Flare-Ups, Aggravation, and Combined Conditions: When is Arthritis Compensable in Oregon workers’ compensation?
If a worker with longstanding cervical arthritis injures her neck while lifting a box at work, can the arthritis itself be a compensable condition under her workers’ compensation claim? In Oregon workers’ compensation law, arthritis is specifically listed as a pre-existing condition. Pre-existing conditions can be compensable only under certain circumstances, but the interplay and overlap of those circumstances creates a highly fact dependent field of analysis.
Underlying arthritis can be compensable if work activities are the major cause of a pathological worsening of the condition. A doctor might argue, for example, that a repetitive activity at work over a period of years sped along the degenerative process in a joint, leading to a quicker or more severe development of arthritis. This, however, is fairly rare and does not impact industrial injury claims, where compensable conditions must arise suddenly. An industrial injury might also superimpose onto the arthritis, in which case the relevant analysis typically comes down to whether any need for treatment of this combined condition is part of the natural development of the arthritis or whether the need for treatment is due in major part to the impact of the injury.
While these categories seem distinct at first glance, in practice the distinction becomes murky. What to make, for example, of a term frequently used by doctors, a “flare-up” of arthritis caused by a work injury? On one hand, a flare-up might connote a minor and temporary increase in symptoms. But if the flare-up requires temporary treatment and if the need for that treatment (as opposed to any long-term impact on the arthritis itself) is due in major part to a work injury, the entire arthritic process might become compensable.
The Board recently issued a decision which highlights the fine distinctions upon which these cases turn and the dramatic increase in liability which can result. In Jose H. Pimentel-Hurtado, 75 Van Natta 603 (2023), each doctor in the record determined the worker had suffered only a cervical strain, a minor condition usually resolving within weeks. They confirmed the injury was the major cause of the need for treatment of this strain. However, the worker’s doctors determined she was slower in recovery due to the complicating effect of her pre-existing cervical osteoarthritis. Each doctor described the strain as essentially a minor flare-up of the arthritis. They described a combined condition, but confirmed the combined condition of the sprain and the arthritis was caused in major part by the underlying arthritis.
However, the Board found the combined neck osteoarthritis condition to be compensable. The Board reasoned the combined condition itself, the “flare-up” of arthritis, might be due in major part to the development of the disease, but the need for treatment of the strain (and therefore of the “flare-up” in cervical arthritis symptoms) was caused in major part by the injury.
The Pimentel-Hurtado decision highlights the route by which a simple strain injury can lead to the compensability of underlying arthritis. As usual in workers’ compensation law, the difference comes down to the fine details in a doctor’s testimony. If you have any questions about an arthritis claim, flare-ups, or combined conditions, please contact me at or 971-867-2718.