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In re Compensation of Carlos-Macias

Court of Appeals of Oregon

May 7, 2014

In the Matter of the Compensation of Francisco M. Carlos-Macias, Claimant.
v.
FRANCISCO M. CARLOS-MACIAS, Respondent SAIF CORPORATION and SHERMAN PAINT & COLLISION, Petitioners,

Argued and Submitted July 18, 2013.

Workers' Compensation Board. 1004446, 1004555.

Julie Masters argued the cause and filed the briefs for petitioners.

Dale C. Johnson argued the cause and filed the brief for respondent.

Before Armstrong, Presiding Judge, and Nakamoto, Judge, and Egan, Judge.

OPINION

Page 828

[262 Or.App. 631] EGAN, J.

Employer Sherman Paint & Collision, and its workers' compensation insurer SAIF Corporation (collectively, petitioners) seek judicial review of an order of the Workers' Compensation Board (board), which 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). Petitioners assert that the board erred when it upheld the denial of claimant's current condition while simultaneously finding a sufficient causal relationship between the proposed diagnostic medical services and his previously accepted conditions to support the compensability of those services. Petitioners argue that the diagnostic services were not related to claimant's " accepted condition" but were instead designed solely to rule out unrelated noncompensable conditions. Finally, petitioners argue that the board's decision is not supported by substantial evidence or substantial reason. For the reasons that follow, we affirm.

The underlying claim dates from a work-related injury sustained when claimant damaged his left shoulder while lifting and dragging a heavy forklift component in November 2007. We begin by recounting the procedural history of this case before turning to the underlying medical history.

After SAIF issued an acceptance for a " left shoulder strain," claimant made a demand for acceptance of additional conditions, namely, shoulder sprain, acromioclavicular (AC) joint sprain, hypertrophic rotator cuff tendinosis, and AC joint impingement. In a modified notice of acceptance, SAIF took responsibility for the AC sprain in addition to the previously accepted left-shoulder strain and also eventually accepted the left-shoulder rotator cuff tendinosis.

SAIF issued a notice of closure in September 2009 that denied an award of permanent partial disability. The Workers' Compensation Division of the Department of Consumer and Business Services (the division) reviewed that closure and concluded that claimant was medically stationary with regard to the " accepted condition(s)" and [262 Or.App. 632] allowed claim closure. The reviewer made a significant change to the notice of closure as it related to permanent partial disability by attributing 75 percent of claimant's loss of range of motion and 50 percent of the loss of repetitious use of the shoulder to the " accepted condition(s)." The order on reconsideration awarded claimant a total of eight percent permanent partial disability to his left shoulder.

Turning now to the medical history, claimant sought initial medical treatment with Dr. Ackerman, who diagnosed a left-shoulder strain. By January 2008, Ackerman had expanded his diagnosis to include a left-shoulder strain and an AC strain. Claimant continued to work buffing cars and his pain began to radiate into the left upper arm. An

Page 829

MRI ordered by Ackerman identified swelling in the AC joint and evidence of rotator cuff tendinosis. Claimant saw an orthopedic surgeon, Dr. ...


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