Title: SAIF v. Lewis
Citation: N/A
Docket Number: S47997
State: Oregon
Issuer: Oregon Supreme Court
Date: November 29, 2002

FILED: NOVEMBER 29, 2002 
IN THE SUPREME COURT OF THE STATE OF OREGON
In the Matter of the Compensation of
Geoffrey R. Lewis, Claimant.
SAIF CORPORATION
and OREGON STATE UNIVERSITY,
Respondents on Review,
	v.
GEOFFREY R. LEWIS,
Petitioner on Review.
(WCB 97-04909; CA A103052; SC S47997)
	On review from the Court of Appeals.*
	Argued and submitted September 7, 2001.
	Robert J. Thorbeck, Salem, argued the cause and filed the
petition for review for petitioner on review.
	David L. Runner, Special Assistant Attorney General, Salem,
argued the cause and filed the brief for respondents on review. 




	G. Duff Bloom, Cole, Cary, Wing &amp; Bloom, P.C., Eugene, filed
a brief for amicus curiae Oregon Trial Lawyers Association.
	Before Carson, Chief Justice, and Gillette, Durham, Leeson,
Riggs, and Balmer, Justices.**
	DURHAM, J.
	The decision of the Court of Appeals is reversed.  The order
of the Workers' Compensation Board is affirmed.  
	*Judicial Review from the Workers' Compensation Board. 170 Or App 201, 12 P3d 498 (2000).
	**De Muniz, J., did not participate in the consideration or
decision of this case.
	DURHAM, J.
	In this workers' compensation proceeding, the Workers'
Compensation Board (board) concluded that claimant's occupational
disease was compensable because medical evidence supported by
objective findings established the existence of the disease, as
ORS 656.802(2)(d) requires.  The Court of Appeals reversed
because, in its opinion, "objective findings," as defined in ORS
656.005(19), did not support the medical evidence of claimant's
disease.  SAIF v. Lewis, 170 Or App 201, 215, 12 P3d 498 (2000). 
Claimant seeks review of the Court of Appeals' decision.  We
reverse.
	The requirement of "objective findings" in support of
medical evidence of an occupational disease arises from ORS
656.802(2)(d), which provides:
		"Existence of an occupational disease or worsening
of a preexisting disease must be established by medical
evidence supported by objective findings."
(Emphasis added.)  ORS 656.005(19) defines "objective findings"
as follows:
		"'Objective findings' in support of medical
evidence are verifiable indications of injury or
disease that may include, but are not limited to, range
of motion, atrophy, muscle strength and palpable muscle
spasm.  'Objective findings' does not include physical
findings or subjective responses to physical
examinations that are not reproducible, measurable or
observable." (1)
	With that statutory framework in mind, we turn to the
facts, which the board summarized as follows:
		"Claimant worked as a bioscience research
technician for SAIF's insured.  On February 11, 1997,
claimant's work involved cleaning a building which
contained insecticides, herbicides and fungicides in
liquid, powder and granular forms.  Claimant and his
co-workers moved the chemicals and cleaned the room. 
Claimant also scraped paint from the ceiling and walls
to prepare them for repainting.  The room was dusty and
the work stirred up dust.
		"Claimant wore protective clothing, including a
charcoal respirator mask.  The mask leaked.  Claimant
also wore goggles part of the time, but he took them
off when they became fogged.
		"During the job, claimant experienced fatigue and
eye irritation.  At about 3 p.m., after working,
claimant felt 'flat,' disoriented, confused, and 'funny
in the eyes.'  He experienced eye irritation, tearing,
coughing, and wheezing on his way home.  That evening,
claimant noticed a 'yellowish-whitish' powder in his
nostrils.  He had difficulty concentrating.  By the
next morning, claimant had a sore throat, sore neck,
fatigue, dizziness, tinnitus, headache, sinus
congestion, bright yellow phlegm and sputum, a chemical
taste in his mouth, and vision abnormalities.
		"Claimant continued working.  He sought medical
treatment from Dr. Huff, his regular physician in early
March, 1997.  By that time he was about 70 percent
recovered.  Dr. Huff referred claimant to Dr.
Stringham, who examined claimant once and ordered
tests.  Dr. Stringham opined that claimant's work
exposure caused the symptoms for which he sought
treatment.
		"Dr. Huff also referred claimant to Oregon Health
Science University, where he was examined by Drs.
Berlin and Burton on May 9, 1997.  Dr. Quarum examined
claimant on May 29, 1997.  By that time, claimant
believed that he was 95 percent recovered.
		"Claimant filed a claim for exposure to pesticide-contaminated dust. * * * SAIF denied the claim for
'injury to [claimant's] respiratory system,' stating
that there was insufficient evidence of 'a diagnosable
condition relating to the chemical exposure.' * * *. 
Claimant requested a hearing."
	The record contains conflicting evidence from expert
witnesses.  The board agreed with insurer that objective findings
did not support the medical evidence of some of claimant's
symptoms.  No party challenges that conclusion on review.  The
board also concluded:
	"However, we note that [claimant's treating physician]
Dr. Stringham reported:  'On a clinical basis,
[claimant] has an exposure.' * * * Dr. Stringham's
opinion in this regard is supported by claimant's
additional symptoms, which included irritated eyes,
sinus congestion, and production of bright yellow
phlegm and sputum.  Because the latter symptoms are
observable and verifiable, they are 'objective' under
the statute."
The board also found that Dr. Stringham's opinion was more
persuasive than the contrary opinions of insurer's experts,
stating that his "reasoning and conclusions are based on a more
accurate history and are more consistent with claimant's clinical
course * * *."
	On judicial review from the board's order in claimant's
favor, the Court of Appeals interpreted the definition of
"objective findings" in ORS 656.005(19) to require a medical
expert to perform three acts when diagnosing an injury or
disease:  (1) to conduct a medical examination to attempt to
verify the injury or disease; (2) to succeed in verifying the
injury or disease during the examination; and (3) to make
findings in accordance with the examination and verification. 
Additionally, the Court of Appeals concluded:  "Necessarily,
then, the indications of an injury or disease must, at the time
of the examination, be presently verifiable."  Lewis, 170 Or App
at 212 (emphasis in original).  This court allowed review to
determine whether the Court of Appeals has construed and applied
correctly the statutory requirement of objective findings in the
context of this case.
	Our objective in construing the pertinent statutes is
to determine the intent of the legislature.  McLean v. Buck
Medical Services, Inc., 334 Or 17, 24, 45 P3d 120 (2002).  We
consider first the text and context of ORS 656.802(2)(d).  The
introductory clause of that statute, "[e]xistence of an
occupational disease * * * must be established * * *[,]" states a
proof requirement.  That is, before the board may deem an
occupational disease to be compensable, the evidentiary record
must persuade the board to find as fact that an occupational
disease existed or exists as the claim asserts. (2)
	The next phrase, "by medical evidence," indicates that
a particular kind of evidence, that is, "medical evidence," must
establish the existence of the occupational disease.  The parties
agree, as do we, that the opinion of a medical expert, such as
Stringham in this case, qualifies as "medical evidence" under the
statute.  
	The foregoing conclusions arise from a straightforward
reading of the text of ORS 656.802(2)(d).  All that remains is to
construe that subsection's final phrase, "supported by objective
findings."  The legislature has defined "objective findings" in
ORS 656.005(19).  We focus our analysis on that definition.  
	The first sentence of ORS 656.005(19) defines
"'[o]bjective findings' in support of medical evidence" as
"verifiable indications of injury or disease" (emphasis added)
and then sets out a nonexclusive list of illustrative examples
"that may include, but are not limited to, range of motion,
atrophy, muscle strength and palpable muscle spasm."  An
"indication" is "something (as a signal, sign, suggestion) that
serves to indicate."  Webster's Third New Int'l Dictionary 1150
(unabridged ed 1993).  "Indicate" means 
	"to point	out or point to or toward with more or less
exactness : show or make known with a fair degree of
certainty : as * * * to show the probable presence or
existence or nature or course of : give fair evidence
of : be a fairly certain sign or symptom of : reveal in
a fairly clear way * * *."
Id.  The word "verifiable" means "1 : capable of being verified 2
: susceptible to the possibility of being either theoretically or
actually proved true or false by reference to empirical facts[.]" 
Id. at 2543.
	The application of those definitions leads to the
conclusion that the legislature intended the phrase "objective
findings in support of medical evidence" in the first sentence of
ORS 656.005(19) to refer to symptoms that indicate the probable
presence of an injury or disease.  Additionally, the indication
of injury or disease must be capable of being "verified," that
is, be susceptible to the possibility that a reference to
empirical facts either theoretically or actually will prove the
claim of injury or disease to be true or false.  The four
examples of conditions set out at the end of that sentence share
each of those characteristics.
	We draw attention to the significance of the legal
context in which we apply the statutory definition in ORS
656.005(19).  As noted below, the requirement in ORS 656.005(19)
that an indication of injury or disease be capable of being
verified itself does not establish an additional requirement that
the indication of injury or disease also be present, such as
during a doctor's diagnostic examination of the claimant.  In the
present case, we apply the requirement of "medical evidence
supported by objective findings," ORS 656.802(2)(d), in the
context of a dispute over compensability, that is, whether the
medical evidence was sufficient to support a finding that
claimant had or has an occupational disease.  Other statutes may
alter the issues to which medical evidence supported by objective
findings must respond.  For example, ORS 656.283(7) provides
procedures for a hearing regarding a worker's disability
following reconsideration under ORS 656.268.  That statute
states:
	"Evaluation of the worker's disability by the
Administrative Law Judge shall be as of the date of
issuance of the reconsideration order pursuant to ORS
656.268.  Any finding of fact regarding the worker's
impairment must be established by medical evidence that
is supported by objective findings."
If a claimant contends in a hearing under ORS 656.283(7) that a
temporary disability has become permanent, then the medical
evidence supported by objective findings logically must be
sufficient to support a finding of fact that the disability not
only existed, but has become permanent.
	As the foregoing discussion demonstrates, the statutory
context of the dispute and the claims of the parties ordinarily
will determine the legal and factual issues that medical evidence
supported by objective findings must address.  This case requires
the court to consider the requirement of medical evidence
supported by objective findings only in the context of a
compensability dispute arising under ORS 656.802(2).
	We turn to the second sentence of ORS 656.005(19).  The
legislature added the second sentence of ORS 656.005(19) in 1995. 
Or Laws 1995, ch 332, § 1.  That sentence excludes from the
definition of "objective findings" both "physical findings" and
"subjective responses to physical examinations" that "are not
reproducible, measurable or observable."  That sentence
incorporates a double negative ("* * * does not include * * *
that are not * * *), the linguistic effect of which is to
identify certain kinds of diagnostic conclusions that constitute
verifiable indications of injury or disease that qualify as
"objective findings."  Such objective findings include either
physical findings or subjective responses to physical
examinations that are "reproducible, measurable or observable." 
The second sentence of ORS 656.005(19) presents those three
characteristics as alternatives.  It follows that, in amending
ORS 656.005(19) in 1995, the legislature determined that any one
of those characteristics, if established, will serve to qualify a
physical finding or a subjective response to a physical
examination as a verifiable indication of injury or disease that
will constitute an "objective finding."  
	We construe those three characteristics according to
their ordinary meaning.  As the following definitions confirm,
each of those characteristics refers to the capability of a
physical finding or a subjective response to a physical
examination being reproduced, measured, or observed.  The
dictionary defines "reproducible" as "capable of being reproduced
: permitting reproduction * * *[.]"  Webster's at 1927 (emphasis
added).  The dictionary defines "measurable" as
	"capable of being measured * * *; specif : large or
small enough to be measured * * * : great enough to be
worth consideration : SIGNIFICANT * * *[.]"
Id. at 1399 (emphasis added).  The dictionary defines
"observable" as
	"requiring or suitable to be observed, regarded or kept
* * * : deserving of observation : NOTEWORTHY * * * :
capable of being observed : DISCERNIBLE, DETECTABLE,
NOTICEABLE         
* * *[.]"
Id. at 1558 (emphasis added). 	 
	The text of ORS 656.005(19) is significant to our
interpretive task both for what that statutory definition
contains and for what it does not contain.  The term "verifiable"
identifies a characteristic of an indication or symptom of an
injury or disease.  The terms "reproducible," "measurable," and
"observable" identify characteristics of physical findings or
subjective responses to physical examinations that qualify those
diagnostic conclusions as verifiable indications of injury or
disease.  The statutory definition of "objective findings,"
however, does not prescribe a particular diagnostic methodology
for making an objective finding about an injury or disease or
determining whether one of those characteristics is present.  For
example, the statute does not address how a health care
professional must conduct an examination or form a diagnosis of a
claimant's injury or disease.  The definition simply anticipates
that the person who makes the objective finding will determine,
in some medically acceptable way, whether the claimant had or has
an indication of injury or disease.  However, unlike the Court of
Appeals, we find no support in the statutory definition for an
additional requirement that the person who makes the objective
finding also must verify, when he or she examines the claimant,
that the injury or disease presently exists. (3)  The Court of
Appeals' interpretation would alter the statutory definition by
requiring health care professionals to rely solely on verified,
rather than verifiable, indications of injury or disease, and
physical findings or subjective responses to physical
examinations that are reproduced, measured, or observed, rather
than those that are reproducible, measurable, or observable.
	The wording of ORS 656.005(19) illustrates why the
foregoing is true.  ORS 656.005(19) anticipates that the person
who makes a finding in support of medical evidence of injury or
disease will identify the particular indication or indications of
injury or disease on which he or she relies.  An indication of
injury or disease must be one that permits the board to
characterize it as "verifiable," or permits the board to
characterize a physical finding or subjective response to a
physical examination as "reproducible, measurable or observable." 
Whether those adjectival characterizations accurately describe a
particular indication of injury or disease is a factual question
for the trier of fact, subject to appellate review for support by
substantial evidence.
	An essential characteristic of the definition in ORS
656.005(19) is that it does not constrain the person who
identifies an indication of injury or disease to rely solely on
his or her own perceptions or examinations.  Medical personnel
act in accordance with ORS 656.005(19) by employing the range of
diagnostic methods that their professions prescribe, including
such techniques as consulting with nurses, technicians,
therapists, and other health care professionals; examining the
patient's medical records; reviewing the reports of witnesses,
investigators, and police officers; and interviewing the patient,
family members, friends, coworkers, and others who might have
information that pertains to an indication of injury or disease. 
Information gleaned from such sources may be sufficient to
establish that a claimant had or has an indication of injury or
disease.  If so, then the board properly may characterize that
indication as "verifiable."
	We have discovered no other contextual sources that
shed any further or different light on the meaning of "objective
findings" in ORS 656.005(19).  In our view, the meaning of that
statutory definition is clear and arises from the ordinary
meaning of the terms that the legislature used in enacting that
statute.
	We next consider whether the board erred in concluding
that medical evidence supported by objective findings, as defined
in ORS 656.005(19), established the existence of claimant's
occupational disease.  In Stringham's opinion, claimant had an
exposure to toxic chemicals.  The board accepted that evidence,
and the parties agree that that evidence is "medical evidence"
within the meaning of ORS 656.802(2)(d) and ORS 656.005(19). 
Thus, the only remaining question is whether "objective
findings," as defined in ORS 656.005(19), support claimant's
medical evidence.
	As noted above, the board stated:
	"Dr. Stringham's opinion in this regard is supported by
claimant's additional symptoms, which included
irritated eyes, sinus congestion, and production of
bright yellow phlegm and sputum.  Because the latter
symptoms are observable and verifiable, they are
'objective' under the statute."
	Were the symptoms that the board and Stringham cited 
"verifiable" indications of disease within the meaning of ORS
656.005(19)?  We agree with the board that the answer is yes. 
All the conditions that the board listed above and that Stringham
recorded in claimant's medical history are physical indications
of disease and, thus, the board properly could consider them as
"physical findings" within the meaning of the second sentence of
ORS 656.005(19).  Moreover, all the symptoms were "observable"
within the meaning of the statute because, when they occurred,
they were capable of being observed.  Specifically, an observer
could detect the irritation in claimant's eyes by noticing the
discoloration, swelling, or other indications of irritation.  The
same capability of observation applies to other conditions that
claimant reported, such as the presence of phlegm and sputum. 
Both the board and Stringham determined that claimant was a
credible witness, and they accepted as true claimant's factual
claim that he had suffered the additional symptoms recited above
immediately after his toxic exposure.  
	Stringham concluded that claimant's indications of
disease had subsided substantially at the time he examined
claimant.  We agree with the board that that circumstance does
not preclude a determination that claimant's indications of
disease were verifiable within the meaning of ORS 656.005(19). 
All that the statutory definition requires is that the indication
of disease be verifiable at some time.  The definition does not
require that the indication of disease be present during a
physical examination of the claimant, including an examination
that occurs after the claimant's symptoms have subsided.
	The decision of the Court of Appeals is reversed.  The
order of the Workers' Compensation Board is affirmed.



1. 	The legislature adopted the current definition of
"objective findings" in 1995.  Or Laws 1995, ch 332, § 1.  The
pre-existing definition of "objective findings" in ORS
656.005(19) (1993) provided:
		"'Objective findings' in support of medical
evidence include, but are not limited to, range of
motion, atrophy, muscle strength, muscle spasm and
diagnostic evidence substantiated by clinical
findings."
In determining the meaning of the current statutory definition,
we consider the pre-existing version of the definition as part of
the statutory context.  SAIF v. Walker, 330 Or 102, 109, 996 P2d
979 (2000).

2. 	A claimant may seek compensation for an occupational
disease from which the claimant has recovered, but must file the
claim within the time limit established by law.  See ORS 656.807
(setting out deadlines for filing claim for occupational
disease).

3. 	As already noted, the factual and legal issues to which
medical evidence supported by objective findings must pertain may
change with the context in which they arise.