70 Van Natta 1224 (2018)
In the Matter of the Compensation of RANDY W. COLLINS, Claimant
WCB No. 16-05571
Oregon Worker Compensation
November 7, 2018
Edward
J Hill, Claimant Attorneys
Gress,
Clark, Young, & Schoepper, Defense Attorneys
Reviewing Panel: Members Ousey and Curey.
ORDER ON REVIEW
The
self-insured employer requests review of Administrative Law
Judge (ALJ) Kekauoha’s order that set aside its denial
of claimant’s medical services claim for lumbar spine
surgery. On review, issue is medical services.
We
adopt and affirm the ALJ’s order with the following
supplementation.[1]
In
January 2016, Dr. Karami performed a facetectomy,
foraminotomy, discectomy, and fusion at the L5-S1 level. (Ex.
93). After the employer denied claimant’s [70 Van Natta
1225]current need for treatment, he requested a hearing. (Ex.
123).
The ALJ
found that the medical evidence supported the compensability
of the L5-S1 surgical procedure. See ORS 656.245(1).
In doing so, the ALJ reasoned that, whether the
“material” or “major” contributing
cause standard applied, Dr. Gritzka’s opinion
persuasively established the compensability of the L5-S1
surgery.
We
adopt the ALJ’s analysis of the medical evidence and
conclusion that the L5-S1 surgery was compensably related to
the accepted L5-S1 disc herniation. ORS 656.245(1)(a).
We
provide the following supplementation to address
claimant’s arguments regarding the validity/scope of
the employer’s denial, as well as the further
processing of his request for reopening of an Own Motion
claim for a “worsened condition.” See
ORS 656.278(1)(a).
First,
claimant contends that the employer’s denial
constitutes an impermissible “current condition”
denial, and a “prospective” denial of medical
services. However, the denial specifically states that it is
denying claimant’s [70 Van Natta 1225] “current
need for treatment.” (Ex. 123). Such language is
distinct from denying claimant’s “current
condition.” Barbara J. Ferguson, 63
Van Natta...
