entirely the result of noncompensa-

ble causes; (3) that claimant was barred by claim and issue

preclusion from arguing that the original injury contributed

to the hip condition; and (4) that the claimant had failed

to show that work was the major contributing cause of the

worsening. Id. at 316-17.

On review, SAIF and claimant agreed that claim

and issue preclusion did not apply. Id. at 317. Recognizing

the parties’ agreement on the point, we remarked that claim

and issue preclusion did not apply. Id. However, the ques-

tion of claim or issue preclusion was not disputed by the

parties, was not developed in arguments, and was not an

issue that was essential for our opinion in Gilkey. See id.

We decided the appeal on another basis. In other words, our

remark about issue preclusion was dictum. See Halperin v.

Pitts, 352 Or 482, 494, 287 P3d 1069 (2012) (describing as

dicta prior comments in decision where there was no dispute

presented); State ex rel. Roberts v. Olcott, 94 Or 633, 651-52,

187 P 286 (1920) (“[Q]uestions not fairly within the issue

564 Fleming v. SAIF

made by the pleadings and presented to the court cannot

be authoritatively passed upon in any case, and, if the court

goes outside of these questions and decides others which are

not before it, its utterance is a mere dictum which binds no

one.”); State v. Zimmerman, 170 Or App 329, 334, 12 P3d

996 (2000) (noting that, in at least two prior cases, the

court stated that second-degree robbery is a lesser included

offense of first-degree robbery, but, because the issue was

not squarely presented in either case and the statement was

not essential to the disposition of either decision, the court

declined to follow the dicta of those decisions).

On appeal, the parties disputed the board’s other

determinations, and, accordingly, we addressed those other

issues. Gilkey, 113 Or App at 317. Specifically, we upheld

with the board’s second determination that the terms of the

prior DCS established the particular, ultimate facts. Id. We

observed that,

“by virtue of the DCS, the parties have agreed that there is

no compensable relationship between the 1975 injury and

claimant’s degenerative hip condition. They are bound by

that agreement, and the 1975 injury cannot be regarded as

having contributed to claimant’s present condition.”

Id. (emphasis in original). In so saying, we concurred with

the board’s treatment of the DCS as determining those

facts. Id. We approved the board’s statement that, by reason

of the DCS, the prior injury “has been found by law to have

no effect” and that the remaining evidence did not establish

work activities as the major contributing cause of the cur-

rent condition and resultant surgery. Id. In other words, the

specific terms of the claimant’s prior DCS were binding on

the claimant when he later presented a related claim involv-

ing the same medical history.

In contrast, a DCS that lacked express admissions

proved not to be an obstacle to a subsequent claim in Bennett

v. Liberty Northwest Ins. Corp., 128 Or App 71, 73, 875 P2d

1176 (1994). Originally, the claimant began noticing a hear-

ing loss while working in noisy conditions for Caterpillar,

Inc. Id. He continued working in noisy conditions for Siltec

Corporation and filed a claim against both employers for

hearing loss. Id. Both employers denied the claim as a

Cite as 302 Or App 543 (2020) 565

condition not arising out of its employment. Id. Caterpillar,

however, entered into a DCS with the claimant. Id. In that

agreement, the two parties agreed that there was a bona

fide dispute and that both parties had “evidence [in respect

of] their respective positions.” Id. Caterpillar agreed to pay

$7,500, and claimant agreed he would take no other bene-

fits on account of the claim. Id. at 73-74. The claim against

Siltec, the second employer, went to hearing. Id. at 74. A

hearings referee and the board affirmed the denial. Id.

On review before this court, the claimant contended

that he had not elected to prove his case solely against the

second employer Siltec. Id. at 75. Siltec contended that he

had elected to prove the claim solely against it. Id. We recog-

nized that a claimant could choose to make its case against

a single employer but that the claimant Bennett had made

claims against both employers. Id. at 78. In critical part, we

noted that

“[t]he DCS does not, by its terms, evidence an agreement by

claimant that work at Caterpillar did not contribute in any

way to claimant’s loss of hearing; nor does it by its terms

indicate an election to prove actual causation as against

Siltec. There is nothing in the DCS with Caterpillar that

shows an election to prove actual causation against Siltec.”

Id. (emphasis added). Because the DCS did not admit that

activities at Caterpillar played no role, we held that the

claimant may include conditions there as part of his proof

of employment as a major contributing cause of his hearing

loss. Id. Accordingly, the claim against Siltec could be deter-

mined according to the last injurious exposure rule.6 Id.

Paired as signposts, Gilkey and Bennett show the

differing effects of a DCS that does or does not include a

set of ultimate facts expressed in stipulations and approved

by the board.7 In this case, the terms of the DCS are more

like those in Gilkey than those in Bennett. Here, the stipu-

lated admissions in the DCS, duly approved by the board,

resolved the claim against the prior employer Simonds with a

6

The dissent disagreed that the last injurious exposure rule should apply

when it was uncontroverted that the disability was caused by exposure during

the earlier employment. Bennett, 128 Or App at 79-82 (Edmonds, J., dissenting).

7

The difference in outcomes is a precautionary note for parties’ lawyers.

566 Fleming v. SAIF

determination that the then-current conditions were “not, in

any way or degree of contribution, the result or consequence

of claimant’s on the job injury * * *, nor materially related to

his work activities with Simonds * * *.” Claimant’s shoulder

problems were “non-compensable, preexisting conditions,

and/or due to a new injury or subsequent work activities

neither caused nor worsened by claimant’s on the job injury

* * *.” Specifically, claimant’s conditions were determined to

be “not medically or legally attributable to the claimant’s

employment with Simonds.” (Emphasis added.) Claimant

“admitted and agreed” to those statements in resolution of

the claim. He did so reserving particular rights as to the

original claim with specific statutory references but he did

so without reserving rights to treat the past claim as part of

a potential occupational disease claim under ORS 656.802.

He specifically waived his right to “file a claim for any other

condition associated with or arising out of his denied claim.”

In all, claimant’s stipulations were specific, concrete, numer-

ous, and just determinative as those in Gilkey.

To be sure, the majority is correct that Gilkey did not

involve a subsequent claim against a successive employer. I

agree that something more is required to explain why the

claimant’s stipulations or the board’s determinations in an

approved DCS, when recognized as determinations of the

board, should be regarded as binding on claimant in the

next claim against the subsequent employer. The general

answer has already been broached with reference to the

nature of the workers’ compensation system: “If the set-

tlement is approved, it takes on the quality of an award,”

13 Larson’s Workers’ Compensation Law § 132.06[2], and,

“[s]ince an approved settlement agreement is given the

effect of a workers’ compensation award, its determina-

tions are given collateral estoppel effect,” 3 Modern Workers

Compensation § 300:16.

Oregon law recognizes that issue preclusion applies

to administrative proceedings, provided that the tribunal’s

decision-making process include certain requisite character-

istics. Drews, 310 Or at 142. Our law recognizes that issue

preclusion may apply either to conclusions of law or findings

of fact. Id. at 140. And, issue preclusion applies to workers’

compensation determinations. Id. at 142. Our requirements

Cite as 302 Or App 543 (2020) 567

are that (1) the issue in the proceedings is the same; (2) the

issue was actually litigated and essential to a final determi-

nation on the merits in the prior proceeding; (3) the party

sought to be precluded had a full and fair opportunity to be

heard on the issue; (4) the party sought to be precluded was

a party or in privity with a party in the prior proceeding;

and (5) the prior proceeding was the type of proceeding to

which the court will give preclusive effect. Nelson v. Emerald

People’s Utility Dist., 318 Or 99, 104, 862 P2d 1293 (1993).

In this case the requisites for issue preclusion are

satisfied: (1) The issue of the role of claimant’s Simonds work

to his injury was the same in the prior proceeding. (2) The

issue was actually litigated in a disputed claim and resolved

with finality in a DCS with stipulations of ultimate facts,

making the DCS the functional equivalent of a stipulated

judgment. (3) Claimant had a full and fair opportunity to lit-

igate his claim. (4) Claimant was the same party in the prior

claim. (5) And determinations of the board are the kind of

administrative determinations to which the court accords

finality.8

Given issue preclusion, the stipulations of ultimate

fact contained in a prior DCS should be the starting point

for a subsequent claim, like any other prior factual deter-

mination of the board in any other prior decision, whether

against the same employer (e.g., an aggravation claim) or

another employer (e.g., a disease claim). That is so because

a DCS determination, when made with stipulations of ulti-

mate facts, is but a part of one person’s continuing history in

the workers’ compensation system. To recognize that such

a DCS is part of this worker’s history does not mean that

he would necessarily be denied subsequent workers’ com-

pensation benefits. It only means that the appropriate stan-

dard of compensability would be proof that the subsequent

8

If I am mistaken in reading our remark in Gilkey as dictum, then that

remark should be reconsidered and rejected as “plainly wrong.” See State v. Civil,

283 Or App 395, 407-17, 388 P3d 1185 (2017) (examining what was not addressed

in a prior decision; describing prior decision to be overruled when “plainly

wrong”); see also Farmers Ins. Co. v. Mowry, 350 Or 686, 692-99, 261 P3d 1 (2011)

(discussing considerations for overruling erroneous decisions). The remark was

made in the absence of developed briefing on an issue, about an issue that was

not disputed on appeal, and before the Supreme Court updated and articulated

its exegesis on issue preclusion in Nelson. See 318 Or at 104.

568 Fleming v. SAIF

employment was the major contributing cause of his injury

or need for treatment.

The conclusion—that a prior DCS with stipulations

matters in a subsequent claim—is reinforced when reflect-

ing on the consequences of the opposite conclusion posed

by the majority’s opinion. The consequences are untenable,

in one way or another, regardless whether we view a DCS,

because it pays benefits, as implying claimant suffered work-

related harm despite stipulations to the contrary, or we view

the DCS, because it says so, as determining that the prior

employment with Simonds was not a cause of injury or need

for treatment.

One untenable consequence of the majority’s deci-

sion is inconsistent standards. Although claimant stipu-

lated that work for a prior employer had no relationship to

his condition, the standard for the next employer’s liability

reduces to the “last injurious exposure” standard, rather

than remain at the “major contributing cause” standard that

ordinarily applies when only the second employer’s work is

at issue. Another worker, whose only exposure to injury

occurred with the second employer, would need to prove

compensability by the “major contributing cause” standard.

Although this claimant stipulated that prior employment

was not a cause of his condition, this claimant would prove

compensability with an inconsistent, lesser standard of “last

injurious exposure.” Those two workers, working for the

same employers with seemingly the same work exposures,

would have two different legal standards of compensability.

Another untenable consequence of the majority’s

decision is the prospect of double recovery—in whole or in

part. Although claimant has recovered the benefits of a DCS

with the first employer requiring payment of all medical bills

to date and the further sum of $25,000 for his shoulder con-

dition, he can recover benefits again from a second employer

based on the same set of medical records. To be sure, it is

difficult to imagine how claimant could claim a right to keep

payment for medical bills already paid, but, then again, tort

law allows a personal injury plaintiff to retain the mea-

sure of damages that is the full face amount medical bills

despite the fact “write-offs” meant that a lesser sum actually

Cite as 302 Or App 543 (2020) 569

satisfied the billing of medical providers. White v. Jubitz

Corp., 347 Or 212, 236-37, 219 P3d 566 (2009). Although the

prospect of claimant retaining a second payment of medical

bills should somehow be impermissible within the workers’

compensation system, claimant has not offered any sugges-

tion how that would be avoided.

More to the point, claimant has not suggested that

he would offset the $25,000 already received for his shoul-

der condition against the award of disability he seeks for

the same condition as against his second employer. His prior

recovery may or may not have been adequate; it could have

been a compromised sum on disputed compensability. But,

he does s eek additional recovery for the same condition

without any consideration of the prior award already recov-

ered with the DCS. It stands to reason that, in a different

case, a claimant may make a favorable settlement with a

first employer and make no stipulations of ultimate fact that

would bind the claimant in a later claim against a subse-

quent employer. Yet, here, it seems untenable that a claim-

ant who does make stipulations of ultimate fact, which the

board adopts in a DCS, may disclaim those stipulated facts

and expect the board to ignore them, permitting him the

potential to recover twice for the same injury.9

Claimant, no doubt suffering disability whether

from work or nonwork related causes, cannot be faulted for

seeking to maximize his benefits. Nor can his employers be

faulted for seeking appropriate determination of compensa-

bility. Only we can be faulted if our answer shortchanges a

claimant or forces employers to overpay for the same injury.

CONCLUSION

For all the reasons reviewed here, the DCS should

be treated like a stipulated judgment when it contains stip-

ulations of ultimate facts. We should recognize that, after

9

Outside of workers’ compensation in the world of personal injury, an injured

party may keep a settlement sum that is more favorable than the settled party’s

percentage share of fault, but the settled party’s percentage share of fault is

nonetheless determined by a jury as among blameworthy parties, and that set-

tled party’s percentage of fault does reduce recoverable damages against the non-

settling defendant. See ORS 31.600(2) (determination of settled party’s share of

fault); ORS 31.610(2) (court shall determine the award of damages in accordance

with the percentages of fault determined by the trier of fact).

570 Fleming v. SAIF

board approval, a DCS with such stipulations represents the

board’s determinations. Nothing in statute or rule requires

the board to disregard its prior determinations. Because

that is so, the board did not err in recognizing that the fac-

tual terms of the DCS required that claimant prove that

work conditions, other than those involving Simonds, were a

major contributing cause of his shoulder condition. All agree

that claimant’s evidence failed to address whether his work

with Treske (alone) met that standard. Therefore, I believe

that the board acted with substantial evidence and reason

when concluding that claimant had not carried his burden

of proof.

I respectfully dissent.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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