In re Comp. of Dunnington, WCB Case No. 17-05121
| Decision Date | 16 April 2020 |
| Docket Number | WCB Case No. 18-02870,WCB Case No. 17-05121 |
| Parties | In the Matter of the Compensation of RALPH L. DUNNINGTON, Claimant |
| Court | Oregon Workers' Compensation Division |
ORDER ON REVIEW
The Dalton Law Firm, Claimant Attorneys
Reviewing Panel: Members Ousey and Woodford.
Claimant requests review of that portion of Administrative Law Judge (ALJ) Bethlahmy's order that upheld the SAIF Corporation's denial of his injury claim for a respiratory irritation condition. On review, the issue is compensability.
We adopt and affirm the ALJ's order with the following supplementation.
In upholding SAIF's denial, the ALJ found the opinion of Dr. Davis, an occupational medicine physician, insufficient to establish that, to a reasonable degree of medical probability, claimant's August 2017 work injury was a material contributing cause of his need for treatment/disability for his respiratory irritation. On evaluation of the remainder of the medical opinion evidence, the ALJ concluded that claimant had not established the compensability of his work injury claim.
On review, claimant contests the ALJ's evaluation of the medical evidence. Specifically, he asserts that Dr. Davis's opinion persuasively establishes the compensability of his respiratory condition. Moreover, claimant argues that the opinion of Dr. Barker, a pulmonologist who examined claimant at SAIF's request, is unpersuasive. For the following reasons, we affirm the ALJ's order.
To establish a compensable injury, claimant must prove that his August 2017 work exposure was a material contributing cause of his disability/need for treatment for his respiratory condition. ORS 656.005(7)(a); ORS 656.266(1); Tricia A. Somers, 55 Van Natta 462, 463 (2003).
Because of conflicting opinions regarding the cause of the need for treatment for claimant's respiratory condition, the issue of causation is a complex medical question that must be resolved by expert medical opinion. Barnett v. SAIF, 122 Or App 279, 282 (1993); Matthew C. Aufmuth, 62 Van Natta 1823, 1825 (2010). More weight is given to those medical opinions that are well reasoned and based on complete information. See Somers v. SAIF, 77 Or App 259, 263 (1986); Linda E. Patton, 60 Van Natta 579, 582 (2008).
Here, claimant relies on Dr. Davis's opinion, who examined claimant in late January 2018. (Ex. 79). Dr. Davis noted claimant's August 2017 exposure to rat feces and other possible contaminants, as well as providing a chronic obstructive pulmonary disease (COPD) diagnosis. (Ex. 79-3). He referred claimant for an allergy consultation and testing to determine whether there was a component of occupational asthma, which was negative. (Ex. 80).
In June 2018, Dr. Davis signed a concurrence letter from claimant's counsel, opining that claimant's work exposure to irritating particulate matter (including dust and rat feces) without the use of a respirator or dust mask was a material contributing cause of a respiratory infection and its need for treatment and disability. (Ex. 96-1). He explained that even a healthy person without COPD "could" become irritated due to the exposure, as described. (Id.) Acknowledging that claimant's cultured infectious bacteria was not the type found in rat feces, Dr. Davis nevertheless concluded that it was the irritation from the particulate matter, and not the infectious microorganisms in the particulate matter, that were responsible, in material part, for the infection leading to claimant's hospitalization. (Id.) However, considering claimant's preexisting COPD, he could not say, to a reasonable degree of medical probability, whether the work injury was the major contributing cause of his need for treatment. (Id.)
In August 2018, Dr. Davis signed a concurrence letter from SAIF's counsel. (Ex. 97). Dr. Davis acknowledged that he had reviewed Dr. Barker's opinions and evaluation. (Ex. 97-1). Dr. Davis agreed that the nuisance of dust "could have symptomatically exacerbated" claimant's preexisting COPD. (Id.) Moreover, he stated that the "possible symptomatic flare up could have led to a subsequent infection." (Ex. 97-1-2). He opined that the infection and the COPD "flare-up" could equally be coincidental to the claimed incident. (Ex. 97-2). Ultimately, after considering the circumstances to a "reasonable degree of medical probability instead of possibility," he agreed with Dr. Barker's opinion, particularly regarding the need for treatment of the infection and underlying COPD.1 (Id.)
In September 2018, Dr. Davis testified that claimant's work exposure was, to a reasonable degree of medical probability, the cause of a symptomatic exacerbation of his chronic COPD. (Ex. 98-6). However, Dr. Davis further statedthat he mostly agreed with his August 2018 opinion. (Ex. 98-8). Moreover, he clarified that claimant's work exposure "could have caused irritation," and that he was unsure whether it would lead to an infection in someone without COPD. (Ex. 98-10).
After considering Dr. Davis's opinion in its entirety, we find it unpersuasive. We reason as follows.
Although Dr. Davis's June 2018 concurrence opinion supports the proposition that claimant's work injury, to a reasonable degree of medical probability, was a material contributing cause of his infection and need for treatment, he subsequently changed that opinion. Specifically, he agreed that it was equally possible that claimant's infection and COPD "flare-up" were coincidental to the work event. Thus, even assuming that Dr. Davis's September 2018...
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