SAIF v. Carlos-Marcia

Summarized by:

  • Court: Oregon Court of Appeals
  • Area(s) of Law: Workers Compensation
  • Date Filed: 05-07-2014
  • Case #: A150950
  • Judge(s)/Court Below: Egan, J. for the Court; Armstrong, P.J.; and Nakamoto, J.
  • Full Text Opinion

Diagnostic services related to discovery of the cause of complaints of pain can be reasonable and necessary expenses, even if the results of the testing reveal that the condition was unrelated to the compensable condition.

The employer Sherman Paint & Collision, and its workers’ compensation insurer SAIF Corporation, sought judicial review of an order of the Workers’ Compensation Board (Board). The claim involved a work-related injury sustained when Carlos-Macias (Claimant) injured his left shoulder while lifting and dragging a heavy forklift component. The Board determined that there was a causal relationship between requested diagnostic medical services and Claimant’s accepted conditions sufficient to support the compensability of those diagnostic services under ORS 656.245(1)(a). The Claimant was awarded permanent partial disability. SAIF argued that the Board erred in upholding the denial of Claimant's current condition. Further, SAIF argued that the diagnostic services were not related to Claimant's current condition, and thus the claim in noncompensable. Lastly, SAIF argued that the Board’s decision is not supported by substantial evidence or substantial reason. The Court held that diagnostic services related to discovery of the cause of complaints of pain can be reasonable and necessary expenses, even if the results of the testing reveal that the condition was unrelated to the compensable condition. Affirmed.

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