The Workers’ Compensation Board clarified a recent Court ruling about how permanent partial disability awards should be “apportioned,” if at all. To explain this case, some background is helpful.
Under the Oregon Workers’ Compensation system, an injured worker is entitled to a permanent partial disability award for on-the-job injuries that cause a permanent loss of earning capacity. Generally, there must be a relationship between the on-the-job injury and resulting disability.
Until recently, insurance companies would "apportion” the disability. In other words, a medical arbiter or insurance retained physician would determine the extent of permanent partial disability. After determining the overall disability, the physician would then apportion the disability between the work related injury and other conditions not related to the injury.
In a recent Supreme Court case, the Court ruled the rule that allowed apportionment was only valid if the apportionment was between the accepted condition and a legally cognizable pre-existing condition. Pre-existing conditions are defined by statute, and limited to conditions that the injured worker treated for prior to her injury, or “arthritis.”
In this case, the injured worker argued that she was entitled to permanent partial disability for a low back strain because the conditions that were causing her limitations were not “legally cognizable pre-existing conditions.” This may have been true, but the problem was that the impairments were not related to the on the job injury, either. The Board found that there must be some relationship between the permanent partial disability and the on-the-job injury. Because the permanent impairment had no relationship whatsoever to the on-the-job injury, the Board found that the recent change in case that disallowed apportionment did not apply to this particular case.
The issue surrounding permanent partial disability can be complicated given the various medical issues that can contribute to a permanent impairment. If you have a workers’ compensation claim, and wonder whether it was closed properly, call us at 503-325-8600. We have helped many people through the claim closure process, and appeals of claim closures.