October 21, 2016
by Andrew Evenson

“Good cause” for untimely injury filing does not require medical evidence

Evenson, Andrew_167x222Under ORS 656.265, notice of an accident resulting in an injury must be given immediately by the worker, but not later than 90 days after the accident. Failure to give notice of a workplace incident bars an injury claim unless the employer already had knowledge of the injury or death; the worker died within 180 days of the date of injury; or the worker can establish “good cause” for failure to give notice within 90 days after the alleged incident.

The Court of Appeals of Oregon recently ruled in Dalia R. Lopez v. SAIF, 505 Or. App. 679 (2016), that a “good cause” showing for untimely injury filing does not require medical evidence. In this case, claimant’s regular work activities included assisting pre-kindergarten students and their parents with issues of food, clothing, shelter, and health care, and she regularly used her own vehicle to make home visits for that purpose. She worked irregular hours. On June 6, 2012, she left work at 3:15pm and was involved in a motor vehicle accident at 3:40pm, sustaining injuries to her face, neck, shoulders, upper back, and abdomen. At the time of the accident, she had in her vehicle a student’s immunization records, which she was apparently returning to the student’s parent at the time of the accident. The next day, a supervisor visited her at the hospital. Claimant told the supervisor she was headed home and was not involved in work activities at the time of the accident. The supervisor later testified that she had no information at that time that claimant’s injuries were work-related. Claimant completed an incident report form in December 2012 and submitted a workers’ compensation claim on January 15, 2013, more than seven months following the accident. Among other reasons, the employer denied the claim as untimely.

At the hearing level, claimant testified that, due to her overwhelmed and medicated state, she did not remember the purpose of her June 6 trip when asked by her supervisor the day following the accident. In fact, she testified that she did not recall the purpose of her trip until September 2012 when she came across some of her old work reports. The ALJ found that the employer did not have sufficient knowledge that claimant’s accident was possibly work-related within 90 days, so affirmed employer’s denial for untimeliness. The board adopted the ALJ’s order and further concluded that claimant had not established “good cause” for the reporting delay because she had failed to produce medical evidence supporting her contention that she was overwhelmed and heavily-medicated as a result of the injuries, causing her to forget the intended June 6, 2012, home visit.

The Court of Appeals interpreted the board’s order as implying that medical evidence was necessary to support a “good cause” finding. However, the Court pointed out that nowhere in ORS 656.265 does it expressly or imply that medical evidence is required to establish “good cause” for untimely filing. Accordingly, because it found that the board’s order relied on a misconception of the law, it remanded the case for reconsideration under the correct legal standard.

Untimely injury filing is not an issue that arises often, but when it does the injured worker is usually required to establish “good cause” for the untimeliness. This ruling from the Court of Appeals is a reminder that “good cause” does not require medical evidence.

Please contact me if you have any questions regarding an Oregon workers’ compensation claim or issue. I can be reached directly at 503-595-6109 or .