In re Compensation of Cardona-Ornelas, 070219 ORWC, 18-00729

Docket Nº:WCB 18-00729
Case Date:July 02, 2019
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...

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