Oregon court says board erred in rejecting treating physician’s opinion

The Oregon Court of Appeals overturned a denial of benefits for a worker’s back condition, finding the Workers’ Compensation Board failed, without reason, to defer to the opinion of a treating physician.

Robert Culley was working for the Department of Justice as a detective when in 2013 he began suffering from bilateral sciatica and low back pain, with pain radiating down both legs, according to In the Matter of the Compensation of Culley, filed Wednesday in Salem.

A magnetic resonance imaging scan taken that year showed multilevel disc disease that produced a relatively minimal canal, and disc bulges that minimally indented the ventral aspect of the thecal sac. In 2014, Mr. Culley began receiving treatment for pain in his left foot, which began after treatment for a left knee Baker’s cyst.

At that time, Mr. Culley also was experiencing low back pain, and he obtained several months of chiropractic treatment after being diagnosed with “lumbar spine sprain/strain.”

In July 2015, Mr. Culley was struck by a bicycle as he was walking through his employer’s parking lot and reported pain in his left ankle but initially did not report any foot or back pain.

The Justice Department’s insurer SAIF Corp., which accepted Culley’s claim, yet later denied adding lumbar radiculopathy following a neurologist’s diagnosis and a series of MRIs that noted the condition — which the doctor ruled was likely work-related, according to court records.

An administrative law judge upheld SAIF’s denial of the claim, reasoning that Mr. Culley had failed to establish that work was a material contributing cause of the claimed radiculopathy. The Workers’ Compensation Board affirmed.

The Oregon Court of Appeals said the case presented “a true battle of the experts,” ruling that the board misread the record in finding a doctor’s causation opinion was based on inaccurate information, and that it erred in discounting the doctor’s opinion because he did not adequately explain his disagreement with another expert’s view that Mr. Culley had not experienced symptoms of radiculopathy.

Since the evidence in the record did not support the board’s rationales for discounting the doctor’s opinion, the court said the decision could not stand.

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