SAIF Corp. v. Williams, 381 P.3d 955

Background

Claimant injured his thoracic spine in a workplace fall in March 2006; SAIF accepted and closed a thoracic strain claim in 2006 with no permanent impairment awarded.
Over the next years claimant had ongoing thoracic pain; imaging showed multiple Tarlov cysts, largest at T5-6, and multiple treating physicians generally considered the T5 cyst an incidental finding.
Claimant consulted Dr. Feigenbaum (Kansas City), who agreed to operate after reviewing records and speaking with claimant about T5-dermatome symptoms; Feigenbaum did not personally examine claimant preoperatively in October 2010.
Feigenbaum performed left T5 surgery in November 2010 with near-complete symptom relief and later opined the 2006 injury rendered the T5 cyst symptomatic and required treatment; SAIF’s experts (Rosenbaum, Sabahi) disagreed and SAIF denied compensability.
An ALJ found compensability, the Workers’ Compensation Board affirmed (1-member dissent), relying in part on (erroneous) factual findings that Feigenbaum had examined claimant pre-surgery and that early 2006 records showed T5-dermatome/anterior chest radiation symptoms.
On judicial review petitioners challenged those factual findings; the court found both statements unsupported by the record, concluded the errors were not harmless, vacated and remanded for reconsideration.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the board relied on factual errors about Feigenbaum’s pre-op exam	Claimant: board’s statement that Feigenbaum examined claimant in Oct 2010 was harmless because Feigenbaum later examined claimant and operated successfully	Petitioners: board misstated that Feigenbaum examined claimant pre-op; that error improperly enhanced Feigenbaum’s opinion	Court: board erred; Feigenbaum did not personally examine claimant pre-op and the error could have affected the credibility choice — remand required
Whether the board correctly found early (2006) T5-dermatome/anterior-chest symptoms in Ha’s reports	Claimant: board merely quoted Ha and did not err in relying on those notes	Petitioners: Ha’s notes do not show T5-level or anterior-chest radiation symptoms in 2006	Court: board’s inference that Ha documented T5/anterior-chest symptoms in 2006 is unsupported by Ha’s reports and not supported by substantial evidence
Whether the board properly credited Feigenbaum over SAIF’s experts despite contested medical opinions	Claimant: other record evidence (expertise, operation success, history) supports crediting Feigenbaum	Petitioners: board’s credibility choice rested on the two factual errors which improperly discounted SAIF’s experts	Court: because board relied on the factual errors in choosing which expert to credit, the credibility determination may have been affected — remand for reconsideration
Whether the factual errors were harmless	Claimant: any errors were harmless given the overall record	Petitioners: errors were material to the board’s analysis	Court: errors were not harmless; impossible to know extent of their influence — vacate and remand

Key Cases Cited

Luton v. Willamette Valley Rehabilitation Center, 272 Or. App. 487 (review standards for board legal and factual determinations)
State Farm Ins. Co. v. Lyda, 150 Or. App. 554 (definition of substantial evidence)
De Los-Santos v. Si Pac Enterprises, Inc., 278 Or. App. 254 (claimant bears burden for new/omitted condition)
SAIF v. Alton, 171 Or. App. 491 (preponderance of medical evidence required for compensability)
Barnett v. SAIF, 122 Or. App. 279 (expert medical evidence required where causation is medical)
SAIF v. Pepperling, 237 Or. App. 79 (appellate review of board’s evaluation of expert opinions)
SAIF v. Calder, 157 Or. App. 224 (remand when board relied on unsubstantiated factual finding)
Driver v. Rod & Reel Rest., 125 Or. App. 661 (remand when error’s impact on outcome uncertain)
Skochenko v. Weyerhaeuser Co., 118 Or. App. 241 (remand where misinterpretation of medical evidence may have influenced result)