72 Van Natta 61 (2020)
In the Matter of the Compensation of DEEPA K. PELPOLA, Claimant
WCB No. 17-05297
Oregon Worker Compensation
January 17, 2020
Schoenfeld & Schoenfeld, Claimant Attorneys
SAIF
Legal Salem, Defense Attorneys
Reviewing Panel: Members Woodford and Ousey.
ORDER
ON REVIEW
The
SAIF Corporation requests review of that portion of
Administrative Law Judge (ALJ) Riechers’s order that
set aside its “ceases” denial of claimant’s
combined cervical, thoracic, and lumbar strain conditions. On
review, the issue is compensability.
We
adopt and affirm the ALJ’s order with the following
supplementation.
In
setting aside SAIF’s denial, the ALJ found that Drs.
Smith and Takacs considered more than the component parts of
the accepted combined conditions (i.e., the accepted
cervical, thoracic, and lumbar strains, and the preexisting
spondylosis and degenerative disc disease conditions) in
determining whether the “otherwise compensable
injury” ceased to be the major contributing cause of
claimant’s disability/need for treatment of the
combined conditions.1 Finding a lack of persuasive medical
evidence establishing that claimant’s preexisting
arthritic conditions were the major contributing cause of the
disability/need for treatment of her combined conditions, the
ALJ concluded that SAIF had not met its burden of proof.
On
review, SAIF contests the ALJ’s statement of its burden
of proof, and challenges the ALJ’s evaluation of the
medical evidence. Claimant agrees with the ALJ’s
conclusion that the denial should be set aside, but argues
that SAIF must establish both that the “otherwise
compensable injury” ceased to be, and that the
preexisting conditions identified in its acceptance and
denial notices were, the major contributing cause of the
disability/need for treatment of her combined conditions. As
explained below, we agree with the ALJ’s initial
description of SAIF’s burden of proof, and that the
“ceases” denial should be set aside.
[72 Van
Natta 62] ORS 656.262(6)(c) authorizes a carrier to deny an
accepted combined condition if the “otherwise
compensable injury” ceases to be the major contributing
cause of the combined condition. The word
“ceases” presumes a change in the worker’s
condition or circumstances such that the “otherwise
compensable injury” is no longer the major contributing
cause of the disability or need for treatment of the combined
condition. Wal-Mart Stores, Inc. v. Young, 219
Or.App. 410, 419 (2008).
In
analyzing a “ceases” denial under ORS
656.262(6)(c), we evaluate only the contributions of the
component parts of the combined condition; i.e., the
otherwise...
