73 Van Natta 379 (2021)
In the Matter of the Compensation of LORI L. SABIN, Claimant
WCB No. 20-00081
Oregon Worker Compensation
May 3, 2021
Julene
M Quinn LLC, Claimant Attorneys
SAIF
Legal Salem, Defense Attorneys
Reviewing Panel: Members Ousey and Woodford.
ORDER
ON REVIEW
Claimant
requests review of Administrative Law Judge (ALJ)
Naugle’s order that: (1) found that an aggravation
claim for claimant’s low back condition had not been
perfected; (2) did not award additional temporary disability
benefits; and (3) declined to award penalties and attorney
fees for allegedly unreasonable claim processing. On review,
the issues are aggravation, temporary disability, penalties,
and attorney fees.
We
adopt and affirm the ALJ’s order with the following
supplementation.
In
March 2018, claimant compensably injured her low back. (Exs.
1, 21).
In
April 2018, the SAIF Corporation accepted a low back sprain
and enrolled claimant in a managed care organization (MCO).
(Ex. 21). In August 2018, SAIF denied a new/omitted medical
condition claim for a lumbar disc annular tear and
radiculopathy. (Ex. 53-1).
In
October 2018, Ms. Toomey, a nurse practitioner, diagnosed a
lumbar strain and tear. (Ex. 55-1).
In
January 2019, Dr. Thorsett examined claimant at SAIF’s
request. (Ex. 59). Dr. Thorsett opined that claimant was
medically stationary with no impairment due to the work
injury. (Ex. 59-6). In February 2019, Ms. Toomey concurred
with Dr. Thorsett’s opinion. (Ex. 60).
A
February 2019 Notice of Closure awarded temporary disability,
but no permanent disability, benefits. (Ex. 62). A May 2019
Order on Reconsideration rescinded the Notice of Closure,
concluding that SAIF did not have sufficient information to
close the claim. (Ex. 65). Specifically, the reconsideration
order reasoned that Ms. Toomey’s concurrence did not
qualify as an attending physician’s opinion because the
MCO policy did not authorize her to provide compensable
medical services after December 1, 2018. (Ex. 65-2).
[73 Van
Natta 380] In May 2019, claimant changed her attending
physician to Dr. Williams, who treated her from May to July
2019. (Exs. 66, 67, 69, 72 – 74). In July 2019, Dr.
Williams opined that claimant was medically stationary,
without impairment. (Exs. 69, 72 – 74).
A July
2019 Notice of Closure awarded temporary disability, but no
permanent disability, benefits. (Ex. 76). An August 2019
Order on Reconsideration modified claimant’s temporary
disability benefits, but otherwise affirmed the Notice of
Closure. (Ex. 78-3). The reconsideration order also found
that Dr. Williams was claimant’s attending physician at
the time of claim closure. (Ex. 78-1).
In
November 2019, Ms. Toomey noted claimant’s low back
pain and left leg numbness, tingling, and weakness. (Ex.
81-1). That same day, claimant and Ms. Toomey completed an
aggravation claim form. (Ex. 82).
Later
that day, claimant sought an MRI from Dr. Vraniak, an
emergency room physician. (Ex. 83). Because the MRI results
did not indicate the need for further emergency care, Dr.
Vraniak advised claimant to follow up with her primary care
provider. (Ex. 83-4-5).
Approximately
a week later, Ms. Holmberg, a physician’s assistant for
Drs. Hadden and Yundt, noted left leg pain, numbness, and
tingling. (Ex. 84-1).
Later
in November 2019, SAIF informed claimant...