Hopkins v. SAIF Corp.

• Decision Date: 09 December 2010
• Docket Number: (WC 0407794; CA A138825; SC S058081).
• Citation: 349 Or. 348,245 P.3d 90
• Parties: In the Matter of the Compensation of Barbara L. Hopkins, Claimant. Barbara L. HOPKINS, Petitioner on Review, v. SAIF CORPORATION and Nyssa Gardens Adult Alternative Living, Respondents on Review.
• Court: Oregon Supreme Court

245 P.3d 90 349 Or. 348 In the Matter of the Compensation of Barbara L. Hopkins, Claimant. Barbara L. HOPKINS, Petitioner on Review, v. SAIF CORPORATION and Nyssa Gardens Adult Alternative Living, Respondents on Review. (WC 0407794; CA A138825; SC S058081). Supreme Court of Oregon. Argued and Submitted Sept. 13, 2010. Decided Dec. 9, 2010.

On review from the Court of Appeals.^*

R. Adian Martin, Ransom, Gilbertson, Martin, & Ratliff, LLP, Portland, argued the cause for petitioner on review.

David L. Runner, Appellate Counsel, Salem, argued the cause and filed the brief for respondent on review.

Before DE MUNIZ, Chief Justice, and GILLETTE, DURHAM, BALMER, WALTERS, and KISTLER, Justices.^**

WALTERS, J.

This case requires that we determine the legislature's meaning of the term "arthritis" in ORS 656.005(24)(a)(A). We conclude that, in defining preexisting conditions for workers' compensation claims, the legislature intended the term "arthritis" to mean the inflammation of one or more joints, due to infectious, metabolic, or constitutional ¹ causes, and resulting in breakdown, degeneration, or structural change. We also decidethat the evidence in the record was sufficient to permit the Workers' Compensation Board (board) to find that, at the time of her work-related injury, petitioner suffered from preexisting "arthritis" as we define it. We therefore affirm the board's denial of petitioner's claim for workers' compensation benefits.

Petitioner was a caretaker at an assisted-living facility. On May 3, 2004, petitioner was preparing medications for the residents when she bent down to retrieve medication from a drawer about eight inches from the ground. Petitioner felt a sharp pain in her hip. When she stood again, her legs felt numb and tingly. Shortly thereafter, petitioner's legs became totally numb, and she was unable to move them. Petitioner was transported by ambulance to the hospital and the next day received an MRI of her thoracic spine, which revealed disc herniations. Dr. Hajjar, a neurosurgeon, performed multiple laminectomies, discectomies, and fusions on petitioner's thoracic spine. Today, petitioner is paraplegic.

Petitioner filed a workers' compensation claim for her thoracic spine condition on May 5, 2004, and respondent denied the claim on August 17, 2004. At the hearing on petitioner's claim,² an administrative law judge (ALJ) consideredboth whether petitioner had suffered a compensable work-related injury and whether she suffered from "arthritis."

Under ORS 656.266(1), a worker has the burden of proving that he or she has suffered a "compensable injury." ³ To establish a "compensable injury," the worker must prove that a work-related injury is a material contributing cause of a disability or need for treatment. ORS 656.005(7)(a); ORS 656.245(1)(a) ("For every compensable injury, the insurer * * * shall cause to be provided medical services for conditions caused in material part by the injury." (Emphasis added.)). See SAIF v. Sprague, 346 Or. 661, 663-64, 217 P.3d 644 (2009) (discussing standards for showing injuries in workers' compensation cases); Albany General Hospital v. Gasperino, 113 Or.App. 411, 415, 833 P.2d 1292 (1992) (discussing legislative history and concluding major contributing cause standard not intended "to supplant the material contributing cause test for every industrial injury claim"). If a compensable injury combines with a preexisting condition to cause or prolong disability or a need for treatment, the combined condition is compensable only if the compensable injury is the major contributing cause of the disability or need for treatment. ORS 656.005(7)(a)(B). In that instance,the employer, not the worker, shoulders the burden of establishing that the worker has a preexisting condition and that the compensable injury is not the major contributing cause of the disability or need for treatment. ORS 656.266(2)(a).⁴ To establisha preexisting condition, the employer must demonstrate that the claimant "has been diagnosed with such condition, or has obtained medical services for the symptoms of the condition," or suffers from "arthritis or an arthritic condition." ORS 656.005(24)(a)(A).⁵ Thus, by proving that a claimant suffers from preexisting "arthritis," ⁶ an employer is relieved of the burden of establishing that that condition was diagnosed or treated prior to the work-related injury.

In this case, the ALJ understood, based on previous board opinions, that both the meaning of the statutory term "arthritis" and whether petitioner suffered from that condition were to be "determined by medical evidence on a case by case basis. Adam M. Karjalainen, 57 Van Natta 172, 173 (2005)." With regard to the first issue—the meaning of "arthritis"—petitioner's treating neurosurgeon, Hajjar, opined that "arthritis" is a condition "which primarily is caused by wear and tear, degeneration and erosion, of mobile joints in the body." As to the second issue—whether petitioner suffered from arthritis—Hajjar testified that, although petitioner suffered from degenerative disc disease,her need for treatment arose from the work-related injury to her spine.

Respondent's medical experts also testified about both issues. Dr. Warnock, a radiologist, testified that, "if one assumes the intervertebral discs to be joints, as many do, then there's an arthritic condition." Dr. Parsons, a neurosurgeon, opined that petitioner's thoracic spine condition was "arthritis" because it was age-related and progressive over time. Parsons considered the intervertebral disc a cartilaginous body and testified that the erosion of such cartilage comes within the definition of "arthritis." Dr. Carr, an orthopedic surgeon, explained that the intervertebral disc is made up of structures similar to articular cartilage and that degenerative disc disease met the definition of "arthritis" because it "involved an inflammatory process or a degenerative condition of a soft tissue interface between two movable bones." Two other experts, Dr. Rosenbaum, a neurosurgeon, and Dr. Young, a radiologist, simply opined that petitioner's condition met the definition of "arthritis."

The ALJ found the testimony of respondent's experts more persuasive and concluded that petitioner had preexisting "arthritis" and that the employer had met its burden to establish that petitioner's otherwise compensable injury was not the major contributing cause of her disability or need for treatment of a combined condition. The ALJ therefore entered an order denying petitioner's claim.

Petitioner appealed to the board, pursuant to ORS 656.295(1).⁷ The board affirmed the ALJ's order, and petitioner sought review by the Court of Appeals, pursuant toORS 656.298(1).⁸ The Court of Appeals vacated the board's decision and remanded it for reconsideration in light of its opinion in Karjalainen v. Curtis Johnston & Pennywise, Inc., 208 Or.App. 674, 146 P.3d 336 (2006), rev. den., 342 Or. 473, 155 P.3d 51 (2007).

Hopkins v. SAIF, 215 Or.App. 356, 168 P.3d 1259 (2007). In Karjalainen, the Court of Appeals had held that the statutory term "arthritis" has a fixed legal meaning: an "inflammation of one or more joints due to infectious, metabolic, or constitutional causes[.]" 208 Or.App. at 682, 146 P.3d 336 (quoting Webster's Third New Int'l Dictionary 123 (unabridged ed 2002) (internal quotation marks omitted)).

On remand, the board decided that the record established that petitioner suffered from "inflammation of a joint" ⁹ and, therefore, that she suffered from "arthritis." The board found that the testimony of respondent's expert, Carr, was more "fully explained and more persuasive" than that of petitioner's expert, Hajjar. The board again affirmed the order of the ALJ.

Petitioner again sought review by the Court of Appeals, which affirmed the board's order without opinion. Hopkins v. SAIF, 232 Or.App. 439, 222 P.3d 1140 (2009). Petitioner filed a petition for review in this court, asserting that the term "arthritis" has a fixed legal meaning that is not dependent on case-by-case expert testimony and that the correct legal meaning is "inflammation of one or more synovial (freely articulating) joints causing a breakdown and eventual loss of cartilage, due to infectious, metabolic, or constitutional causes." The definition used by the board—"inflammation of a joint"—was so broad, petitioner contended, that it would include acute injuries such as ankle sprains, whereas, under the correct definition of "arthritis," petitioner's preexisting condition would not qualify. Intervertebral discs(where the inflammation in her spine is located), petitioner asserted, are not mobile, or freely articulating, joints.

In its brief in this court, respondent agrees that the term "arthritis" is a statutory term with a fixed legal meaning. Respondent contends that the correct definition of "arthritis" is that stated by the Court of Appeals in Karjalainen—"inflammation of a joint due to infectious, metabolic, or constitutional causes[.]" 208 Or.App. at 682, 146 P.3d 336 (quoting Webster's at 123) (internal quotation marks omitted). The causes required by that definition, respondent asserts, eliminate the possibility that a sprained ankle could be considered "arthritis" because those causes imply a disruption to "the integrity of the joint and lead to degeneration over time."

Thus, the issue presented for our consideration is the meaning of the statutory term "arthritis." We begin by confirming that the meaning of a statutory term is a matter of law, not a question of fact for expert testimony. See Miller v. Water Wonderland Improvement District, 326 Or. 306, 309, 951 P.2d 720 (1998) (meaning of statute presents question of law). Whether one expert is more persuasive than another in a particular case can be important in resolving a factual question; it cannot, however, determine the legal meaning of a statutory term.

We also think it helpful to note, preliminarily, that the parties agree that the...