439 P.3d 1011
Or. Ct. App.2019Background
- Claimant has a congenital unfused apophysis of the fifth metatarsal and developed work‑related traction apophysitis while walking at a hospital job.
- Medical opinions conflicted: treating Dr. Loveland attributed apophysitis to repetitive walking (work) while SAIF's Dr. Fellars saw only exacerbation, not pathological worsening.
- ALJ and Workers' Compensation Board found work was the major contributing cause and characterized the apophysis as a "passive contributor" that merely increased susceptibility.
- Statutory framework: ORS 656.802 requires the worker to prove employment was the major contributing cause of an occupational disease; ORS 656.005(24)(b) defines a preexisting condition in occupational disease claims as one that "contributes to disability or need for treatment."
- Lower courts applied precedent (Spurgeon, Buckallew, Obie, Murdoch) distinguishing causes from mere predispositions; SAIF argued the board misapplied the law by treating a possible contributing congenital condition as a non‑preexisting susceptibility.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether an unfused apophysis is a "preexisting condition" under ORS 656.005(24)(b) for occupational disease causation | Apophysis merely predisposed claimant to apophysitis; it did not actively contribute, so it is not a preexisting condition to be weighed | The unfused apophysis actively contributed to the inflammation and therefore is a preexisting condition that must be considered under ORS 656.802(2)(e) | Court held board erred; remanded to resolve inconsistency in medical findings and apply correct legal standard regarding contribution |
| Whether ORS 656.005(24)(c) (exclusion of mere susceptibility) applies to occupational disease claims | N/A (board used (24)(c) to exclude susceptibility) | SAIF: (24)(c) applies only to injury claims; occupational disease analysis must use (24)(b) and ORS 656.802(2)(e) | Court agreed (24)(c) is inapplicable to occupational disease claims and reaffirmed that susceptibilities not actively contributing are not considered causes, but must be analyzed under (24)(b) and ORS 656.802(2)(e) |
| Proper standard for weighing preexisting conditions in occupational disease causation | Predispositions that do not actively contribute should not be weighed | Preexisting conditions that contribute to disability/need for treatment must be treated as causes and weighed in major‑contributing‑cause analysis | Court reaffirmed that only preexisting conditions that actively contribute are considered causes; if a condition only passively predisposes, it should not be weighed, but the board must resolve medical inconsistencies on contribution |
| Whether the board’s factual finding (apophysis only increased susceptibility) was supported by substantial evidence | Claimant/board: Loveland’s opinion supported susceptibility finding | SAIF: Loveland’s description suggests the apophysis mechanically caused inflammation, so the board’s finding is inconsistent and unsupported | Court found the board’s finding not supported by substantial evidence given the apparent inconsistency and remanded for reconsideration |
Key Cases Cited
- Dethlefs v. Hyster Co., 295 Or. 298 (1983) (occupational disease compensable if work is major contributing cause)
- Liberty Northwest Ins. Corp. v. Spurgeon, 109 Or. App. 566 (1991) (distinguishes causes from predispositions in causation analysis)
- Portland Adventist Med. Ctr. v. Buckallew, 124 Or. App. 141 (1993) (predisposition can be distinct from cause; work may still be major cause)
- Multnomah County v. Obie, 207 Or. App. 482 (2006) (interprets 2001 statutory amendments; predispositions that do not contribute are not preexisting conditions in occupational disease context)
- Murdoch v. SAIF, 223 Or. App. 144 (2008) (preexisting conditions that merely render claimant susceptible are not causes for occupational disease)
- Corkum v. Bi‑Mart Corp., 271 Or. App. 411 (2015) (interprets "susceptible" to mean increased likelihood without active contribution)
- Lowells v. SAIF, 285 Or. App. 161 (2017) (worker personal factors count only if they are causes, not mere susceptibilities)