March 5, 2024
by Andrew Evenson

Ordered to accept a new/omitted condition in Oregon? Combined condition processing remains a responsive option

On January 9, 2024, the Workers’ Compensation Board ruled in Maria F. Opferman, 76 Van Natta 10 (2024), that the employer’s post-litigation acceptance of a concussion combined with a preexisting condition was valid. Through prior litigation, an administrative law judge (ALJ) ordered the employer to accept a concussion. In lieu of accepting a concussion as a standalone condition, the employer generated medical evidence to support combined condition processing. It then accepted the claim for a concussion combined with underlying depression and, thereafter, it issued a combined condition “ceases” denial.

Claimant’s counsel appealed the “ceases” denial and also alleged a de facto denial of the concussion condition that a prior ALJ deemed compensable. Claimant’s counsel argued that the employer’s acceptance of a concussion as a combined condition was deficient and, rather, that the ALJ’s prior order required the employer to accept and process a concussion as a standalone condition. Ultimately, the Board disagreed and affirmed the employer’s processing of a concussion as a combined condition, as well as the employer’s “ceases” denial. In reaching that conclusion, the Board found that the ALJ’s prior order did not otherwise direct the employer to accept a concussion as a standalone condition. Rather, it ordered the employer to process the condition according to law, and it left open the question of how to process the condition to the employer. So, the Board found that the employer met all of its burdens of proof to support the combined condition processing and “ceases” denial, which it affirmed.

Combined condition processing is a complex process, and it is the employer’s burden of proof to meet its valid criteria. This case presented an interesting analysis on that process, and it affirmed the employer’s aggressive processing response to a previously-unfavorable litigation order. If you have any questions regarding combined condition processing, litigation analysis and recommendations, and/or any other Oregon workers’ compensation topics, please contact me at 503-595-6109 or .

Posted by Andrew Evenson.