Background

• Claimant, a loan document specialist, fell during a morning break in employer’s lunchroom and sustained injuries to the head, left shoulder, right wrist, and right toe.
• The Workers’ Compensation Board upheld the employer’s denial of the claim, and claimant sought judicial review.
• Claimant has Churg-Strauss Syndrome (CSS) with treatments for related symptoms and sleep apnea.
• An IME by Dr. Green could not identify a definite cause and noted CSS-related balance issues could contribute to a fall; he later suggested CSS or sleep apnea were possible factors.
• The ALJ found the fall compensable as an unexplained fall after crediting Green’s report against earlier statements; the Board reversed, concluding the fall was not compensable due to potential idiopathic causes.
• The central legal issue is whether the fall arose out of the claimant’s employment, under ORS 656.005(7)(a), with the burden on claimant to prove compensability by a preponderance of the medical evidence.

Issues

Key Cases Cited

• McTaggart v. Time Warner Cable, 170 Or App 491 (Or. App. 2000) (unexplained fall requires elimination of idiopathic factors)
• SAIF v. Uptegrove, 226 Or App 45 (Or. App. 2009) (two-prong course-and-arising-out test; burdens on claimant)
• Phil A. Livesley Co., 296 Or 25 (Or. 1983) (idiopathic factors may cause a fall; compensable only if idiopathic factors are eliminated)
• Mackay v. SAIF, 60 Or App 536 (Or. App. 1982) (equally possible idiopathic vs work factors; not compensable)
• Garcia v. Boise Cascade Corp., 309 Or 292 (Or. 1990) (substantial-evidence standard for review of board findings)