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SAIF v. Ramos

Summarized by:

  • Court: Oregon Court of Appeals
  • Area(s) of Law: Workers Compensation
  • Date Filed: 09-26-2012
  • Case #: A145800
  • Judge(s)/Court Below: Haselton, C.J. for the Court; Armstrong, P.J.; and Duncan, J.

The Worker鈥檚 Compensation Board (board) is permitted to rely on a medical arbiter鈥檚 examination, even where such examination had been cancelled by the Appellate Review Unit; and render a claimant鈥檚 condition as 鈥渕edically stationary鈥 so long as the subsequent treatments are solely to improve claimant鈥檚 functional abilities.

This was an appeal by SAIF of the Worker鈥檚 Compensation Board鈥檚 (Board) order awarding permanent partial disability (PPD) benefits to Rebeca F. Ramos (Ramos). Ramos suffered a knee injury while working as a laborer at a plant nursery. Following a second surgery, Ramos was examined by claimant鈥檚 attending physician, Dr. Black, and an independent medical examiner, Dr. Vessely. Both doctors reported that Ramos was 鈥渕edically stationary鈥 and able to work. SAIF then closed the claim and awarded Ramos two percent PPD benefits. Ramos appealed her PPD award to the Appellate Review Unit (ARU). The ARU initially scheduled a medical arbiter examination with Dr. Tatsumi but then cancelled the examination. However, Dr. Tatsumi continued with the examination and reported that Ramos鈥 condition significantly limited her ability to repetitively use her right knee. On review, the Board increased Ramos鈥 PPD award to 11 percent based on Dr. Tatsumi鈥檚 report. On appeal, SAIF assigned errors to the board鈥檚 reliance on Dr. Tatsumi鈥檚 examination when it had been cancelled by ARU and its determination that Ramos鈥 condition was 鈥渕edically stationary鈥 at the time of Dr. Tatsumi鈥檚 examination. The Court held that the board was within ORS 656.268(8)(a), ORS 656.268(6)(f), and OAR 436-035-0007, which required the board to consider the medical arbiter鈥檚 report and this decision was unreviewable by the Court because there was no predicate rule. The Court also held that there was substantial evidence to support the board鈥檚 determination that Ramos鈥 condition was 鈥渕edically stationary鈥 at the time of Dr. Tatsumi鈥檚 examination. Affirmed.

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