Roy v. McCormack Pacific Co.

17 P.3d 550, 171 Or. App. 526, 2000 Ore. App. LEXIS 2122
CourtCourt of Appeals of Oregon
DecidedDecember 27, 2000
Docket97-00659; CA A105275
StatusPublished
Cited by3 cases

This text of 17 P.3d 550 (Roy v. McCormack Pacific Co.) 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
Roy v. McCormack Pacific Co., 17 P.3d 550, 171 Or. App. 526, 2000 Ore. App. LEXIS 2122 (Or. Ct. App. 2000).

Opinion

*528 EDMONDS, P. J.

In this workers’ compensation case, claimant seeks judicial review of an order of the Board, in which the Board upheld SAIF’s denial of compensation for claimant’s current condition and consequential injury. We reverse.

Claimant was injured twice. In August 1996, he suffered a torn meniscus in his left knee in a work-related accident (the August injury). The torn portion of the meniscus was surgically removed on October 1,1996. SAIF determined that claimant’s August injury and his resulting condition were compensable. It accepted a “left knee strain and contusion,” and “a grade 3 tear of the posterior horn of the medial meniscus, repaired on October 1, 1996, as a result of the work-related injury of August 14, 1996.” Claimant began to recover and was engaged in physical therapy when he injured the same knee again by falling on his way across a parking lot after a physical therapy appointment on October 25 (the October injury). SAIF became aware of the October injury through reports of claimant’s treating physician about the new injury and not because of any action on claimant’s part.

Before the October injury occurred, claimant’s physician had anticipated that claimant would be released for light-duty work in a few days and that he would be medically stationary by January or February 1997. After it occurred, the physician determined that the October meniscus tear was distinct from the August meniscus tear and that claimant’s'fall was only partially caused by the weakened state of his knee from the August injury. The physician reported that the August injury and claimant’s resulting condition was only a 25 percent factor in causing claimant to fall in October and that the October fall itself was the major cause of the October injury and claimant’s current condition.

When SAIF learned of the October injury, it determined that it had caused a “consequential condition.” 1 SAIF *529 concluded that because the October injury was caused only in minor part by the residual weakness remaining after the August injury, claimant’s current condition was no longer compensable. SAIF wrote claimant and denied coverage for his October injury and his post-October 25 condition, stating:

“We have recently received information that you sustained a new off work injury to your left knee on October 25, 1996. The new injury has been diagnosed as a Grade III retear of the posterior horn of the medial meniscus. Since your accepted claim is not the major cause of this new consequential injury, and since the new injury is the major cause of the your current disability and need for medical treatment, the new injury and your current condition on and after October 25, 1996 are not compensable in this claim.
“Therefore, we must issue this denial of your new consequential injury and current condition. SAIF Corporation will continue to provide medical benefits related to your accepted left knee strain and contusion.”

Claimant requested a hearing on the denial before the hearings division. He argued that his current condition was not a consequential injury and thus, not subject to a major contributing cause standard. He also argued that

“[t]he original injury cannot be denied by way of a current condition denial so long as that material relationship is present, and the claim has not been closed. The denial in this case, occurred prior to claim closure. See, ORS 656.262(7)(b) and Michael C. Leggett, 50 Van Natta 151 (1998) (preclosure denial not permitted unless insurer has accepted a combined condition.).”

The administrative law judge (ALJ) upheld SAIF’s denial, as did the Board on appeal by claimant. The Board specifically held that the October injury was a consequential *530 injury, that claimant’s current condition was therefore subject to the major contributing cause standard of proof, ORS 656.005(7)(a)(A), and that the evidence failed to show that the August injury was the major contributing cause of claimant’s post-October 25 condition. Its order states:

“We affirm the ALJ’s conclusion that claimant’s new meniscus tear is a noncompensable consequential condition under ORS 656.005(7)(a)(A). It, therefore, follows that claimant’s ‘current condition’ is not compensable so long as the new meniscus tear remained the major contributing cause of claimant’s disability and need for treatment. To conclude otherwise would circumvent the legislature’s intent in enacting ORS 656.005(7)(a)(A).
“Finally, we note that our decision does not effect [sic] SAIF’s continued responsibility for any future treatment and disability that is compensably related to the accepted August 14,1996 injury.”

Claimant now concedes that his October injury was a new, consequential injury, rather than a worsening or aggravation of the August injury or a new medical condition. However, he argues that: (1) the Board erred when it upheld the denial that SAIF issued without first closing the accepted claim, and (2) the Board erred when it failed to address the ruling of the ALJ that excluded two exhibits from the record. We address the latter issue first.

At the hearing before the ALJ in April 1997, claimant’s counsel requested that the record be left open for the specific, limited purpose of the admission of a later-scheduled deposition of Dr. Witczak. Claimant was granted leave to submit that deposition testimony when it was procured. SAIF submitted the transcript of Dr. Witczak’s deposition. On January 5,1998, the ALJ scheduled closing arguments to occur in the following weeks. On January 19, 1998, claimant offered a medical arbiter’s report dated July 1, 1997, and a hearings division December 31, 1997, opinion and order on claimant’s extent of disability from the August injury into evidence. After SAIF objected, the ALJ entertained arguments on the admissibility of the exhibits and ruled, denying claimant’s request to reopen the record for the admission of the exhibits. The ALJ reasoned that the medical arbiter’s report had been in existence for several months before it was *531 offered and that claimant offered no explanation for that delay. He also concluded that SAIF would be prejudiced by the admission of the report because it would not be able to cross-examine the physician who had prepared the report. As to the opinion and order regarding claimant’s permanent disability rating, the ALJ reasoned that it was inadmissible because it was then being challenged by claimant, and therefore was not a final order.

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Related

SAIF Corp. v. Krise
103 P.3d 1146 (Court of Appeals of Oregon, 2004)
Hewlett-Packard Co. v. Toy
23 P.3d 1015 (Court of Appeals of Oregon, 2001)
Roy v. McCormack Pacific Co.
19 P.3d 999 (Court of Appeals of Oregon, 2001)

Cite This Page — Counsel Stack

Bluebook (online)
17 P.3d 550, 171 Or. App. 526, 2000 Ore. App. LEXIS 2122, Counsel Stack Legal Research, https://law.counselstack.com/opinion/roy-v-mccormack-pacific-co-orctapp-2000.