Allen v. SAIF

Under ORS 656.005(7)(a)(A), in order for a claimant with an injury determined to be a “consequential condition” arising out of an earlier compensable injury to recover, that claimant must prove that the earlier compensable injury was the major contributing cause of the subsequent injury.

Allen (Claimant) appealed the Workers’ Compensation Board’s (Board) decision denying him compensation. Claimant sought compensation for a rotator cuff injury he thought was caused by an earlier compensable injury. SAIF denied the claim. On appeal, Claimant argued that SAIF had incorrectly characterized the injury as a “consequential condition,” and, therefore, had applied the incorrect standard of proof. ORS 656.005(7)(a)(A) provides that if the Board determines that an injury is a consequential condition arising out of an earlier compensable injury, a claimant must prove that the compensable injury was the major contributing cause of the subsequent injury. To meet that standard, a claimant must show that the initial injury was more than 50 percent responsible for the consequential condition. Two physicians testified that the earlier injury was less than 50 percent responsible for the rotator cuff injury. The Court found there was substantial evidence in the record to support the Board’s finding that (1) the rotator cuff injury was a “consequential condition,” since it did not directly arise out of claimant’s workplace accident, and, therefore, (2) that the Board applied the major contributing cause standard correctly. Because there was less than 50 percent certainty that Claimant’s earlier injury was the major contributing cause of his new injury, the Court held Claimant did not meet the relevant standard of proof to show that the injury was compensable. Affirmed.