SAIF Corp. v. Nehl

939 P.2d 96, 148 Or. App. 101, 1997 Ore. App. LEXIS 643
CourtCourt of Appeals of Oregon
DecidedMay 21, 1997
Docket95-03780; CA A92311
StatusPublished
Cited by8 cases

This text of 939 P.2d 96 (SAIF Corp. v. Nehl) 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. Nehl, 939 P.2d 96, 148 Or. App. 101, 1997 Ore. App. LEXIS 643 (Or. Ct. App. 1997).

Opinion

*103 WARREN, P. J.

In this workers’ compensation case, SAIF Corporation (SAIF), as the employer’s insurer, seeks review of an order setting aside its denial of claimant’s low back injury claim. The Board held that surgery to repair claimant’s preexisting spine fusion hardware was compensable under ORS 656.005(7)(a)(B) because his on-the-job injury constituted the major contributing cause of claimant’s need for treatment for his combined condition. We affirm.

We take the facts from the administrative law judge’s (ALJ) findings of fact, which the Board adopted on its review and which SAIF does not challenge. Claimant began employment as an Adult Parole and Probation Officer with the State of Oregon in the late 1970’s. In 1992, he sustained a noncompensable low back injury and underwent a left L3-4 microdiscectomy. In January 1993, he experienced a recurrent disk herniation and a second L3-4 microdiscectomy was performed in October 1993. Claimant experienced ongoing low back and left leg symptoms that were diagnosed as “status post repeat L3-4 discectomy and spondylolysis of L5.” Claimant’s symptoms did not improve, and he underwent a surgical fusion from L3 to the sacrum with the installation of Steffe plates, which were secured to the spine with screws. Claimant continued to experience ongoing, constant low back aching and left leg pain after the fusion but returned to work nonetheless.

On January 10, 1995, claimant’s treating physician examined him after he complained of continuous low back and left leg pain plus bilateral hip and groin pain. Physical therapy was prescribed and x-rays were taken on February 6, 1995.

On February 8,1995, claimant squatted to talk with a mental health patient. When he stood up, he experienced a change in his back pain. Later that day, claimant attempted to help the same patient to her feet. Again, claimant experienced a different sensation in his back. Following a tense encounter with the patient, claimant began to notice more intense pain in his low back. He then experienced more back, buttock and thigh pain on the right side than was typical for *104 him at that time. On February 14, 1995, claimant filed a claim for low back injury. SAIF denied the claim by letter dated March 13,1995. 1

On March 13, 1995, claimant was examined by Dr. Misko and x-rays were taken. Claimant was found to have loss of bone around the screws in the L3 vertebrae. In June 1995, he underwent a fourth surgery on his low back.

After a hearing, the ALJ set aside SAIF’s denial because “claimant’s otherwise compensable on-the-job injury was the major contributing cause of the need for treatment of his combined low back condition.” 2 ORS 656.005(7)(a)(B). 3 SAIF sought review before the Workers’ Compensation Board (the Board), which adopted and affirmed the ALJ’s order. This petition followed.

We review the Board’s legal conclusions for errors of law, ORS 183.482(8)(a), and determine whether its findings are supported by substantial evidence in the record. ORS 183.482(8)(c).

On review, SAIF argues that the Board erred in its application of the “major contributing cause” standard under ORS 656.005(7)(a)(B). Claimant responds that the Board properly applied the statute and that its findings are supported by substantial evidence.

*105 The Board, in adopting and affirming the ALJ’s order, explained its application of the statute as follows:

“The focus of the fact finder in determining the applicability of ORS 656.005(7)(a)(B) is on the entire combined condition. It requires a determination of the relative contributions to the need for treatment of the combined condition or to the disability arising from the combined condition.
“Here, the existence of claimant’s claimed combined condition is undisputed. So is the fact that claimant’s combined condition required medical treatment. The evidence establishes those facts without contradiction.
“* * * In this case the ‘combined condition’ is claimant’s post surgical low back with loosened hardware.
‡ * * *
“It is important to note in this case that the surgical treatment being claimed (the surgical repair of the failed fusion instrumentation) is directed at a very specific and limited part of claimant’s ‘combined condition.’ * * *
“ORS 656.005(7)(a)(B), and the legislative history behind that provision, make clear that if claimant’s otherwise compensable injury is the major contributing cause of the specific need for treatment of claimant’s combined condition, then that treatment is compensable. That is true even though claimant’s disability may not have been caused in major part by the otherwise compensable injury.” (Footnote omitted.)

SAIF contends that the Board misapplied the statute because it ignored claimant’s “entire” condition and dealt only with the question of what caused the loosened screws. The problem with that approach, SAIF maintains, is that it “emphasizes the event that precipitated claimant’s need for medical treatment, and not the entire collection of events and [factors] that contributed to the [cause of the need for medical treatment of his combined condition].” SAIF argues that claimant must show that his entire combined condition, not just his specific need for treatment, was caused in major part by his on-the-job injury. In that light, SAIF maintains that claimant’s surgical treatment is not compensable because claimant’s preexisting low back condition, which encompasses three surgeries, the installation of the screws and his *106 ongoing low back, leg and groin pain, greatly outweighs the relative contribution of his on-the-job injury to the causation of claimant’s entire low back condition.

According to SAIF, the issue here is whether the term “combined condition” is limited to the condition for which claimant seeks treatment or whether it also encompasses all of claimant’s preexisting low back problems.

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Related

Brown v. SAIF Corp.
325 P.3d 834 (Court of Appeals of Oregon, 2014)
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51 P.3d 632 (Court of Appeals of Oregon, 2002)
Schuler v. Beaverton School District No. 48J
48 P.3d 820 (Oregon Supreme Court, 2002)
Saif Corp. v. Bryant
21 P.3d 1104 (Court of Appeals of Oregon, 2001)
Franke v. Lamb-Weston, Inc.
997 P.2d 876 (Court of Appeals of Oregon, 2000)
Schuler v. Beaverton School District No. 48J
992 P.2d 467 (Court of Appeals of Oregon, 1999)
Gray v. Western Panel Mfg & EBI Companies
986 P.2d 1249 (Court of Appeals of Oregon, 1999)
SAIF Corp. v. Nehl
942 P.2d 859 (Court of Appeals of Oregon, 1997)

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Bluebook (online)
939 P.2d 96, 148 Or. App. 101, 1997 Ore. App. LEXIS 643, Counsel Stack Legal Research, https://law.counselstack.com/opinion/saif-corp-v-nehl-orctapp-1997.