In re Comp. of Carroll, WCB Case No. 18-06129
| Decision Date | 09 July 2021 |
| Docket Number | WCB Case No. 18-06129 |
| Parties | In the Matter of the Compensation of DANIEL C. CARROLL, Claimant |
| Court | Oregon Workers' Compensation Division |
Unrepresented Claimant
SAIF Legal Salem, Defense Attorneys
Reviewing Panel: Members Ousey and Woodford.
Claimant, pro se,1 requests review of Administrative Law Judge (ALJ) Somers's order approving a Disputed Claim Settlement (DCS) agreement. On review, the issue is the propriety of the DCS. We affirm.
After claimant, who was unrepresented, filed a request for hearing challenging the SAIF Corporation's October 29, 2018, denial of his new/omitted medical condition claim for a left Achilles tendon tear, a hearing was scheduled for February 26, 2019. Thereafter, the ALJ granted claimant's unopposed request for postponement to allow him to seek representation, and the hearing was rescheduled for June 13, 2019. (Hearing File).
On May 31, 2019, the ALJ held a recorded telephonic conference to address claimant's motion to postpone the rescheduled hearing. (Tr. I-1). Claimant described his health issues and his inability to obtain various records from SAIF. (Tr. I-1-2, -8-13). SAIF also moved for a postponement to develop the medical record. (Tr. I-3-5). The ALJ granted the parties' motions for postponement and, thereafter, the hearing was reset for September 5, 2019. (Tr. I-14).
After claimant again requested that his hearing be postponed, the ALJ held a July 26, 2019, recorded telephonic conference in which claimant explained that he was still waiting to receive medical information, he continued to have significantmedical problems, and he would be unable to attend a medical examination arranged by SAIF. (Tr. II-1-2, -4-21). The ALJ granted claimant's request for postponement over SAIF's objection. (Tr. II-21). The hearing was set for November 7, 2019.
The parties appeared for the scheduled November 7, 2019, hearing. Over SAIF's objection, the ALJ granted claimant's motion to postpone the hearing to retain an attorney. (Tr. III-7). The hearing was reset for March 3, 2020.
On February 27, 2020, after receiving a letter from claimant that the ALJ interpreted as a motion for postponement, the ALJ held another recorded telephonic conference. (Tr. IV-1). Based on claimant's medical difficulties, the ALJ again, over SAIF's objection, granted claimant's request for a postponement. (Tr. IV-2-4, -17-19). The hearing was reset for July 7, 2020.
Thereafter, claimant retained an attorney, who requested a postponement. The ALJ granted the postponement request and the hearing was reset for November 10, 2020. Claimant's attorney subsequently withdrew from representation. (Hearing File).
On October 19, 2020, the Hearings Division received a proposed DCS and a letter from claimant.
The DCS identified September 9, 2020, as the "date of settlement,"2 and it pertained to SAIF's October 29, 2018, denial of claimant's left Achilles tendon tear condition and SAIF's subsequent March 19, 2019, denial of claimant's claim for depression and mental stress conditions related to his 2017 injury claim. The DCS provided that a bona fide dispute existed, the terms of the agreement were reasonable, and claimant agreed to accept $1,500 in full settlement of all issues raised arising out of SAIF's denials. (Hearing File).
The DCS provided that claimant understood that, if the ALJ approved the settlement agreement, SAIF's denials would remain in full force and effect, he would have no further entitlement to compensation for the denied conditions, and his request for hearing would be dismissed with prejudice. Pursuant to the DCS, claimant also confirmed that he declined to consult an attorney and voluntarily waived the assistance of an attorney. Finally, the DCS provided that claimantcertified that he read the document, understood all terms, and had no further unanswered questions regarding the agreement. Claimant signed the DCS, dated it October 14, 2020, and wrote "??" next to the date. (Hearing File.)
Claimant's letter, which was also dated October 14, 2020, thanked the ALJ for her time and informed her that he agreed to settle his claim. Claimant wrote, "I do feel like I'm being taken advantage of and I don't completely understand all of the terms." (Hearing File).
Referring to claimant's comment in his letter that he thought he was being taken advantage of, the ALJ inquired whether claimant felt he signed the DCS agreement voluntarily and without any undue pressure. (Tr. V-5). Claimant reiterated the reasons he agreed to settle (as described in his letter) and stated that he signed the DCS under his own will (Tr. V-5-6). He also noted concerns related to his health problems and stress from unfinished business pertaining to his claim and stated that there was a little pressure from the claim adjuster to return the DCS documents in a timely manner. (Tr. V-6-7). Nevertheless, claimant explained that he agreed to the DCS because he needed to focus on his health, rather than the unfinished business of his claim. (Id.)
Satisfied that claimant signed the DCS agreement voluntarily without undue duress, the ALJ asked about claimant's comment that he did not completely understand all of the terms of the DCS, particularly in light of the DCS provision that he signed specifically certifying that he understood the terms. (Tr. V-6). Claimant explained that there were parts of the settlement document that he did not understand (which was why he wrote "??" by his signature), but he contacted the Ombudsman's office and was able to get some of his questions answered. (Tr. V-6-7). After claimant agreed that he understood the agreement to his satisfaction, including the provisions that he would accept SAIF's offer of payment and the case would be dismissed, the ALJ said that, based on claimant's statements, the DCS agreement would be approved and the case dismissed. (Tr. V-9, -11). Both parties confirmed that they were satisfied with the ALJ's approval of the DCS and dismissal of the case.3 (Id.)
On October 22, 2020, the ALJ issued an "Order Approving Settlement (DCS)," approving the DCS agreement and dismissing the case with prejudice.
On November 21, 2020, claimant requested review of the ALJ's order, asking the Board to "find in [his] favor" and stating the following:
We interpret claimant's appeal of the ALJ's order approving the DCS as an objection to, and a request for rescission of, the approved DCS agreement.4 For the following reasons, we affirm.
Under ORS 656.289(4), parties may resolve a bona fide dispute regarding the compensability of a denied claim pursuant to a DCS. It is well established that settlements are to be encouraged within the limits of the statute and, onceapproved, they should be set aside only if they clearly violate the statute. Kasper v. SAIF, 93 Or App 246, 250 (1988); Jack A. Strubel, 69 Van Natta 1140 (2017). We regard setting aside an approved settlement to be an extraordinary remedy to be granted sparingly in the most extreme circumstances. See Dorothy J. Carnes, 57 Van Natta 2003, 2004 (2005); Pruitt Watson, 45 Van Natta 1633, recons, 45 Van Natta 2227 (1993). Absent a showing of extreme circumstances, we have declined to set aside a DCS. See Carnes, 57 Van Natta at 2004; Floyd D. Gatchell, 48 Van Natta 467 (1993). The grounds for setting aside an approved DCS include mistake, inadvertence, surprise, excusable neglect, fraud, misrepresentation, or other misconduct of an adverse party. See Gatchell, 48 Van Natta at 467; Mary Lou Claypool, 34 Van Natta 943, 946 (1982).
We have previously held that, where a record regarding any objections to the approved settlement has not been developed, the appropriate remedy is remand for the development of such a record. See ORS 656.295(5); Jack A. Strubel, 68 Van Natta 408 (2016) (); Kimberly Coven, 66 Van Natta 171 (2014) (same); Mary A. Summers, 42 Van Natta 2393 (1990) (same).
Here, in contrast to the aforementioned cases, the record has been sufficiently developed to evaluate the circumstances surrounding the parties' DCS agreement. Specifically, because claimant requested review of the ALJ's order, the recorded prehearing telephonic proceedings were transcribed as provided by ORS 656.295(3). ORS 656.283(5).5 Moreover, the record includes a transcript of the October 22, 2020, telephonic proceeding pertaining to claimant's understanding and willingness to sign the DCS document. Finally, claimant does not assert additional objections to the DCS other than those previously addressedby the ALJ. Consequently, we find the record sufficiently developed to...
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