Vorhies v. Department of Retirement Systems
199 Wash. App. 543
| Wash. Ct. App. | 2017Background
- James Vorhies, a former LEOFF Plan 2 police officer, resigned after neck injuries and surgeries and received line-of-duty (duty) disability retirement from DRS but was denied catastrophic (total line-of-duty) disability benefits.
- DRS accepted cervical spine injury for duty benefits, but concluded Vorhies could still "engage in" some substantial gainful activity given his transferable skills and PCEs; vocational expert Berndt supported employability while Larson did not.
- PCEs showed limitations (e.g., seldom turn neck; limited hours sitting/standing/walking) but indicated capacity for some light/sedentary work; Vorhies had not sought employment post-retirement.
- Vorhies appealed DRS’s denial administratively and then to superior court, which reversed DRS and awarded attorney fees; DRS appealed to the Court of Appeals.
- The Court of Appeals reviewed de novo legal questions and whether DRS correctly applied WAC 415-104-482 and RCW 41.26.470(9) in denying catastrophic benefits.
Issues
| Issue | Plaintiff's Argument (Vorhies) | Defendant's Argument (DRS) | Held |
|---|---|---|---|
| Whether workers’ compensation law must govern catastrophic LEOFF determinations | LEOFF standard should incorporate workers’ comp principles (focus on ability to obtain employment) | LEOFF is an independent statutory scheme; rules do not require applying L&I law | DRS correct: workers’ comp law is not directly applicable to catastrophic LEOFF determinations |
| Standard of proof and earnings-threshold analysis | DRS misstated the standard by speculating higher wages would reduce hours needed to meet the $1,040/month threshold | DRS used preponderance standard and correctly calculated that at lowest wage Vorhies could meet threshold by limited hours; comment about plausibility of higher pay was ancillary | DRS used the correct standard and the conclusion was supported by the record |
| Whether eligibility requires ability to "obtain" employment (vs. "engage in" work) | Must show ability to obtain and perform jobs in labor market; mere physical ability is insufficient | Statute/rule ask whether member can "engage in" substantial gainful activity; obtaining specific jobs is not determinative | DRS correctly applied the "engage in" standard; not required to show ability to obtain particular job |
| Whether DRS erred by ignoring headaches, res judicata, age, skill acquisition, and workplace accommodations | Headaches should have been considered; prior duty-retirement decision should preclude re-litigation; age and inability to quickly acquire skills reduce employability; employer accommodations shouldn't be presumed available | Headaches were not asserted as a disabling condition in the application; duty retirement does not resolve catastrophic element; age not a rule factor; transferable skills and demonstrated ability to learn are relevant; DRS did not require proof employers would refuse accommodations | Court upheld DRS on all points: headaches not part of asserted disability, no res judicata on catastrophic element, age not required factor, considering transferable skills (including ability to acquire skills) was proper, and DRS did not demand proof employers would deny accommodations |
Key Cases Cited
- Tapper v. Employment Security Department, 122 Wn.2d 397 (discusses APA review of administrative records)
- Tucker v. Department of Retirement Systems, 127 Wn. App. 700 (standards for administrative review and burden on challenger)
- Shaw v. Department of Retirement Systems, 193 Wn. App. 122 (agency interpretation of statutes it administers given weight)
- Leeper v. Department of Labor & Industries, 123 Wn.2d 803 (workers’ comp relevancy of labor-market job availability to permanent-total disability)
- Malland v. Department of Retirement Systems, 103 Wn.2d 484 (limits on res judicata in LEOFF context)
- Hegwine v. Longview Fibre Co., 162 Wn.2d 340 (substantial-evidence review of agency factfinding)