Or. Admin. R. 436-035-0014

Current through Register Vol. 63, No. 9, September 1, 2024

Section 436-035-0014 - Worsened Pre-existing Conditions and Combined Conditions

(1)Worsened pre-existing conditions. If a worsened pre-existing condition is compensable under ORS 656.225, a worker is eligible for an award for permanent disability caused by the worsened pre-existing condition.

Example: (No apportionment)

Compensable injury (remains major contributing cause): Herniated disk L5-S1/diskectomy.

Pre-existing condition: arthritis (spine).

Closing exam ROM = 10% (under these rules).

Surgery (lumbar diskectomy) = 9%.

Combine: 10% and 9% which equals 18% low back impairment due to this compensable injury.

The worker is released to regular work. (Social-vocational factoring equals zero.)

(2)Combined conditions.

(a) If a worker has an accepted combined condition, the worker is eligible for an award for permanent disability caused by the combined condition unless there is a subsequent denial of the combined condition.

(b) If a worker has a combined condition denied in its entirety, the worker is not eligible for an award of permanent disability if the permanent disability is not due in any part to the accepted condition(s) and direct medical sequela(e). If the permanent disability is due in part to the accepted condition(s) and direct medical sequela(e), then the worker is not eligible for an award for the portion of the permanent disability due to the denied combined condition.

(3)Permanent partial disability awarded after a denial of the combined condition. If a claim is closed under ORS 656.268(1)(b), because the compensable injury is no longer the major contributing cause of the disability of the combined condition or the major contributing cause of the need for treatment of the combined condition, the likely permanent disability that would have been due to the current accepted condition must be estimated. The current accepted condition is the component of the otherwise denied combined condition that remains related to the compensable injury.

Or. Admin. R. 436-035-0014

WCD 9-2004, f. 10-26-04, cert. ef. 1-1-05; WCD 2-2010, f. 5-5-10, cert. ef. 6-1-10; WCD 1-2015, f. 1-29-15, cert. ef. 3/1/2015; WCD 7-2019, temporary amend filed 08/30/2019, effective 9/3/2019 through 2/29/2020; WCD 3-2020, amend filed 02/07/2020, effective 3/1/2020; WCD 3-2022, temporary amend filed 06/07/2022, effective 6/7/2022 through 12/3/2022; WCD 8-2022, amend filed 11/08/2022, effective 12/4/2022

Examples referenced are available from the agency.

Statutory/Other Authority: ORS 656.726

Statutes/Other Implemented: ORS 656.726, ORS 656.005, ORS 656.214, ORS 656.225 & ORS 656.268