SAIF Corp. v. Sparks
258 Or. App. 227
Or. Ct. App.2013Background
- Claimant, a California-based master mason, worked on two Oregon projects (Corvallis June–Sept 2008; Portland Oct 2008–Feb 2009) and received regular hourly wages plus fixed subsistence/travel payments ($76/day in Corvallis; $600/month in Portland; one $12 travel payment).
- Subsistence/travel payments were paid as a fixed sum in each paycheck, without requirement to submit receipts and irrespective of actual expenses incurred.
- Claimant was injured in February 2009; subsistence/travel payments stopped and he filed for temporary total disability (TTD) benefits based on his average weekly wage.
- Insurer (SAIF) calculated TTD excluding the subsistence/travel payments, treating them as job-related reimbursements; claimant argued they were wages and should be included.
- ALJ and the Workers’ Compensation Board found the payments were wages (not reimbursements) because they were fixed, not tied to actual expenses, and claimant was not required to produce receipts; board affirmed ALJ and SAIF sought judicial review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether subsistence and travel payments are "wages" for calculating TTD under ORS 656.210 and OAR 436-060-0025(5)(c) | Claimant: Payments are wages/considerations because they were fixed, paid with wages, not contingent on receipts, and not equivalent reimbursements | SAIF: Payments are reimbursements for job expenses (per diem-like) and thus excluded from wages when calculating TTD; previous board decisions support treating them as reimbursements | Court held payments are wages, not reimbursements, and must be included in average weekly wage for TTD calculations |
| Whether the board needed to find whether claimant's actual expenses exceeded payments | SAIF: Board should have found whether expenses exceeded reimbursements to determine reimbursement character | Board/Claimant: Not necessary because payments were contractual fixed sums paid irrespective of expenses | Court held no such factual finding was required given payments were fixed and untied to actual expenditures |
| Whether the board abused discretion by departing from prior board decisions | SAIF: Decision inconsistent with prior board holdings; thus an abuse of discretion | Board: Provided adequate explanation and applied correct legal analysis to facts here | Court held board did not abuse its discretion and provided adequate reasoning |
| Proper interpretation of "reimburse" in OAR 436-060-0025(5)(c) | Claimant: "Reimburse" means pay back an equivalent; these payments were not equivalent repayments | SAIF: Argued these payments function as per diem/reimbursements under the rule | Court: Adopted ordinary meaning of "reimburse" (equivalent repayment) and concluded payments were not reimbursements |
Key Cases Cited
- PGE v. Bureau of Labor & Indus., 317 Or. 606 (interpretive methodology for statutes and administrative rules)
- State v. Gaines, 346 Or. 160 (modification of PGE methodology)
- Baker v. Liberty Northwest Ins. Corp., 257 Or. App. 205 (standard of review for administrative legal errors)
- Haskins v. Palmateer, 186 Or. App. 159 (applying statutory interpretation principles to administrative rules)