Van Blokland v. Oregon Health Sciences University

• Jurisdiction: Oregon
• Parties: In the Matter of the Compensation of Patricia M. Van Blokland, Claimant. Patricia M. Van BLOKLAND, Petitioner, v. OREGON HEALTH SCIENCES UNIVERSITY and SAIF Corporation, Respondents. 83-06632; CA A42003.
• Citation: 87 Or.App. 694,743 P.2d 1136
• Court: Oregon Court of Appeals
• Decision Date: 14 October 1987

Page 1136

743 P.2d 1136

87 Or.App. 694

In the Matter of the Compensation of Patricia M. Van Blokland, Claimant Patricia M. Van BLOKLAND, Petitioner, v. OREGON HEALTH SCIENCES UNIVERSITY and SAIF Corporation, Respondents.

83-06632; CA A42003.

Court of Appeals of Oregon.

Argued and Submitted July 20, 1987.

Decided Oct. 14, 1987.

James L. Edmunson, Eugene, argued the cause for petitioner. On the brief were Karen M. Werner and Malagon & Moore, Eugene.

John A. Reuling, Jr., Asst. Atty. Gen., Salem, argued the cause for respondents. With him on the brief were Dave Frohnmayer, Atty. Gen., and Virginia L. Linder, Sol. Gen., Salem.

Before WARDEN, P.J., and VAN HOOMISSEN and YOUNG, JJ.

YOUNG, Judge.

Claimant seeks review of an order of the Workers' Compensation Board which affirmed the referee's award of an additional 35 percent unscheduled permanent partial disability of the low back, rejected claimant's contention that the claim had been prematurely closed and upheld SAIF's denial of payment for a weight loss program. On de novo review, we hold that the weight loss program is compensable and that the claim was prematurely closed.

Claimant is five feet six inches tall. Her weight has fluctuated from 234 pounds (in November 1981) to 300 pounds (in April 1983). She had compensable left knee surgeries in 1973, 1974, 1975 and 1976, which resulted in a total award of 25 percent permanent partial disability. In 1980, she re-injured the knee and was awarded an additional five percent permanent partial disability. Since at least October, 1980, after she re-injured her knee, claimant's doctors have advised her to lose weight. In January 1982, she developed low back pain due to altered body mechanics caused by her unstable knee. In April 1982, Dr. Eckhardt, her treating physician, performed a discectomy, and claimant was awarded 10 percent unscheduled permanent partial disability for the low back.

In the spring of 1983, claimant's weight increased to 300 pounds. She enrolled in a weight loss program and lost 12 pounds. In November 1983, Eckhardt rated claimant's left leg impairment as moderate and her back impairment as "mildly moderate." In December 1983, her back pain worsened and she was hospitalized. In March, 1984, Eckhardt noted that claimant's obesity "contributes significantly to * * * her overall back disability" and that a well supervised weight reduction program probably would be the most important treatment claimant could receive. On June 21, 1984, Dr. Achterman ¹ asked SAIF to approve claimant's enrollment in the Risk Factor Obesity Program, because "for a patient of this type this is the only sort of program which will work." ² SAIF offered to place claimant in Weight Watchers, and Achterman agreed. Claimant attended Weight Watchers for eight weeks, lost 15 pounds and then stopped attending, because she was "no longer motivated" by the program.

In May 1985, Achterman and Dr. Misko both recommended the Risk Factor Obesity Program. Misko termed the program "essential" to claimant's recovery. In June, 1985, Orthopaedic Consultants examined claimant and concluded that she was medically stationary but that she should lose weight and that surgery was not indicated. On July 8, Misko repeated his request that SAIF enroll claimant in the Risk Factor Obesity Program.

In January, 1986, Misko reported that claimant was not medically stationary, because "I believe the Risk Factor Obesity Clinic is reasonable and necessary, and following her obtaining reasonable weight and if [she] still at that time complains of back and leg pain that surgery would be indicated." Achterman wrote that claimant "is in definite need of treatment which can be offered through the Risk Factor Obesity Clinic."

"It is my considered opinion that this patient is in definite need of treatment which can be offered through the Risk Factor Obesity Clinic. I do not feel that it is likely that this patient will benefit from a surgical exploration of her disc, until she has lost considerable weight. I would put the required weight loss in the range of 80-100 pounds.

"Both Dr. Misko and I feel that in order to have any understanding as to the overall need for surgery in this patient, that the weight should be lost first. It may well be that with successful weight loss, that this patient would not be in need of the surgery which has been proposed."

The first issue is whether the weight loss recommended by the doctors is a compensable medical service under ORS 656.245(1), which provides, in part:

"For every compensable injury, the insurer or the self-insured employer shall cause to be provided medical services for conditions resulting from the injury for such period as the nature of the injury or the process of the recovery requires."

SAIF argues that it is not liable for the weight loss program, because claimant's obesity is not a result of her injury. SAIF's contention that the "condition" in question is obesity is incorrect. The conditions intended to be ameliorated by the obesity program are claimant's compensable injuries. Although it is true that the purpose of the Risk Factor Obesity...