Category: Caselaw Update
Oregon Court of Appeals further defines susceptibilities or predispositions vs. preexisting conditions.
The Oregon Court of Appeals recently decided another case addressing what qualifies as a preexisting condition. Doris L. Lowells v. SAIF, 285 Or App 161 (2017). In Lowells, the court confirmed “chronic pain disorder” was not a compensable occupational disease because the major cause of the condition was claimant’s weight,…
What can Brown do for you? In a long-awaited decision, the Oregon Supreme Court reverses Brown v. SAIF
It has been almost three years since the Oregon Court of Appeals issued its decision in Brown v. SAIF, 262 Or App 640 (2014), finding that a “compensable work injury” referred to the injurious incident and all the conditions that flowed from it, accepted or not. The case was appealed…
LHWCA Caselaw Summary
The following is a review of recent relevant Longshore and Harbor Workers’ Compensation Act caselaw. There were relatively few decisions and none created new law with the possible exception of the 4th Circuit’s decision in Metro Machine Corporation. The Benefits Review Board issued 13 LHWCA decisions in November, 5 in…
Claimant only required to show idiopathic factors were less likely to have caused unexplained injury
The Oregon Court of Appeals established new case-law on claimant’s burden of proof in “unexplained fall” claims. If an injury is unexplained, as a matter of law, it is presumed to arise out of employment. Whether an injury is unexplained, is a question of fact. An injury is only deemed truly…
“Good cause” for untimely injury filing does not require medical evidence
Under 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;…
Claimant’s request for hearing on 10 year old denial is untimely.
On October 26, 2006, SAIF issued a denial of claimant’s injury claim. The denial was mailed via certified mail and a person who identified himself as claimant signed for the denial. In June 2015, claimant requested hearing on the denial. Claimant testified that the address the denial was sent to was…
Pohrman Lives On
U.S. Bank v. Pohrman, 272 Or App 31 (2015), the Court of Appeals case that determined an injury suffered while an employee is on break can be compensable, lives on in recent Board cases. In Angelina Cox, 68 Van Natta 792, the employer required all employees to take two paid…
Do you know your employer sponsored wellness program can create Workers Compensation Liability?
An employee twisted her knee while walking – she was off the clock, on a lunch break, and walking off the employer’s premises. However, because she was walking as part of a “walking program” promoted by the employer, she was entitled to receive Workers’ Compensation benefits. Employees were not required…
Pre-Authorization of Medical Services: New Guidance From WCD
The WCD issued a significant decision addressing an insurer’s obligation to respond to requests for pre-authorization by medical providers. Our rules impose specific processing requirements related to elective surgery or diagnostic imaging, but adjustors frequently receive requests to pre-authorize other therapies and referrals. The provider wants to be sure they…
Workers’ Compensation Board confirms permanent impairment is awarded based on accepted conditions or their direct medical sequelae; distinguishes recent Court of Appeals case.
The Workers’ Compensation Board recently ruled that permanent impairment awarded based on the accepted conditions and their direct medical sequelae. See William Snyder, 68 Van Natta 199 (2016). Although Board’s ruling is nothing new, Snyder is significant given a footnote in the recent Court of Appeals case Magana-Marquez v. SAIF,…
When is a worker a “subject worker?”
The vast majority of workers in Oregon will be subject to the workers compensation system, with some exceptions. It is important to consider whether an injured worker is a subject worker when investigating the claim. Two recent cases address this important question. Carpenter hired to remodel apartment on a couple’s farm not…
SBH Client Prevails on Rare Self-Injury Defense
Attorneys Brian Perko and Rebecca Watkins recently secured a decision from the Oregon Court of Appeals upholding a denial based on the defense that the worker intentionally caused himself injury. If an injury occurs from the deliberate intention of the worker to produce such injury, it is not compensable and…
Court of Appeals confirms no permanent disability awarded when work injury has no contribution to claimant’s impairment.
There have been many new issues in claim processing and particularly in rating permanent impairment after Brown/Schleiss and the WCD’s new closure rules. One particular argument we have seen from claimant’s counsel is that all of a worker’s physical limitations (restricted range of motion, loss of sensation, etc.) should be…
Attorney fees awarded when carrier rescinds denial of authorization for medical services
The Oregon Court of Appeals recently ruled that a claimant’s attorney is entitled to a fee when an insurer/self-insured employer rescinds a denial of authorization for medical services. SAIF v. Bales, 274 Or App 700 (2015). This means when a carrier denies authorization of medical treatment, rescinds the denial, and the…
Applicant Injured on way to Orientation is not a Subject Worker
In a recent Oregon Workers’ Compensation Board case, the Board found an applicant who was injured on her way to orientation on the employer’s premises was not a covered worker. In Mary K. Meyers, 67 Van Natta 1725 (2015), claimant applied for a telemarketing position, completed a written application and…
Claimant’s Testimony of “Lifting Kegs” Not Enough for Increased Work Disability Award
A line cook was injured and his claim was closed with 11% whole person impairment and 27% work disability. On Reconsideration, the worker submitted an affidavit outlining his job duties. He claimed his job required physical activity qualifying for classification as “very heavy.” He described being required to lift full…
