OUTCOME: We prevailed. The Workers’ Compensation Board reversed the ALJ’s decision, and found that Mr. Farr had proven the compensability of his aggravation claim.
SAIF accepted an acute left L4-5 disk herniation among other conditions in 2007. In 2012, Mr. Farr sought treatment for worsening pain in his low back and legs. Mr. Farr subsequently filed an aggrava tion claim, which SAIF denied.
OUTCOME: We prevailed. The ALJ found issued a fully favorable decision on May 22, 2014.
Mr. Causer protectively filed for disability benefits on December 28, 2011. His claim was denied. We were finally able to present his case to a federal Administrative Law Judge on April 23, 2014.
OUTCOME: We prevailed. The Board concluded that Mr. Westbrook’s back condition was due to his work injury and the Board ordered the insurer to accept his claim.
Mr. Westbrook injured his back while lifting a heavy box at work. The workers’ comp insurer denied his claim after a doctor they paid for said his back pain was due to preexisting conditions.
OUTCOME: We prevailed. The Board found that Mr. Estrada had establish “good cause” for his untimely filed injury claim. This case was appealed by the insurer to the Oregon Court of Appeals and we are awaiting oral arguments.
Juan Estrada, 65 Van Natta 613 (March 21, 2013). Applying ORS 656.265(4)(c), the Board held that a worker had established “good cause” for his untimely filed hernia injury claim because, although he e xperienced a “weird pull” in his testicle area while loading a heavy item at work, he neither sought medical treatment, missed any work, nor experienced any physical limitations until some five months after the incident, when he eventually filed his claim. Although recognizing that ORS 656.265(1) does not require a worker to give notice of a work accident to his employer only if it is “significant” or “severe,” the Board was persuaded that the worker thought his “weird pull” was just soreness and that he was not aware that he had been injured until some five months later when he noticed swelling in his testicle area and then sought medical treatment, which diagnosed his hernia. Reasoning that the worker had not required any assistance while continuing to perform his work activities after the work incident and had not sustained any physical limitations at home during his weekends, the Board concluded that he had established “good cause” for his untimely filed injury claim and, as such, his claim was not time-barred.
OUTCOME: We prevailed. The Board ordered the insurer to accept the condition causing Mr. Cheney’s need for surgery.
Mr. Cheney injured his back while working in 1989, which eventually led him to have surgery. In 2011 Mr. Cheney’s back had worsened and surgery was indicated again. The insurer refused to pay for the surgery.
OUTCOME: We won. With the help of Mr. Mondragon’s doctor, we were able to prove that the work incident caused his clavicle disability and need for treatment.
Mr. Mondragon injured his left clavicle after shoveling snow for his employer. The workers’ comp insurer claimed that a previous injury was the cause of his need for treatment.
OUTCOME: We won. The Board ordered the insurer to accept Mr. Becker’s claim and he received the workers’ compensation benefits he deserved.
Mr. Becker is a machinist for an airplane manufacturer who developed neck problems that eventually led to surgery.
OUTCOME: We won. The employer’s denial was set aside and Mr. Lienhard’s claim was remanded to the employer for processing.
Robert A. Lienhard, 63 Van Natta 313 (February 10, 2011). Applying ORS 656.310(1), the Board held that, because the carrier had not overcome the presumption that claimant had provided timely and suffi cient notice of his injury claim to his employer, his injury claim was not barred as untimely. The carrier denied claimant’s wrist injury claim, contending that he had not provided timely notice of the injury to his employer. Claimant requested a hearing, asserting that the carrier had not rebutted the statutory presumption that he had sufficiently provided notice to his employer of his injury. See ORS 656.310(1). The Board agreed with claimant’s contention. Citing ORS 656.310(1), the Board stated that there is a rebuttable presumption that “[s]ufficient notice of injury was given and timely filed[.]” Relying on Nat’l Farmers’ Union Ins. v. Scofield, 57 Or App 23, 25, rev den 293 Or 373 (1982), and Bob J. Traweek, 61 Van Natta 2180, 2181 (2009), aff’d without opinion 238 Or App 580 (2010), the Board observed that, before a claim can be barred for late filing, the carrier must overcome the presumption that sufficient notice of injury was given and timely filed. Turning to the case at hand, the Board found that claimant had credibly testified that he had not mentioned his work-related wrist injury involving a sledgehammer accident to his physicians because they had informed him that his wrist symptoms were attributable to a carpal tunnel syndrome resulting from his repetitive work activities. Moreover, the Board noted that claimant had credibly testified that he informed a supervisor of his sledgehammer incident. In contrast to claimant’s credible testimony, the Board stated that the carrier had neither called any witnesses nor provided any evidence rebutting claimant’s assertion that he told his supervisor of the sledgehammer accident. Under such circumstances, the Board concluded that the carrier had not rebutted the presumption that claimant had sufficiently and timely provided notice to his employer of his injury. Accordingly, the Board held that claimant’s injury claim was not untimely under ORS 656.265(1) and (4).
OUTCOME: We won. Mr. Otterson’s claim was found to be compensable and he received the workers’ compensation benefits he deserved.
Corey A. Otterson, 63 Van Natta 156 (January 25, 2011). Applying ORS 656.265(4)(c), the Board held that claimant’s hernia injury claim was not barred as untimely filed because his lack of knowledge th at he had incurred a significant injury established good cause for his failure to provide his employer with notice of the accident within the statutory 90-day period. Four days after a work incident, claimant sought medical treatment. Following tests for bladder function and diabetes, he was released to work with an assessment of “abdominal pain” of unclear etiology. Claimant credibly testified that he returned to work the following day and that his condition continued to improve until some nine months later, when he again sought treatment and his hernia was diagnosed. The carrier denied the claim, asserting that claimant had not established good cause for failing to file the claim within 90 days of the work incident. The Board disagreed with the carrier’s contention. In doing so, the Board distinguished Kim M. Sears, 62 Van Natta 774 (2010), where it had not found “good cause” for an untimely filed injury claim because the claimant had sought medical treatment the day after the work incident complaining of pain and received an “off work” slip, which she delivered to her supervisor. Under such circumstances, the Board explained that, in Sears, it was not persuaded by her contention that she did not report the injury because she had intended to “work through it,” and, as such, it had not found “good cause” under ORS 656.265(4)(c) for her untimely notice of her injury. Unlike Sears, the Board noted that claimant had not received an “off work” slip after he sought medical treatment some four days after his work incident. Moreover, the Board found that, following tests for his bladder and diabetes, claimant’s condition had been assessed as “abdominal pain” of unclear etiology and that he had returned to his work the following day. Under such circumstances, the Board was persuaded that claimant’s lack of knowledge that he had incurred a significant injury established good cause for his failure to provide his employer with notice of an accident within the statutory 90-day period. See Anthony A. Long, 62 Van Natta 2560 (2010). Consequently, the Board concluded that claimant’s injury claim was not void as untimely. Furthermore, based on claimant’s credible testimony and supporting medical evidence, the Board determined that his work injury was a material contributing cause of his need for treatment/disability for his hernia and, as such, his claim was compensable.
