Oregon: Employer Need Not Pay for Additional Surgery Since Procedure Was Only Tangentially Related to Original Injury

An Oregon court held substantial evidence supported a decision by the state’s Workers’ Compensation Board that medical services requested by a claimant were not compensable under Or. Rev. Stat. § 656.245(1)(a), which requires the employer to provide “medical services for conditions caused in material part” by a compensable injury. In 1999, the claimant suffered a fractured femur and arterial damage—a traumatic blockage of the popliteal artery near her left knee—in a compensable accident. Her treatment included a popliteal bypass graft and several bypasses of other arteries to improve blood flow to the graft. Ten years later, because tests showed that several arteries leading to the popliteal graft were blocked and there was a lack of blood flow to that graft, doctors recommended an aortobifemoral bypass. The employer contended the proposed surgery was not causally related to the compensable injury, but rather the result of the claimant’s arteriosclerosis, which existed before the injury. The Board agreed, noting that, according to medical testimony, the graft had stayed open and was not occluded. The appellate court affirmed, distinguishing the case from SAIF v. Sprague, 346 Ore 661, 217 P3d 644 (2009), in which the employer had been required to pay for gastric bypass surgery that improved a claimant’s overall condition generally and her compensable knee condition specifically. The court indicated that unlike in Sprague, where one of the conditions treated by the medical services (gastric bypass surgery) was caused by the compensable injury, here the medical evidence showed that the surgery would only treat conditions that had no causal connection to the compensable injury.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is the co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance. Bracketed citations link to lexis.com.

See Weiker v. Douglas County Sch. Dist. No. 4, 239 Ore. App. 389, 2015 Ore. App. LEXIS 654 (May 28, 2015) [239 Ore. App. 389, 2015 Ore. App. LEXIS 654 (May 28, 2015)]

See generally Larson’s Workers’ Compensation Law, § 94.03 [94.03]

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law.

For more information about LexisNexis products and solutions connect with us through our corporate site