Pedro v. SAIF

As defined by ORS 656.005(7)(a)(B), a combined condition is one that entails two separate conditions which combine and occur “[i]f an otherwise compensable injury combines at any time with a preexisting condition to cause or prolong disability or a need for treatment,” and injury in this context refers to a medical condition, not an accident. Brown v. SAIF, 361 Or 241, 272 (2017).

Pedro appealed an order of the Workers Compensation Board that affirmed an order from SAIF Corporations which denied Pedro’s omitted condition—L4-5 disc protrusion—under ORS 656.267(1).  As defined by ORS 656.005(7)(a)(B), a combined condition is one that entails two separate conditions which combine and occur “[i]f an otherwise compensable injury combines at any time with a preexisting condition to cause or prolong disability or a need for treatment,” and injury in this context refers to a medical condition, not an accident. Brown v. SAIF, 361 Or 241, 272 (2017).  The court held that the L4-5 disc protrusion was caused, in material part, by the workplace injury, and that although the condition had not been accepted at the time that the board conducted their combined condition analysis, there was no reason to deviate from requesting an insurer accept an omitted condition caused in material part by a workplace incident for which other material conditions relating to the incident were accepted. The L4-5 disc protrusion was a combined condition with pre-existing arthritis and denial was not supported by substantial evidence. Reversed and remanded.