A pre-existing condition can complicate an Oregon workers' comp claim

April 08, 2014 (Press-News.org) A pre-existing condition can complicate an Oregon workers' comp claim

The workers' compensation system provides a safety net for employees who suffer serious on-the-job injuries. Unfortunately, studies conducted over the years show that many Oregon workplace accidents and injuries go unreported. Failing to report an injury or illness that appears minor at the time could cause problems down the road.

For example, a firefighter suffered a shoulder dislocation after a fall. She believed it was not serious and failed to report the injury. After years dealing with frequent dislocations, a MRI found surgery was necessary. If the firefighter was no longer at the same employer she might find it more difficult to bring a workers' compensation claim.

What if the initial injury happened while skiing? A subsequent workplace accident might aggravate the injury. The opinion of treating doctors along with medical records would be important to determine whether treatment for the injury would be covered by workers' comp.

Major contributing cause

Oregon statute defines "compensable injury" as an accidental injury that "arises out or in the course of employment." For the worsening of a pre-existing condition to be a compensable injury the workplace accident must be the "major contributing cause" of the condition.

A recent Oregon appeals case, SAIF Corp. v. Walker, upheld a board decision that the worsening of a L4-5 disc herniation was a "consequential condition" of a subsequent foot injury. The employee suffered an on-the-job injury while pushing heavy barrels. He was treated for the lower back injury. Two years later, a pallet jack fell on his left foot. The man also reported severe back pain, right leg pain and a limited range of motion in his lower back. A treating physician noted that he was compensating for the left foot, which aggravated the right leg symptoms and the back injury.

Another doctor performed an independent medical evaluation. He agreed that lower back treatment was necessary after the foot injury. But his opinion was that the foot injury was a "material" contributing cause not the "major" contributing cause of the back injury.

An Administrative Law Judge seized on the term "material" in denying the back injury claim. On appeal, the board reversed finding that the first doctor's opinion was better explained and more consistent with the injury. The Oregon Court of Appeals left the weighing of expert opinion to the board and agreed that substantial evidence supported the decision.

This case demonstrates some of the complexity of the Oregon workers' compensation system. A workers' comp attorney can explain how a medical opinion may impact your claim and fight to make sure you receive all the benefits to which you are entitled.

Article provided by Alvey Law Group
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