55 Van Natta 4185 (2003). MURIEL E. DEXTER, Claimant.
Court | Oregon |
Oregon Workers Compensation
2003.
55 Van Natta 4185 (2003).
MURIEL E. DEXTER, Claimant
4185In the Matter of the Compensation of MURIEL E.
DEXTER, ClaimantOwn Motion No. 02-0329MOWN MOTION ORDER REVIEWING CARRIER CLOSUREErnest M Jenks, Claimant Attorneys
Johnson Nyburg and Andersen, Defense AttorneysReviewing Panel: Members Biehl and
Lowell. Member Biehl concurs.Claimant
requests review of the insurer's December 17, 2002 "Notice of Closure: Own Motion Claim" (Notice of Closure), which closed
her claim with an award of temporary disability compensation from December 30,
1999 through March 4, 2002. The insurer declared
claimant medically stationary as of March 4, 2002.
Claimant contends that the medically stationary date assigned is inaccurate and
that her claim was prematurely closed. In the alternative, she asserts that she
is entitled to an additional temporary disability award for the period from
March 5 to December 17, 2002, and to an award of
permanent partial disability based on her "post-aggravation rights" new or
omitted medical condition ("L4-5 stenosis; L3-4
spondylolisthesis; L3-4, L4-5, and L5-S1 disc bulge/herniation; L3-4 and
L4-5 nerve root compression; L3 to sacrum fusion;
and surgical infection").1 We affirm the Notice of
Closure. FINDINGS OF FACT On February 16, 1979, claimant sustained a compensable injury. The
insurer accepted a low back injury. The claim was closed by Determination Order
in March 1980 with an award of 20 percent unscheduled permanent partial
disability (PPD). Claimant was then 36 years old and performed work in a
"light" capacity prior to her injury. The insurer rated her Specific Vocational
Preparation (SVP) at 4. At various times during the
period from March 1980 to February 1985, claimant's condition worsened
resulting in additional awards of unscheduled PPD 1
Claimant's February 16, 1979 claim was accepted as a
disabling claim and was first closed on March 17,
1980. Thus, claimant's aggravation rights expired on March 17, 1985. Therefore,
when claimant sought claim reopening on October 2002, the claim was within our
Own Motion jurisdiction. ORS 656.278(1) (2001).
Consistent with our statutory authority, on November 7, 2002, we issued our
Own Motion Order authorizing the reopening of the
claim and noted that when claimant was medically stationary, the insurer should
close the claim pursuant to OAR 438-012-0055. (WCB Case No. 02-0087M). On
December 17, 2002, the insurer issued its Notice of Closure. 55 Van Natta 4185 (2003)4186
disability that brought her total award to 82.5
percent. Claimant's aggravation rights expired in March 1985. Claimant's low back condition repeatedly worsened between
1985 and 1998. Her claim was successively reopened
and closed pursuant to our Own Motion authority. On February 10, 2000, the
claim was reopened based on a further worsening of claimant's condition that
required surgical treatment. On March 4, 2002, an
insurer-arranged medical examiner (Dr. Smith) declared claimant's condition
medically stationary. Thereafter, on March 25, 2002,
the insurer closed the claim, awarding temporary disability benefits from
March 30, 1999 through March 4, 2002. Claimant
requested Board review of the closure, and requested that the insurer accept
multiple "post-aggravation rights" new and/or omitted medical conditions.
Thereafter, claimant requested a hearing regarding the insurer's alleged
de facto denial of the requested new medical conditions.
In an October 25, 2002 Stipulation and Order, the
insurer rescinded its March 25, 2002 Notice of
Closure and agreed to accept the following omitted medical conditions: (1) L4-5
stenosis; (2) L3-4 spondylolisthesis; (3) L3-4, L4-5, and L5-S1 disc
bulge/herniation; (4) L3-4 and L4-5 nerve root compression; (6) L3 to sacrum fusion; and (7) surgical site infection.2 In
October 2002, we issued an Own Motion Order of Dismissal, dismissing claimant's
request for Board review of the March 25, 2002 Notice of Closure. On November 7, 2002, the insurer voluntarily reopened the
claim pursuant to ORS 656.278(5) (2001) to provide benefits for the
above-listed "post- aggravation rights" new/omitted medical conditions. On December 3, 2002, claimant was evaluated by Dr. Dinneen,
an insurer- arranged medical examiner. Dr. Dinneen reported reduced lumbar
ranges of motion, but did not comment on the validity of those findings. Dr.
Dinneen considered claimant's condition medically stationary and opined that
claimant's "post-aggravation rights" new medical conditions were "inherent in
all of the prior diagnoses" and "would not of themselves add anything to
[claimant's] impairment status." Dr. Dinneen stated that claimant's condition
was "objectively medically stationary" and that her impairment remained the
same as noted in Dr. Smith's March 4, 2002 report.
2 As a part of the
Stipulation and Order, claimant agreed to withdraw her request for hearing and
her requested review of the insurer's claim closure. 55 Van Natta 4185 (2003)4187 On December 17, 2002, the insurer closed the Own Motion
claims for "worsening" and "post-aggravation rights" new medical condition by
issuing a single Own Motion Notice of Closure that: (1) declared claimant
medically stationary as of March 4, 2002; (2) awarded temporary disability
benefits from December 30, 1999 through March 4,
2002; and (3) awarded no permanent disability benefits for the
"post-aggravation rights" new/omitted medical conditions. Claimant requested review of the insurer's closure and a medical arbiter
examination. On June 4, 2003, we issued an Interim Own Motion Order authorizing
appointment of a medical arbiter and postponing the remainder of our review of
the Own Motion claim closure pending receipt of the arbiter's report. A medical arbiter's report...
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