Opinion

Johnson v. SAIF

  • 307 Or. App. 1
  • 475 P.3d 465
Court
Court of Appeals of Oregon
Filed
Oct 7, 2020
Status
Published
On the bench
Egan
Cited by
3 cases
Authority
More cited than 65.4%

The opinion

1

Submitted on remand from the Oregon Supreme Court November 26, 2019,

reversed and remanded October 7, 2020, petition for review allowed

February 19, 2021 (367 Or 559)

See later issue Oregon Reports

In the Matter of the Compensation of

Marisela Johnson, Claimant.

Marisela JOHNSON,

Petitioner,

v.

SAIF CORPORATION

and The Terrace Corporation,

Respondents.

Workers’ Compensation Board

1202168, 1201864; A160491

475 P3d 465

On remand from the Supreme Court, the Court of Appeals is asked to recon-

sider its opinion in Johnson v. SAIF, 291 Or App 1, 7, 418 P3d 27 (2018), in light

of Caren v. Providence Health System Oregon, 365 Or 466, 446 P3d 67 (2019). In

its original opinion, the Court of Appeals affirmed the board’s order determining

that claimant’s benefits for impairment could be reduced by the portion of claim-

ant’s impairment attributable to a denied preexisting shoulder condition. Caren

holds that when a worker’s impairment is caused by a combination of a work-

related injury and a preexisting condition and the work-related injury is a mate-

rial contributing cause of the total impairment, the worker is entitled to be com-

pensated for the “full measure” of impairment, unless the employer has issued

a preclosure denial of the worker’s combined condition that has contributed to

the worker’s total impairment. Held: Although SAIF denied claimant’s shoulder

condition, SAIF has not denied the combined condition that was identified by the

medical arbiter and that resulted in claimant’s range-of-motion impairment in

her hand. Accordingly, under Caren, claimant is entitled to be awarded the “full

measure” of impairment.

Reversed and remanded.

On remand from the Oregon Supreme Court, Johnson v.

SAIF, 365 Or 657, 451 P3d 1014 (2019).

Donald M. Hooton filed the briefs for petitioner.

Julie Masters filed the brief for respondents.

Before Ortega, Presiding Judge, and Egan, Chief Judge,

and Lagesen, Judge.

EGAN, C. J.

Reversed and remanded.

2 Johnson v. SAIF

EGAN, C. J.

This case is on remand from the Supreme Court

for reconsideration in light of the court’s opinion in Caren v.

Providence Health System Oregon, 365 Or 466, 446 P3d 67

(2019). Caren involved a workers’ compensation claim that

the employer accepted for “lumbar strain.” Medical arbiters

ultimately opined that 70 percent of the claimant’s range-

of-motion impairment was due to preexisting arthritis, and

the claimant’s permanent disability award was apportioned,

or reduced, accordingly. The claimant had not requested

acceptance of a combined condition, and the employer had

not accepted or denied a combined condition.

The Workers’ Compensation Board upheld the

apportionment, rejecting the claimant’s contention that

she was entitled to an award for her full range-of-motion

impairment. In a per curiam opinion, Caren v. Providence

Health System Oregon, 289 Or App 157, 406 P3d 158 (2018),

we affirmed the board’s order upholding an apportionment

of benefits to reduce the claimant’s benefits for impairment

by the impairment attributable to the preexisting condi-

tion. We cited our opinion in McDermott v. SAIF, 286 Or

App 406, 420, 398 P3d 904 (2017), vacated and remanded,

365 Or 651, 451 P3d 1014 (2019), in which we had held that

a worker’s benefits for impairment at the time of claim clo-

sure could be reduced by the percentage of impairment

“due to” the worker’s legally cognizable preexisting condi-

tion, unless the preexisting condition had been claimed

by the worker, accepted by the employer as part of a com-

bined condition, and remained compensable at the time of

closure.

The Supreme Court allowed review in Caren to over-

rule our analysis in McDermott. Under the Supreme Court’s

opinion in Caren, if the work injury is a material contribut-

ing cause of the worker’s new impairment but a portion of

the new impairment is caused by a combining of the work

injury and a cognizable preexisting condition, then benefits

for the new impairment may be reduced by the new impair-

ment caused by the combined condition only if the employer

has identified the combined condition and denied it before

claim closure pursuant to the procedure described in ORS

Cite as 307 Or App 1 (2020) 3

656.268(1)(b). 365 Or at 487. It is not the claimant’s burden

to first seek acceptance of a combined condition.1 Id.

In this case, claimant had an accepted claim for an

injury to her left hand and a denied claim for an injury to

her left rotator cuff. In evaluating claimant’s impairment

from the accepted hand claim only, the medical arbiter

identified limited range of motion attributable to the hand

injury. He also identified a loss of grip strength, which he

attributed to a combined condition attributable 50 percent

to the hand injury and 50 percent to the shoulder conditions.

The Appellate Review Unit (ARU) issued an order on recon-

sideration awarding claimant benefits for seven percent

whole-person impairment for impairment to the left hand.2

The impairment value for loss of grip strength was appor-

tioned to the hand claim at 50 percent. The board upheld the

apportionment, and we affirmed the board’s order, rejecting

claimant’s contention that there should be no reduction in

the impairment benefits for claimant’s hand injury for a loss

of grip strength attributable to claimant’s denied shoulder

condition. Johnson v. SAIF, 291 Or App 1, 7, 418 P3d 27

(2018). We first cited our opinion in McDermott, and rea-

soned that McDermott resolved most of claimant’s statutory

construction contentions. Id. at 4.

We then considered and addressed claimant’s con-

tention that apportionment is precluded under the Supreme

Court’s opinion in Schleiss v. SAIF, 354 Or 637, 655, 317 P3d

1

We note that the Supreme Court’s opinion in Caren implicitly overrules our

opinion in Croman Corp. v. Serrano, 163 Or App 136, 140, 986 P2d 1253 (1999),

in which we held that the preclosure denial of a combined condition claim applies

only to an accepted combined condition claim.

2

We note that the subsequently accepted claims for shoulder and left trape-

zius muscle sprain were not before the ARU. Impairment attributable to those

conditions would be determined in a subsequent closure related to those condi-

tions. See Yi v. City of Portland, 288 Or App 135, 138, 404 P3d 1098 (2017). (path

for review of disability for a condition accepted after claim closure is not through

modification of the notice of closure but through reconsideration of a subsequent

notice of closure). ORS 656.262(7)(c) provides, in part:

“When an insurer or self-insured employer determines that the claim

qualifies for claim closure, the insurer or self-insured employer shall issue at

claim closure an updated notice of acceptance that specifies which conditions

are compensable. * * * Any objection to the update notice or appeal of denied

conditions shall not delay claim closure pursuant to ORS 656.268. If a con-

dition is found compensable after claim closure, the insurer or self-insured

employer shall reopen the claim for processing regarding that condition.”

4 Johnson v. SAIF

244 (2013), because claimant’s preexisting shoulder con-

dition was not a “legally cognizable” preexisting condition

for which apportionment is available. Although we agreed

with the claimant that his condition was not “legally cog-

nizable” as a preexisting condition, we nonetheless upheld

the apportionment of impairment benefits. Johnson, 291

Or App at 6. That is because the shoulder claim had been

denied. See ORS 656.262(2) (“The compensation due under

this chapter shall be paid periodically, * * * except where

the right to compensation is denied by the insurer or self-

insured employer.”); ORS 656.268(15) (“Conditions that are

direct medical sequelae to the original accepted condition

shall be included in rating permanent disability of the claim

unless they have been specifically denied.”). We concluded

that a worker is not entitled to benefits for impairment due

to a condition that has been denied and that benefits for

impairment could be reduced by that the portion of claim-

ant’s impairment attributable to the denied shoulder claim.

Johnson, 291 Or App at 7.

The Supreme Court now asks us to reconsider our

opinion in light of its opinion in Caren. When a worker’s

impairment is caused by a combination of a work-related

injury and a cognizable preexisting condition, and the work-

related injury is a material contributing cause of the total

impairment, Caren holds that the worker is entitled to be

compensated for the “full measure” of impairment, unless

the employer has issued a preclosure denial of the worker’s

combined condition that has contributed to the worker’s

total impairment. 365 Or at 487.

Caren did not explicitly address the issue presented

here—whether a worker should be compensated for the “full

measure” of impairment caused in material part by a work

injury in combination with a noncognizable preexisting con-

dition that the employer has previously denied outright. But

there is discussion in Caren that leads us to conclude that

claimant is entitled to the “full measure” of impairment. The

court held in Caren that, when a worker’s impairment is due

to a combining of the compensable injury and a preexisting

condition, “the legislature intended that injured workers

would be fully compensated for new impairment if it is due

Cite as 307 Or App 1 (2020) 5

in material part to the compensable injury, except where an

employer has made use of the statutory process for reduc-

ing liability after issuing a combined condition denial.” 365

Or at 468. Although SAIF denied claimant’s shoulder condi-

tion, SAIF has not denied the combined condition that was

identified by the medical arbiter and that resulted in claim-

ant’s range-of-motion impairment in her hand. Accordingly,

under Caren, claimant is entitled to be awarded the “full

measure” of impairment.

Reversed and remanded.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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