71 Van Natta 686 (2019)
In the Matter of the Compensation of JOSE L. CARDONA-ORNELAS, Claimant
WCB No. 18-00729
Oregon Worker Compensation
July 2, 2019
Hooton
& Chen LLP, Claimant Attorneys
MacColl Busch Sato PC, Defense Attorneys
Reviewing Panel: Members Curey and Lanning.
ORDER ON REVIEW
The
self-insured employer requests review of Administrative Law
Judge (ALJ) Somers’s order that found that a proposed
surgery was causally related to claimant’s accepted
left distal fibula fracture. On review, the issue is medical
services.
We
adopt and affirm the ALJ’s order with the following
supplementation.
The ALJ
was persuaded by Dr. Rask’s opinion that, despite
sustaining a left fibular fracture at home following a
work-related accepted left distal fibula fracture,
claimant’s original work-related fracture had not
healed and required surgery. In doing so, the ALJ reasoned
that Dr. Rask had explained that the accepted fibula fracture
and the subsequent fracture were in slightly different
locations based on x-ray imaging.
On
review, the employer contends that Dr. Rask’s opinion
is not persuasive because his opinion changed regarding the
healing status of claimant’s accepted left fibula
fracture and the cause of his need for surgery.[1] Further,
the employer argues that the procedure is not compensable
because Dr. Rask ultimately attributed the need for surgery
to an unaccepted “nonunion” condition, which is
“distinct” from the accepted left fibula fracture
condition. Based on the following reasoning, we disagree with
the employer’s contentions.
[71 Van
Natta 687] ORS 656.245(1) provides, in part, that “for
every compensable injury, the insurer or self-insured
employer shall cause to be provided medical services for
conditions caused in material part by the injury.” The
phrase “compensable injury” as used in that
provision refers to the “work accident” that
caused the medical condition, and is not limited to the
accepted conditions. Garcia-Solis v. Farmers Ins.
Co., 365 Or. 26, 42-3 (2019).
Because
of the disagreement between medical experts regarding the
cause of claimant’s conditions and need for treatment,
the claim presents a complex medical question that must be
resolved by expert medical opinion. Barnett v. SAIF,
122 Or.App. 279, 282 (1993); Matthew C. Aufmuth, 62
Van Natta 1823, 1825 (2010). More weight is given to those...