Birrueta v. Dep't of Labor & Indus. of State
| Decision Date | 15 September 2016 |
| Docket Number | No. 92215–2,92215–2 |
| Citation | 186 Wash.2d 537,379 P.3d 120 |
| Court | Washington Supreme Court |
| Parties | Jose L. Birrueta, Respondent, v. Department of Labor and Industries of the State of Washington, Petitioner. |
Paul Michael Weideman, Anastasia R. Sandstrom, Seattle Labor & Industries A.G. Office, 800 5th Ave Suite 2000 Seattle, WA, 98104–3188, for Counsel for Petitioner.
Michael V. Connell, Attorney at Law, P.O. Box 228, Yakima, WA, 98907–0228, for Counsel for Respondent.
Robert Andrew Battles, Association of Washington Business, 1414 Cherry St. Se, Olympia, WA, 98501–2341, Kristopher Ian Tefft, Washington Self–Insurers Association, 828 7th Ave Se, Olympia, WA, 98501–1509, Amicus Curiae on behalf of Association of Washington Business, Washington Self–Insurers Association.
YU
, J.
¶ 1 After the Department of Labor and Industries (Department) learned it had been overpaying respondent Jose Birrueta's industrial insurance benefits for years, it issued two orders, one assessing an overpayment and another changing Birrueta's status from married to unmarried for compensation purposes. Because Birrueta was overpaid due solely to an innocent misrepresentation about his marital status made on his behalf, we hold the Department's orders were timely and authorized in accordance with RCW 51.32.240(1)(a)
. We therefore reverse the Court of Appeals and reinstate the ruling of the Board of Industrial Insurance Appeals (Board) upholding the Department's orders.
FACTS AND PROCEDURAL HISTORY
¶ 2 Birrueta was injured at work on August 31, 2004, and was totally disabled by his injury. While he was receiving medical treatment immediately following his injury, “an unknown person assisted Mr. Birrueta in completing a report of industrial injury.” Certified Bd. R. (CBR) at 27. Birrueta acknowledges that the report bears his signature below the statement, “I declare that these statements are true to the best of my knowledge and belief,” id. at 84, although he does not specifically remember signing it. The report states that at the time of his injury, Birrueta was married with one child.
¶ 3 In fact, at the time of his injury, Birrueta was unmarried and had no children—the report of industrial injury inaccurately lists his sister as his wife and his niece as his child. It is undisputed that the reason for these errors was a miscommunication between Birrueta and the person who filled out his industrial injury report, attributable to a language barrier and the fact that Birrueta was “in and out of consciousness” at the time the report was filled out on his behalf, Tr. of Telephone Hr'g (Mar. 21, 2012) at 5; see also CBR at 80-81.
¶ 4 Between 2004 and 2008, the Department issued multiple compensation orders, each of which stated that Birrueta was married with no children at the time of his injury.1 The last of these orders “became final on or about May 4, 2009.” CBR at 28. Birrueta raised several challenges to the Department's orders over the years, both pro se and with the assistance of counsel, but there is no indication that he ever attempted to correct the Department's mistaken belief that he was married at the time of his injury.
¶ 5 In early 2011, the Department determined that Birrueta was permanently and totally disabled and thus entitled to a pension. With the aid of a legal assistant in his attorney's office, Birrueta filled out the required pension benefits questionnaire, accurately stating that he was unmarried at the time of injury. It is undisputed that the Department did not know that Birrueta was unmarried until it received his completed pension benefits questionnaire.
¶ 6 After learning Birrueta's true marital status, the Department issued two orders, both of which are now at issue. The first order assessed an overpayment against Birrueta of $100.86 based on the amount Birrueta was overpaid between the time Department learned his true marital status and the time he was placed on a pension. The second order changed Birrueta's marital status for compensation purposes from married to unmarried effective the day after the Department learned Birrueta's true marital status.
¶ 7 Birrueta appealed the Department's orders to the Board, contending that the Department's prior orders stating that Birrueta was married at the time of injury were “final and binding on all parties, which includes the Department.” Id. at 31. Both parties sought summary judgment. An Industrial Appeals Judge (IAJ) issued a proposed decision and order granting summary judgment to the Department, finding that there were no disputed material facts, that Birrueta innocently misrepresented his marital status when he applied for industrial insurance benefits, and that the Department's orders were authorized by RCW 51.32.240(1)
. The Board adopted the IAJ's proposed decision and order as the Board's final decision, Birrueta then sought review in superior court.
¶ 8 The superior court adopted the Board's unchallenged factual findings but agreed with Birrueta that as a matter of law, the Department was “without authority” to issue the recoupment order or to change his marital status for compensation purposes. Clerk's Papers at 13. The court thus ordered the Department to set aside those orders as “ and void.” Id. The Court of Appeals affirmed in a unanimous, published opinion, and we granted the Department's petition for review. Birrueta v. Dep't of Labor & Indus., 188 Wash.App. 831, 355 P.3d 320 (2015)
, review granted, 184 Wash.2d 1033, 380 P.3d 411 (2016).
ISSUES
¶ 9 A. Was the Department statutorily authorized to issue the orders assessing an overpayment against Birrueta and changing his marital status for compensation purposes even though the Department's binding determination setting his compensation rate was final?
¶ 10 B. Is Birrueta entitled to attorney fees on review?
STANDARD OF REVIEW
¶ 11 The facts are undisputed. The resolution of this case depends entirely on statutory interpretation, a matter of law which we review de novo, Gorre v. City of Tacoma , 184 Wash.2d 30, 36, 357 P.3d 625 (2015)
. “Our ultimate task, of course, is to ascertain and carry out the legislature's intent.” Id. at 37, 357 P.3d 625 (citing Dep't of Ecology v. Campbell & Gwinn, LLC, 146 Wash.2d 1, 9, 43 P.3d 4 (2002) ).
ANALYSIS
¶ 12 The purpose of the Industrial Insurance Act (IIA), Title 51 RCW, is to provide “sure and certain relief for workers, injured in their work ... regardless of questions of fault and to the exclusion of every other remedy, proceeding or compensation,” RCW 51.04.010
. To effectuate this purpose, the IIA sets forth in detail when an injured worker is entitled to compensation and the amount of compensation the worker is entitled to receive. Ch. 51.32 RCW. There is no dispute that Birrueta is statutorily entitled to compensation at a rate equal to 60 percent of his wages at the time of injury, RCW 51.32.060(l)(g). There is also no dispute that he has been receiving compensation at a rate equal to 65 percent of his wages at the time of injury because his innocent misrepresentation caused the Department to mistakenly believe he was married. RCW 51.32.060(1)(a), .090(1). The question is what action the Department may undertake given the circumstances presented.
and 51.52.060. “Adjudicator error” includes the failure to consider information in the claim file, failure to secure adequate information, or an error in judgment.
The Department contends its orders were timely and authorized in accordance with RCW 51.32.240(1)(a)
, Birrueta contends that subsection (1)(a) applies only to temporary orders and that the Department's orders were untimely pursuant to RCW 51.32.240(1)(b).2
¶ 14 In accordance with the statute's plain language, we hold that subsection (1)(a) applies to any order, temporary or binding, that results in an erroneous overpayment of benefits caused by an innocent misrepresentation (or clerical error, mistake of identity, “or any other circumstance of a similar nature”). Meanwhile, subsection (1)(b) applies only to overpayments caused by adjudicator error. We further hold that “adjudicator error” means an error attributable to an adjudicator's misinterpretation of the law or failure to properly apply the law to the facts in the claim file—the types of errors that may be addressed on reconsideration or direct appeal and not any error contained in an adjudication.
¶ 15 In this case, the overpayment to Birrueta was caused solely by an innocent misrepresentation and not by adjudicator error. The Department's orders were thus timely and authorized in accordance with subsection (1)(a).
¶ 16 RCW 51.32.240(1)
sets forth procedures and time limits for the Department (and self-insured employers) to recoup previously overpaid benefits. RCW 51.32.240(2)
has similar provisions for a worker to seek an adjustment of previously underpaid...
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