SAIF Corp. v. Camarena

332 P.3d 341, 264 Or. App. 400
CourtCourt of Appeals of Oregon
DecidedJuly 23, 2014
Docket120026M; A152627
StatusPublished
Cited by1 cases

This text of 332 P.3d 341 (SAIF Corp. v. Camarena) 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
SAIF Corp. v. Camarena, 332 P.3d 341, 264 Or. App. 400 (Or. Ct. App. 2014).

Opinion

LAGESEN, J.

SAIF Corporation seeks review of orders of the Workers’ Compensation Board holding that claimant is entitled to temporary disability benefits under ORS 656.278(l)(b) and awarding claimant attorney fees against SAIF under ORS 656.382(2) on reconsideration of the order awarding temporary disability benefits. SAIF contends that the board’s finding that claimant’s treating physician authorized temporary total disability “for * * * curative treatment” is not supported by substantial evidence in the record and that ORS 656.382(2) did not authorize the board to award attorney fees to claimant in connection with SAIF’s request for reconsideration of the board’s own-motion order awarding temporary disability benefits to claimant. We affirm.

I. BACKGROUND1

Claimant suffered a compensable left ankle injury in March 2003 while at work for a company insured by SAIF. On August 15, 2011, claimant’s left ankle gave out, and, as a result, claimant suffered an injury to his back. Claimant reported the injury to his attending physician, Dr. Vaughan, the next day. Claimant and Vaughan filled out a Workers’ Compensation Division Form 827, “Worker’s and Physician’s Report for Workers’ Compensation Claims.” Vaughan made several findings on the form, including that claimant’s mid back was injured, that it was tender, that spasms in his back were likely, that claimant’s injury was not medically stationary, and that claimant was authorized for temporary disability with full release from work at least until claimant’s follow-up appointment 10 to 14 days later. Vaughan also prescribed a treatment plan of “pain pills, muscle relaxers, ice, [and] heat.” Vaughan did not write anything in the section of the form asking for a “ [p] alliative care plan/justification.”

Vaughan continued treating claimant for several months. At one of his appointments with Vaughan, on October 11, 2011, claimant and Vaughan completed another Form 827 in which claimant reiterated how he was injured, [402]*402and Vaughan again noted that claimant’s injury was not medically stationary, continued the authorization of full release from work, and again left blank the section of the form for describing a palliative care plan. Vaughan referred claimant for an MRI on October 14, 2011, which showed no significant structural damage, but did indicate myofascial spasms.

A month later, Vaughan authorized claimant’s return to light-duty work, prescribing “no heavy lifting (10 lbs or less). No prolonged standing. Limited bending and twisting.” On November 21, 2011, Vaughan responded to a request for information about claimant’s condition from SAIF. In her response, Vaughan noted that claimant was not yet medically stationary, that he had been referred to physical therapy, and that, if claimant continued to show no improvement, she was considering referring him to a physical medicine and rehabilitation specialist. On February 6, 2012, Vaughan released claimant “back to work at his own discretion.”

Two days later, claimant began treatment with Dr. Wagner, a physical medicine and rehabilitation doctor, following a referral by Vaughan. Wagner noted that claimant’s pain ranged from a four out of 10 to a 10 out of 10 and that his pain was alleviated by “sitting in his recliner, pain medications, chiropractic manipulation, massage, [and use of a] TENS unit.”2 Wagner further noted that he “would’ve expected the strain, by definition, to be resolved” by the time of the appointment. Wagner prescribed a SPECT scan3 “to evaluate for a hot facet/capsular strain which may be the culprit for his delayed healing,” but if that scan came back negative, Wagner believed that 12 visits for “aggressive rehabilitation” could bring about “case closure without permanent restrictions or permanent partial disability based on the accepted thoracic strain.” Claimant went back [403]*403to Wagner for a follow-up on March 7, 2012, after getting the SPECT scan. According to Wagner, the SPECT scan results were “reassuring,” which led Wagner to opine that claimant’s ongoing pain was the result of “body habitus and inadequate rehabilition.” Wagner recommended aggressive rehabilitation and that claimant discontinue use of opioids “as patient is past the acute phase of the injury.”

Vaughan saw claimant two days later, on March 9, 2012. Vaughan noted that the SPECT scan results “showed no pathology” and diagnosed claimant with thoracic strain and myofascial pain “secondary to the on the job injury.” She further noted that claimant had been feeling better after using the TENS unit and going to physical therapy.

On March 13, 2012, claimant sought own-motion relief from the board due to SAIF’s failure to award claimant temporary disability benefits for the new or omitted medical condition of a mid-back strain. Claimant also sought penalties and penalty-related attorney fees under ORS 656.262(ll)(a), which provides for penalties and related attorney fees if the carrier “unreasonably delays or unreasonably refuses to pay compensation, or unreasonably delays acceptance or denial of a claim.” ORS 656.262(ll)(a). The board granted relief, concluding that claimant was entitled to temporary disability benefits for the new or omitted medical condition under ORS 656.278(l)(b). The board declined to award penalties or related attorney fees. Board member Langer dissented.

SAIF sought reconsideration of the board’s determination that claimant was entitled to temporary disability benefits, which the board ultimately denied. The board also awarded claimant attorney fees on reconsideration under ORS 656.382(2). Board member Langer continued to dissent on the issue of whether claimant ought to be awarded temporary disability benefits. SAIF then sought reconsideration again, arguing that ORS 656.382(2) did not authorize attorney fees on reconsideration of an own-motion order of the board. The board disagreed.

SAIF timely sought review of the board’s orders in this court. In its first assignment of error, SAIF contends [404]*404that the board’s finding that Vaughan’s authorization of temporary disability was “for curative treatment” is not supported by substantial evidence and that, consequently, claimant is not entitled to temporary disability benefits under ORS 656.278(l)(b). In its second assignment of error, SAIF challenges the award of attorney fees to claimant, arguing that the board misconstrued ORS 656.382

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Cite This Page — Counsel Stack

Bluebook (online)
332 P.3d 341, 264 Or. App. 400, Counsel Stack Legal Research, https://law.counselstack.com/opinion/saif-corp-v-camarena-orctapp-2014.