325 P.3d 827
Or. Ct. App.2014Background
- Claimant sustained a November 2007 work-related left shoulder injury; SAIF accepted left shoulder strain and later AC sprain and rotator cuff tendinosis.
- SAIF denied permanent partial disability in 2009; the division reviewed and apportioned disability to accepted conditions.
- Claimant’s medical history includes surgery for left shoulder issues and multiple physicians diagnosing strain, sprain, impingement, SLAP tear, and AC joint problems.
- Diagnostic tests were ordered (EMG and triple-phase bone scan) to assess possible CRPS/RSD and extent of injury, but were denied by OHS.
- Board upheld current-condition denial while reversing to allow compensability of the diagnostic tests, relying on Lin’s opinions about extent of the accepted injury.
- Petitioners challenge both the current-condition denial and the diagnostic-test finding, arguing inconsistency and lack of sufficient explanation; the court affirms.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether board erred in upholding current-condition denial while approving diagnostic tests. | Petitioners contend no accepted condition supports the tests. | Board allowed tests to determine extent/causation under ORS 656.245(l)(a). | Affirmed |
| Whether the board properly relied on Lin's opinion to support test compensability while discounting it for current-condition denial. | Lin was contradictory; Swartz undermines his use. | Lin’s opinion supports testing to determine extent of the accepted injury. | Affirmed |
Key Cases Cited
- Counts v. International Paper Co., 146 Or App 768, 934 P.2d 526 (Or. App. 1997) (diagnostic testing payable if reasonable to uncover work-related issues)
- Faught v. SAIF, 70 Or App 388, 689 P2d 1038 (Or. App. 1984) (psychiatric evaluations payable in work-injury claims)
- Brooks v. D & R Timber, 55 Or App 688, 639 P2d 700 (Or. App. 1982) (diagnostic/therapeutic procedures may be paid even when unrelated to compensable injury)
- Swartz, 247 Or App 515, 270 P3d 335 (Or. App. 2011) (treatment compensability vs. extent distinctions subtle; not controlling here)
- Brown v. SAIF, 262 Or App 640, 325 P3d 834 (Or. App. 2014) (distinguishes compensable injury from accepted condition in context)
- Weiland v. SAIF, 64 Or App 810, 669 P2d 1163 (Or. App. 1983) (weighs medical opinions; consistent framework for evidence)
- Schleiss v. SAIF, 354 Or 637, 317 P3d 244 (Or. 2013) (separates issues of current-condition vs. extent of disability)