Oregon Court of Appeals Decision Changes Workers' Comp Claims

Posted on May 21, 2014

In a significant decision that many are calling a "sea change" in the Oregon Workers' Compensation system, the Oregon Court of Appeals clarified the the meaning of a "combined condition" under the Oregon Workers' Compensation statute.

In the past, a "combined condition" occurred when an accepted medical condition "combined" with a "pre-existing condition" to cause disability or a need for medical care.

Insurance companies would often determine that a compensable condition, like a neck or low back strain, combined with some other condition that existed prior to the injury. 


The short answer is that it makes it easier for an insurance company to deny a claim, and harder for an injured worker to prove a claim.  Insurance companies would often say that the worker hurt herself, but that her injury combined with some preexisting condition.  (Sometimes, a worker may have a preexisting condition without ever having treated for that condition!)  After a few short months, the insurance carrier could then say that the preexisting condition was the main reason for the need for medical care, and could deny the claim.

Now, a "combined condition" is not a combining of the accepted injury and the pre-existing condition, but instead a combining of the actual injury event and the pre-existing condition.  This may not sound like a big difference, but many people who work with injured workers think that this may make it easier for injured workers to keep the benefits they deserve, because the insurance company cannot make it's own mind up about what a combined condition is.

It is too early to tell what is going to happen, but this new case may give injured workers a better chance of getting the medical care and other benefits they deserve.

If you have a denied claim, or wonder if your are dealing with a "combined condition," call us at 503-325-8600 with your questions.  We are following this case closely.

Joe Di Bartolomeo
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Top-rated Personal Injury Lawyer Helping Oregon and Washington Families