De Los-Santos v. Si Pac Enterprises, Inc.

Summarized by:

  • Court: Oregon Court of Appeals
  • Area(s) of Law: Workers Compensation
  • Date Filed: 05-11-2016
  • Case #: A157315
  • Judge(s)/Court Below: Lagesen, J. for the Court; Ortega, P.J.; & Garrett, J.
  • Full Text Opinion

Under ORS 656.267, in order to prevail on a new or omitted condition claim, the claimant must prove that the new or omitted condition not only exists, but also qualifies as a condition, rather than a mere symptom.

Claimant appealed the Workers' Compensation Board's denial of his new or ommitted condition. Claimant initiated a new or omitted condition claim as permitted by ORS 656.267(1). Claimant requested that her insurer formally accept the condition of “radiculopathy/radiculitis” as part of her compensable injury. Insurer denied Claimant's request. Claimant requested a hearing before an administrative law judge (ALJ) who upheld insurer’s denial. Claimant then sought review before the Worker’s Compensation Board, which also upheld insurer’s denial. On review of the board’s final order, Claimant argued that the board erred when it held that she was required to prove that her claimed condition exists. The Court expanded its holding in Young v. Hermiston Good Samaritan, 223 Or App 99 (2008) and held that in order to prevail on a new or omitted condition claim under ORS 656.267, a claimant must prove that the claimed new or omitted condition not only exists, but also qualifies as a condition, rather than a mere symptom. Affirmed.

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