SAIF Corp. v. Grover
SAIF Corp. v. Grover
Opinion of the Court
SAIF seeks review of an own-motion order of the Workers’ Compensation Board. See ORS 656.278(l)(a). In that order, the Board concluded that claimant was entitled to temporary total disability (TTD) benefits from SAIF for the time in which he was hospitalized for back surgery, even though at that time he was receiving permanent total disability (PTD) benefits from another carrier. We conclude that a worker who is permanently totally disabled and receiving payments for that disability cannot at the same time be temporarily totally disabled. Accordingly, we reverse the Board’s order.
Before he became disabled, claimant was self-employed as a mason.
*479 “Claimant’s injuries occurred over a number of years, and each materially contributed to his overall disability. The most recent injury that bears a causal relation to claimant’s total disability is the aggravation of the knee conditions. EBI was responsible for the first knee injury, and it was the aggravation of that injury that last contributed to the disability. * * * EBI is the responsible carrier.”
EBI Companies v. Grover, 90 Or App 524, 526, 752 P2d 1274, rev den 306 Or 155 (1988) (citation omitted; emphasis supplied).
In 1996, claimant was hospitalized for back surgery at three spinal vertebrae levels; he submitted a claim to SAIF for that surgery. SAIF issued a partial denial in which it agreed to pay the medical expenses only for the treatment at one level.
In Gwynn v. SAIF, 304 Or 345, 745 P2d 775 (1987), the Supreme Court attempted to provide a clear description of the meaning of temporary, permanent, partial and total disability:
*480 “[T]he adjectives ‘permanent’ and ‘temporary’ describe duration, not the extent, of disability. ‘Partial’ and ‘total’ describe extent. It follows that if a worker meets the test of being totally disabled but that it cannot be said that the disability is permanent, that worker is temporarily totally disabled.
“If a worker is permanently disabled but not to the extent of being totally disabled, as the statute defines total disability, that worker must be permanently partially disabled. The fact that the worker is not totally disabled excludes the worker from the class of those permanently totally disabled, and either the fact that the disability is permanent or that it is not total excludes the worker from the class of those temporarily totally disabled.
“To be a bit redundant but to emphasize a point, one who is only temporarily disabled cannot fall into either class of permanent disability.”
Gwynn, 304 Or at 351. What was left unsaid by the court in Gwynn, but which must follow, is that one who has been determined to suffer from permanent total disability cannot, by force of logic, be temporarily totally disabled as well.
Claimant argues that he is entitled to benefits under both categories, because two different insurers are involved. He contends that, although EBI is responsible for the permanent disability benefits, SAIF has an independent responsibility to pay temporary disability benefits for the time that he spent in the hospital for treatment of the back injury previously accepted by SAIF. That argument is not well taken. Once the Board determined that claimant was permanently and totally disabled, claimant was entitled to full wage-replacement benefits under ORS 656.206(2). Temporary total disability benefits are also wage-replacement benefits. Nothing in the relevant statutes suggests that a person who is receiving permanent and total wage replacement is entitled to receive additional wage-replacement benefits.
We find further support for our conclusion that PTD and TTD are mutually exclusive benefit categories in the fact that the legislature has recognized situations in which overlap of disability benefits may occur and has provided offset mechanisms to ensure against double recovery. See, e.g., ORS
Reversed.
The facts and timing of claimant’s injuries leading to his PTD status are found in EBI Companies v. Grover, 90 Or App 524, 526, 752 P2d 1274, rev den 306 Or 155 (1988).
Claimant did not appeal the partial denial, and we do not address it.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.