The Oregon Workers' Compensation Board recently decided an appeal of a denied claim for degenerative disc disease of the lumbar spine. The injured worker claimed that his work, which involved using a jackhammer, was the major cause of the development of the degenerative changes in the lower back.
"Occupational disease" claims require that the injured worker show that the major cause of the medical condition, when compared to all other causes combined, is the work activity. Degenerative disc disease and arthritic conditions present special challenges in the workers' compensation arena.
In this case, the Board pointed to a medical opinion that did not include a comprehensive understanding of claimant's work activity. One critical factor in proving an occupational disease claim is for the attending physician to have a complete and thorough understanding of the injured worker's activities. Only then is the doctor able to provide a well informed opinion, that can withstand the muster of an aggressive insurance company.
If you have an occupational disease claim, and have questions about whether you should appeal your denial, call us at 503-325-8600. We can evaluate your case, and tell you whether a makes sense to attempt to set aside the claim denial.