SAIF Corp. v. Banderas

When a preponderance of medical evidence establishes the attending physician's findings are more accurate and have not been rebutted by a medical arbiter panel, a review board may favor the physician's findings rather than the medical arbiter panel.

SAIF appealed a grant by the Workers' Compensation Board (Board) of permanent disability benefits. Banderas suffered an injury while pushing a wood cart. The initial injury was accepted by SAIF. Through a series of examinations during a 2 year period, Banderas's physician consistently diagnosed a chronic pain caused by a secondary injury resulting from the initial injury. Upon review by a medical arbiter panel, Banderas's benefits were discontinued because the injury causing chronic pain was different than the originally accepted injury. An administrative review board reinstated Banderas's benefits on the basis that the secondary injury was caused by the initial injury. SAIF argued that the Board erred when it rejected the panel's findings and that Banderas did not suffer pain of "direct medical sequela." First, the Court of Appeals held the Board correctly favored the physician because the panel never rebutted his findings and a preponderance of the evidence suggested the physician's findings were more accurate. Regarding the second issue, the Court affirmed the Board's finding of "direct medical sequela" from the chronic secondary issue to the original injury because of the consistent presence as noted by her physician. Affirmed.