Reynolds v. USF Reddaway, Inc.

394 P.3d 998, 283 Or. App. 21
CourtCourt of Appeals of Oregon
DecidedDecember 21, 2016
Docket1204682; A157147
StatusPublished
Cited by3 cases

This text of 394 P.3d 998 (Reynolds v. USF Reddaway, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals of Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reynolds v. USF Reddaway, Inc., 394 P.3d 998, 283 Or. App. 21 (Or. Ct. App. 2016).

Opinion

ARMSTRONG, R J.

Claimant seeks review of an order of the Workers’ Compensation Board holding that his claim for a new/ omitted medical condition for an L5-S1 disc herniation is barred by claim preclusion or the “law of the case.” Reviewing the board’s order for substantial evidence and legal error, ORS 183.482(8)(a), (c), we conclude that the claim is not barred, and we therefore reverse and remand for consideration of the claim’s compensability.

Claimant began working for employer as a truck driver in 1989 and injured his back at work on January 28, 2011, when the seat of his truck collapsed as he was sitting down, jarring his low back. An MRI of February 14, 2011, revealed possible causes of claimant’s pain:

“[T]here may be some discogenic material in close apposition to the proximal SI nerve root. Vague suggestion that the proximal left SI nerve root may be minimally swollen. Also is some bony spurring centrally and to the left.”

Employer’s workers’ compensation claims processing agent, Gallagher Bassett, accepted a claim for a disabling lumbar strain and processed the claim to closure in March 2011.

On April 1, 2011, based on the recommendation of his physician, claimant requested acceptance of a new/ omitted medical condition that he described as a “herniated disc of my L5/S1.” But an MRI taken on April 8, 2011, revealed “mild bulging” and “no evidence for disk herniation.”1 Gallagher Bassett denied the claim by a letter of June 3, 2011, stating, “Based on our investigation of this matter your work accident of January 28, 2011, did not com-pensably result in an L5-S1 disc herniation.” Claimant did not seek a hearing, and the denial became final.

In May 2011, claimant began working for a different employer. Beginning in October 2011, claimant’s symptoms became worse, and he sought treatment for back pain and pain down his leg and into his foot. An MRI of January 9, [23]*232012, identified a “focal left lateral disk protrusion” that had “slightly increased in size and conspicuity” since the April 8, 2011, MRI. Claimant continued treatment with steroid injections.

When the steroid injections did not provide relief, Dr. Hansen, claimant’s treating physician, ordered a fourth MRI. That MRI, taken May 15, 2012, was read to show a large disc herniation:

“Large inferiorly extruded left central disc herniation and L5-S1 with posterior displacement and compression of the left SI nerve root and mild compression of the left L5 nerve root.”

Hansen performed surgery, removing a disc extrusion and a small osteophyte. On July 31, 2012, Hanson signed a form 827 for a new/omitted condition claim for L5-S1 disc herniation. Gallagher Bassett denied the claim in a letter of August 12, 2012, stating, again, “Based on our investigation of this matter your work accident of January 28, 2011, did not compensably result in an L5-S1 disc herniation.” Claimant requested a hearing.

In a letter to claimant’s counsel in January 2013, Hansen reported his findings based on the surgery and the four MRIs. Hansen opined that, at the time of the work injury of January 28, 2011, claimant had suffered an injury to his L5-S1 disc in the form of a disc displacement or protrusion, which doctors at that time did not diagnose and which resulted in L5 nerve root irritation and lumbar radiculitis.2 Hansen opined that the disc injury gradually worsened from a displacement and protrusion to a herniation or extrusion, “not by any additional injury or traumatic event, but by an expected natural progression of that injury.”

Dr. Yodlowski reviewed the medical record on behalf of Gallagher Bassett. She opined that, although the work injury was the precipitating cause of the need for treatment, there was no L5-S1 disc herniation, and that the cause of [24]*24claimant’s condition was the chronic long-term consequence of degenerative disease.

At the hearing, Gallagher Bassett asserted that claimant’s new/omitted condition claim for a disc herniation was barred by claim preclusion because the June 3, 2011, denial of the same condition had become final. An administrative law judge (ALJ) rejected the assertion, finding that claimant’s L5-S1 disc condition had worsened since the June 3, 2011, denial. The ALJ further found that the worsening was related to the original injury and determined that the claim was compensable.

The board adopted the ALJ’s findings but determined that the claim was barred because it was based on the same “operative facts” as those underlying the June 3, 2011, denial of the initial new/omitted condition claim. In the alternative, the board held that the June 3, 2011, denial established the “law of the case” that there was no causal relationship between the L5-S1 disc herniation and the com-pensable injury. On judicial review, claimant contends that the board erred in determining that the claim was barred.

We readily reject the board’s conclusion that the June 3, 2011, denial constituted the “law of the case.” As we recently said in ILWU, Local 8 v. Port of Portland, 279 Or App 157, 164, 379 P3d 1167, rev den, 360 Or 422 (2016), the law-of-the-case doctrine is preclusive only with respect to a prior ruling or decision of an appellate court as opposed to a trial court or administrative body.

We also reject the board’s conclusion that the claim was barred by claim preclusion. The doctrine applies in the workers’ compensation context, Drews v. EBI Companies, 310 Or 134, 795 P2d 531 (1990), and generally bars relitigation of a claim based on the “same factual transaction” that was or could have been litigated between the parties in a prior proceeding that has reached a final determination. Casey v. City of Portland, 277 Or App 574, 372 P3d 571 (2016); Liberty Northwest Ins. Corp. v. Rector, 151 Or App 693, 698, 950 P2d 387 (1997); SAIF v. Hansen, 126 Or App 662, 664-65, 870 P2d 247 (1994). Oregon takes a “transactional” approach to what constitutes a “claim” for purposes of claim preclusion, meaning that a claim is not defined by the particular form [25]*25or proceeding by which relief is sought, but by “ ⅛ group of facts which entitled [the claimant] to relief.’” Drews, 310 Or at 146 (quoting Troutman v. Erlandson, 287 Or 187, 201, 598 P2d 1211 (1979)).

We have had many opportunities to address the application of claim preclusion and its exceptions in the workers’ compensation context. One common exception precludes application of the doctrine when the claimant’s condition has changed since the prior litigation. For example, in Kepford v. Weyerhauser Co., 77 Or App 363, 366, 713 P2d 625, rev den, 300 Or 722 (1986), we held that a change in the claimant’s condition and the existence of post-surgical findings concerning the cause of the condition constituted a new set of facts that could not have been litigated in the earlier proceeding. In Liberty Northwest Ins. Corp. v. Bird, 99 Or App 560, 564, 783 P3d 33 (1989), rev den, 309 Or 645 (1990), we said that a change in an injured worker’s condition could constitute a new set of operative facts that previously could not have been litigated and that would prevent application of claim preclusion. See also Yi v. City of Portland,

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Bluebook (online)
394 P.3d 998, 283 Or. App. 21, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reynolds-v-usf-reddaway-inc-orctapp-2016.