72 Van Natta 561 (2020)
In the Matter of the Compensation of QUENTIN G. HILLHOUSE, Claimant
WCB No. 19-04429
Oregon Worker Compensation
June 26, 2020
Scott
M McNutt Sr, Claimant Attorneys
SAIF
Legal Salem, Defense Attorneys
Reviewing Panel: Members Woodford and Lanning.
ORDER
ON REVIEW
The
SAIF Corporation requests review of ALJ Ilias’s order
that set aside its denial of claimant’s new/omitted
medical condition claim for a left partial thickness tear of
the medial collateral ligament (MCL). On review, the issue is
compensability.
We
adopt and affirm the ALJ’s order with the following
supplementation.
In
setting aside SAIF’s denial of claimant’s
new/omitted medical condition claim for a left partial
thickness tear of the MCL, the ALJ found that the opinion of
Dr. Bert established that the claimed condition was a
separate and distinct condition that was not encompassed in
SAIF’s acceptance of the left knee MCL sprain. The ALJ
discounted the opinion of Dr. Jennings because it was not
sufficiently explained and did not respond to the contrary
opinion of Dr. Bert.
On
review, SAIF contends that the medical evidence does not
support the conclusion that the denied tear condition was new
or omitted. For the following reasons, we affirm the
ALJ’s order.
A
new/omitted medical condition claim must be for a
“condition” that is either “new” or
“omitted.” ORS 656.267(1); Labor Ready v.
Mogensen, 275 Or.App. 491, 498 n 9 (2015) (a new/omitted
medical condition requires notice of a new or omitted
condition, rather than a new diagnosis). A condition is
“new” if it arose after acceptance of an initial
claim, was related to an initial claim, and involved a
condition other than the condition initially accepted.
Johansen v. SAIF, 158 Or.App. 672, 679 (1999). A
condition is “omitted” if it was in existence at
the time of the acceptance, but was not mentioned in the
notice of acceptance or was left out. Mark A. Baker,
[50 Van Natta 2333], 2336 (1998).
A
new/omitted medical condition claim may be denied if the
condition has already been accepted. See Akins v.
SAIF, 286...
