Dedera v. Raytheon Engineers & ConstrsDedera v. Raytheon Engineers & Constrs
Claimant seeks review of a Workers’ Compensation Board (board) order denying claimant temporary disability benefits. He contends that the board erred in construing
The pertinent facts are undisputed. Claimant sustained a compensable low-back injury in November of 1997 while working for employer as a carpenter. The claim for that condition was closed in May of 1998 and ultimately claimant received an award of five percent unscheduled permanent disability.
On February 26, 1999, claimant sought treatment from Dr. Zirkle, an orthopedic surgeon, for constant pain in his low back and for pain and numbness in his left leg. Zirkle diagnosed nerve root irritation from a probаble disc herniation, prescribed medication, and recommended that claimant see a neurosurgeon. Claimant returned to Zirkle in August of that year, reporting that he had been “shopping around from doctor to doctor” but had been unable to see a neurosurgeon because his claim was closed. Zirkle again examined claimant and determined that he should be considered for surgical intervention. On August 18, 1999, in оrder to help claimant get his claim reopened, Zirkle filled out a “Notice of Claim for Aggravation” authorizing “time loss” (that is, temporary disability) from “2-26-99 — present.”
Zirkle then referred claimant to Dr. Cindrich, a neurosurgеon, who saw claimant on August 31, 1999. Cindrich ordered an EMG and, on review of that, an MRI. He made no attempt to authorize temporary disability on seeing
On September 1, 1999, the insurer wrote to Zirkle requesting confirmation that he was claimant’s current attending physician. A member of Zirkle’s staff wrote back that he was not сlaimant’s attending physician.
The insurer began paying interim compensation on September 2, 1999. Those payments ended as of November 15,1999, when the insurer issued an aggravation denial, and claimant requested а hearing. Then, in February of 2000, claimant requested that the insurer accept the “new condition” of “L4 radiculopathy secondary to L3-4 disc herniation.” Although the insurer partially denied that claim as well, the boаrd set aside the denial in March of 2001. Insurer then accepted claimant’s new condition but did not pay any additional temporary disability on reopening the claim, stating that there was no express authorizаtion for such benefits as of September 1,1999, when Zirkle’s office had indicated that he was not claimant’s attending physician. On May 1, 2001, claimant saw Cindrich again, and Cindrich retroactively authorized temporary disability from September 1,1999, forward, indicating that claimant was “totally incapacitated.” Because
Claimant requested a hearing, seeking an award of temporary disability from August 4, 1999 (14 days before Zirkle’s original authorization) to April 17,2001 (the date the insurer commenced disability payments). An administrative law judge denied claimant compensation for that period, finding that no attending physician had properly authorized time loss for that period.
On appеal, the board found that Zirkle was claimant’s attending physician at the time he authorized time loss.
Claimant argued on reconsideration that the board had deviated from its prior holding in Debra D. Osler, 53 Van Natta 343 (2001). In Osler, the claimant’s attending physician authorized temporary disability and withdrew as claimant’s attending physician in the same chart note. Id. at 343. The employer contended that, because the physician withdrew as the attending physician, the physician’s authorization of temporary disability expired on that datе. Id. The board disagreed, explaining that “[a] claimant is entitled to temporary disability for those periods of time for which there is authorization from an attending physician” under
In its order on reconsideration, the board distinguished Osler, noting that there the claimant had not obtained a new attending physician after the first one withdrew. Here, thе board reasoned, claimant’s acquisition of a new attending physician (Cindrich) rendered ineffective Zirkle’s time-loss authorization. Accordingly, once Cindrich assumed the role of attending physician on August 31,1999, only he could authorize temporary disability. Because Cindrich gave no such authorization until May 1, 2001, the board held that temporary disability was lawfully denied from September 1, 1999 to April 17, 2001 (14 days before issuance of that authоrization).
“Temporary disability compensation is not due and payable pursuant toORS 656.268 after the worker’s attending physician * * * ceases to authorize temporary disability or for any period of time not authorized by the attending physician * *
Accordingly, in determining whether Zirkle’s time-loss authorization expired when claimant changed attending physicians, we must determine (1) whether claimant’s attending physician “cease[d] to authorize temporary disability” or (2) whether the time period of temporary disability at issue was “not authorized by the attending physician.”
The first level of statutory analysis we must undertake under PGE v. Bureau of Labor and Industries,
We begin with the question of whether claimant’s attending physician “cease[d] to authorize tеmporary disability.” As commonly understood, to “cease” means “to put a stop
We turn to the question of whether the “period of time” at issue was “not authorized by the attending physician” under
In sum, Zirkle was the attending physician at the time that he authorized temporary disability for claimant, and he granted an open-ended authorization. He did not “cease” that authorization when Cindrich became claimant’s
Reversed and remanded for reconsideration.
Notes
Because of this disposition, we do not reach claimant’s alternative assignment of error.
Zirkle later confirmed that his authorization of temporary disability to the “present” was intended to аpply prospectively into the future until the condition was treated, rather than merely to the day of his authorization.
Practically speaking, nothing about Cindrich’s assumption of that role triggered the need for a new time-loss authorization, and the insurer did not request additional authorization.