Injured workers call into our office frequently with questions about their “combined condition” denial. A combined condition denial is often confusing for injured workers, who have their workers’ compensation benefits suddenly cut off because insurance companies decide that the major cause of their condition is no longer (or never was) an otherwise compensable injury, but instead caused in major part by a “preexisting condition.” The recent Oregon Supreme Court decision in Hopkins v. SAIF, 349 OR 348 (December 9, 2010), may have made things that much tougher for injured workers by concluding that the legislature did not limit the term “arthritis” to a particular form of “arthritis.”
In Hopkins, the Supreme Court held that, in defining a “preexisting condition,” the legislature intended the term “arthritis” to mean the inflammation of one or more joints, due to infectious, metabolic, or constitutional causes, and resulting in breakdown, degeneration, or structural change. In reaching this conclusion, the Supreme Court disagreed with claimant’s argument that “arthritis” should be limited to inflammation of moveable (or “freely articulating”) joints. With this definition of arthritis, the Supreme Court went on to affirm the Board’s conclusion that Ms. Hopkins had preexisting arthritis.
If you are an injured worker and have received a denial, whether it is for a combined condition or otherwise, please call Martin L. Alvey P.C. to discuss your claim.