71 Van Natta 437 (2019)
In the Matter of the Compensation of TABATHA A. YARBOROUGH, Claimant
WCB No. 17-05713
Oregon Worker Compensation
April 23, 2019
Hollander & Lebenbaum et al, Claimant Attorneys
Goehler & Associates, Defense Attorneys
Reviewing Panel: Members Ousey and Woodford.
ORDER ON REVIEW
The
insurer requests review of Administrative Law Judge (ALJ)
Otto’s order that set aside its denial of
claimant’s new/omitted medical condition claim for a
low back condition. On review, the issue is compensability.
[1]
We
adopt and affirm the ALJ’s order with the following
supplementation.
The ALJ
set aside the insurer’s denial of claimant’s
new/omitted condition claim for an L4-5 disc bulge, reasoning
that claimant’s treating physicians, Dr. Hassan and Dr.
Puziss, persuasively established the compensability of the
claimed condition.
On
review, the insurer contends that Dr. Puziss’s
diagnoses of disc herniation and L4-5 disc protrusion are not
consistent with the claimed L4-5 disc bulge. Further, the
insurer argues that Dr. Puziss’s opinion establishes
that there was no need for treatment for the L4-5 disc
condition (however it is described), and that the new/omitted
medical condition claim is, thus, not compensable. Based on
the following reasoning, we disagree with the insurer’s
contentions.
To
prevail on her new/omitted medical condition claim, claimant
must prove that the claimed conditions exist and that the
September 2015 work injury was a material contributing cause
of the disability/need for treatment for the claimed
conditions. ORS 656.005(7)(a); ORS 656.266(1); Betty J.
King, 58 Van Natta 977 (2006); Maureen Y.
Graves, 57 Van Natta 2381 (2005).
Because
of the disagreement between medical experts regarding the
compensability of the claimed conditions, the claim presents
complex medical questions that must be resolved by expert
medical opinion. Barnett v. SAIF, [71 Van Natta 438]
122 Or.App. 279 (1993); Matthew C. Aufmuth, 62 Van
Natta 1823, 1825 (2010). More weight is...
