Vukasin v. Liberty Northwest Insurance Corporation

ORS 656.245(1)(a) allows compensation for medical services that are causally related to a compensable workplace injury. This does not include services for accepted conditions that can be shown to have been resolved or cured and occurred again later, unrelated to a workplace injury.

Vukasin appealed judgment of the Workers’ Compensation Board upholding insurer’s denial to cover ankle surgery in 2009. In 2000, Vukasin was injured while working at OHSU. In 2009, the surgery was to correct Vukasin’s ATFL and ankle instability but the insurer rejected compensation. Vukasin argued that the denial of ankle instability as an accepted condition in 2000 was incorrect and that denial of coverage for the 2009 surgery arising from accepted conditions of the 2000 injury should be reversed. Vukasin also argued that the Board was not equipped to determine whether her surgery was related to the 2000 injury, and since the surgery was treating accepted conditions from 2000, the surgery must be covered. The Court first found that the ankle instability was wrongly denied in 2000 as an accepted condition. The Court then decided that the causality between the 2000 injury and 2009 surgery was a question of fact rightly determined by the Board. There was sufficient evidence to show that the conditions being treated by the surgery were not the same conditions in 2000. While they were similar conditions, there was evidence that those suffered in 2000 had been resolved or cured, and the injuries being treated in 2009 were new and not related to the 2000 injury. Therefore, coverage was rightfully denied and the Board’s ruling was upheld. Affirmed.