Title: Multifoods Specialty Distribution v. McAtee
Citation: N/A
Docket Number: S47519
State: Oregon
Issuer: Oregon Supreme Court
Date: April 11, 2002

Filed:  April 11, 2002
IN THE SUPREME COURT OF THE STATE OF OREGON

In the Matter of the Compensation of
David E. McAtee, Claimant.
MULTIFOODS SPECIALTY DISTRIBUTION,
	Respondent on Review,
	v.
DAVID E. McATEE,
	Petitioner on Review.
(WCB 97-01943; CA A101980; SC S47519)

	En Banc
	On review from the Court of Appeals.*
	Argued and submitted November 1, 2001.
	Donald M. Hooton, Milwaukie, argued the cause and filed the
brief for petitioner on review.
	Jerald P. Keene, of Reinisch, MacKenzie, Healey, Wilson &amp;
Clark P.C., Portland, argued the cause and filed the response to
questions for respondent on review. 
	DE MUNIZ, J.
	The decision of the Court of Appeals is affirmed.  The order
of the Workers' Compensation Board is reversed.
	*Appeal from an order of the Workers' Compensation Board. 164 Or App 654, 993 P2d 174 (1999).
		DE MUNIZ, J.
		In this workers' compensation case, employer Multifoods
Specialty Distribution accepted claimant McAtee's injury as a
"lumbar strain (combined condition)."  The term "combined
condition" referred to earlier compensable injuries and a
resulting degenerative condition that existed simultaneously with
the lumbar strain.  Subsequently, employer denied the claim based
on information that the lumbar strain was no longer the major
contributing cause of claimant's discomfort and need for
treatment.  An administrative law judge (ALJ) determined that
employer permissibly had denied the claim.  The Workers'
Compensation Board (board) decided, however, that, because
employer had accepted a claim that included the degenerative
condition, responsibility for the degenerative condition shifted
to employer.  The Court of Appeals reversed the board, holding
that employer had not accepted the prior degenerative condition. 
Multifoods Specialty Distribution v. McAtee, 164 Or App 654, 993
P2d 174 (1999).  We allowed claimant's petition for review and,
we conclude that employer accepted the prior degenerative
condition only as part of a combined condition.  Given that,
employer could deny the claim when the lumbar strain that
claimant suffered was no longer the major contributing cause of
claimant's need for treatment.  Thus, we affirm the decision of
the Court of Appeals.
		In 1981, claimant suffered a lower-back injury while
working for Papa John's Sandwich Company.  Papa John's insurer,
Wausau, accepted the claim.  Claimant was diagnosed with disc
herniation and underwent surgery that included spinal disc
repair.  In 1983, claimant's condition worsened.  Wausau accepted
the reopened claim, and claimant underwent further surgery.
		In November 1996, claimant fell and suffered an acute
lumbar strain while working for employer. (1)  X-rays revealed
severe post-operative and degenerative changes in his lower back. 
Claimant's physician concluded that the lumbar strain and
claimant's pre-existing degenerative lower-back condition
required treatment.  In December 1996, claimant acquired a
different physician, who also diagnosed acute lumbar strain and
noted that there was no evidence of disc herniation.
		On January 29, 1997, in response to an inquiry from an
insurer, the new physician opined that the lumbar strain was no
longer the source of claimant's discomfort and that claimant's
remaining discomfort and need for treatment was due to his pre-existing degenerative condition.
		On January 30, 1997, employer accepted the claim as
"acute lumbar strain (combined condition)."  The next day,
employer issued a denial of benefits, stating that, "[c]urrent
medical evidence indicates that your pre-existing condition is
now the major contributing cause for medical treatment," and
closed the claim with an award of benefits through January 31,
1997.  
		Claimant requested a hearing before an ALJ.  The ALJ
concluded that the new injury and the old injury constituted a
"combined condition." (2)
		"In this case the otherwise compensable injury was
the November 6, 1996 slip that resulted in the strain. 
This injury combined with the preexisting surgeries and
degenerative disc disease.  Insurer accepted the
combined condition.  Thus, insurer acknowledged the
otherwise compensable injury at the outset was the
major contributing cause of the combined condition and
major contributing cause of the need for treatment."
The ALJ upheld employer's denial of benefits, ruling that
employer permissibly had denied benefits under ORS 656.262(7)(b)
when it discovered that the lumbar strain was no longer the major
contributing cause of the injury. (3)  
	In response, claimant sought review by the board, which
reversed the ALJ.  The board concluded "that claimant's current
condition involves the same degenerative changes and related
surgeries that were part of the accepted claim with Wausau." 
Employer remained responsible for the pre-existing component of
claimant's combined condition, the board reasoned, because
responsibility for the pre-existing condition had shifted to
employer under ORS 656.308(1). (4)  Further, it held that employer
could not issue a denial of the claim because, under the second
sentence of ORS 656.308(1), employer's acceptance had shifted
responsibility for the pre-existing condition from Wausau to
employer.
		Employer petitioned for judicial review by the Court of
Appeals, and that court reversed the board's order.  Multifoods
Specialty Distribution, 164 Or App at 657-63.  The court
concluded that claimant's 1996 lumbar strain did not involve the
same condition that Wausau had accepted and that responsibility
for claimant's degenerative disc condition remained with Wausau. 
According to the Court of Appeals, employer never had accepted
responsibility for the older condition.  Id. at 663. 
		We allowed claimant's petition for review, and now we
review the board's order for errors of law.  Wilson v. State Farm
Ins., 326 Or 413, 415, 952 P2d 528 (1998).  This case involves
two questions.  First, what did employer accept when it accepted
a "lumbar strain (combined condition)"?  Second, what part of the
claim, if any, did employer have the ability to deny when it
denied the claim?
		Employer stated that it had accepted a "lumbar strain
(combined condition)."  The lumbar strain was the newer injury,
and both parties agree that, standing alone, it was a compensable
injury.  The question is whether, under the relevant statutes,
employer accepted the underlying degenerative disc condition as
if it were a new injury claim or accepted the degenerative disc
condition only insofar as it had a relationship to the
compensability of the lumbar strain.
		The statutes distinguish between a combined condition
and a new compensable injury involving the same condition.  A
combined condition occurs when a new injury combines with an old
injury or pre-existing condition to cause or prolong either
disability or a need for treatment.  ORS 656.005(7)(a)(B).  A 
"combined condition" is compensable "only if, so long as and to
the extent that" the new injury is the major contributing cause
of the combined condition.  Id.
		In contrast to a "combined condition," a claimant may
have a new compensable injury involving the same condition.  ORS
656.308(1) provides that responsibility for a compensable injury
remains with the employer for whom the employee worked when the
injury occurred, unless the employee sustains a new compensable
injury involving the "same condition" with a different employer. 
In that circumstance, the subsequent employer becomes responsible
because the injury is treated as a new injury claim.
		Thus, the essence of the dispute centers on the
legislature's intent regarding the manner in which ORS
656.005(7)(a)(B) and ORS 656.308(1) are to operate together.  
		First, we look to the text and context of the statutes. 
The best evidence of legislative intent is the text of the
statutes themselves.  PGE v. Bureau of Labor and Industries, 317
Or 606, 610, 859 P2d 1143 (1993).  If the intent is clear from
the text and context, further analysis is unnecessary.  Id. at
611.
		Construing ORS 656.308(1) and ORS 656.005(7)(a)(B)
together, we conclude that the analysis must focus on the
claimant's old and new injuries, and whether they are the same,
or whether they are different but combined.  Juxtaposing the
phrase "new compensable injury involving the same condition" in
ORS 656.308(1) with the definition of combined condition in ORS
656.005(7)(a)(B) clarifies that, when a new injury has some
relationship to a pre-existing condition, the new injury either
may involve the same condition, ORS 656.308(1), or the new injury
may combine with a different pre-existing condition in such a way
that the pre-existing condition causes or prolongs disability or
the need for treatment of the new injury.  ORS 656.005(7)(a)(B). 
Determining whether it is the former or the latter is important
only if the pre-existing condition was a compensable one,
because, in that case, the acceptance of a new compensable injury
involving the same condition triggers a shift in responsibility
to the current employer.
		ORS 656.005(7)(a)(B) provides the standards for
determining the compensability of a combined condition and,
according to the last sentence of ORS 656.308(1), for determining
the occurrence of a new compensable injury or disease under ORS
656.308(1).  Under ORS 656.308(1), responsibility for a
compensable injury remains with an employer "unless the worker
sustains a new compensable injury involving the same condition." 
The issue in this case is whether claimant's new compensable
injury, i.e., a lumbar strain, "involved" the same condition that
Wausau had accepted because Papa John's had been responsible
under ORS 656.308(1).  We begin by addressing the meaning of the
statutory term "involving."  The legislature has not defined the
term, therefore, we give the term its plain, ordinary meaning. 
PGE, 317 Or at 611.
		The root word for "involving" is "involve."  The
dictionary provides the following pertinent definitions for the
word "involve":
		"6a: to have within or as part of itself :
CONTAIN, INCLUDE * * * c: to have an effect on :
concern directly : AFFECT * * *."
Webster's Third New Int'l Dictionary, 1191 (unabridged ed 1993).  
	Under ORS 656.308(1), a new compensable injury
"involves" the same condition for which another employer is
responsible if the new compensable injury meets either of the
definitions set out above.  Accordingly, Papa John's remains
responsible for claimant's degenerative disc condition unless the
relationship between that compensable condition and claimant's
lumbar strain meets either of the definitions of "involve" quoted
above.  That is a factual inquiry.
	In determining whether the board erred in finding that
claimant's strain "involved" the same degenerative condition for
which he previously was treated, our review is confined to the
record created before the ALJ.  ORS 183.482(7).  Factual findings
must be supported by substantial evidence in the record.  ORS
183.482(8)(c). 
	Substantial evidence does not support the board's
finding that claimant's lumbar strain involved the same condition
for which he previously was treated, namely, a disc injury.  The
record indicates that the pre-existing injury consisted of damage
to the spinal disc structure, namely, a herniated disc and other
lumbar disc disease, which later degenerated.  The later injury
consisted of a strain, i.e., damage to muscle and ligaments. 
Claimant's attending physician noted that, in conjunction with
the lumbar strain, there was no evidence that the prior condition
-- the herniated disc -- had recurred.  Hence, the new lumbar
strain bore no relationship to the deterioration of claimant's
spinal discs sufficient to support a finding under ORS 656.308(1)
that the herniated disc "involves" the lumbar strain.  
	Instead, claimant's lumbar strain combined with the
herniated disc such that claimant had two medical problems 
simultaneously:  (1) a strained back muscle and/or ligaments; and
(2) deteriorating spinal discs.  Eventually, the strain healed,
and the discomfort from the older disc condition remained.  When
claimant's physician was asked whether the new injury combined
with the pre-existing condition to cause the need for treatment
and disability, she wrote that "[patient] had a mechanism of
strain * * *, and this combined with the prior condition had
called for extended treatment."
	The record thus supports only a finding that the pre-existing degenerative disc disease caused or prolonged the need
for treatment for the lumbar strain as a combined condition under
ORS 656.005(7)(a)(B).  We conclude that employer accepted a new
injury (the lumbar strain) that included the degenerative
condition as a combined condition.
	After accepting the claim as "acute lumbar strain
(combined condition)," employer denied benefits and closed the
claim the next day, because "medical evidence indicate[d] that
[the] pre-existing condition [was] the major contributing cause
for medical treatment."
	ORS 656.262(6)(c) provides that an employer may deny a
combined condition if the otherwise compensable injury ceases to
be the major contributing cause of the combined condition. (5) 
Further, ORS 656.262(7)(b) provides that, to close an accepted
claim, the employer must issue a written denial to the worker
stating that the accepted injury is no longer the major
contributing cause of the worker's combined condition. (6)  A
subsequent employer who accepts a compensable injury with a
combined condition also is responsible for the pre-existing
condition until the new condition is no longer the major
contributing cause of the combined condition.  At that point, the
new employer may issue a written denial and close the claim.
	The medical evidence in the record establishes that
claimant's attending physician was asked then what was the major
cause of the disability and need for treatment, if claimant had a
combined condition?  She responded:
	"Initially accident, however, by this time typically
strains should have resolved.  Studies indicate no
other reason for pain except degenerative condition."
Substantial evidence in the record supports the finding that, by
January 1997, claimant's unresolved discomfort was due to the
degenerative condition, rather than to the more recent strain.
	As we have explained, a "combined condition" is
compensable only if the new injury is the major contributing
cause of the combined condition.  ORS 656.005(7)(a)(B).  As of
January 1997, because the lumbar strain was no longer the major
contributing cause of claimant's physical complaints, ORS
656.262(7)(b) permitted employer to issue a denial of the claim.
	Finally, claimant contends that the issued denial in
this case was procedurally defective because it was a proper
compensability denial but not a proper responsibility denial. 
Claimant argues that the denial failed to state information
pertinent to a responsibility denial.  OAR 438-005-053 provides
that a denial of responsibility "on the basis of injury or
exposure with another employer * * *," shall "[a]dvise the
claimant to file separate, timely claims against other
potentially responsible insurers or self-insured employers,
including other insurers for the same employer, in order to
protect the claimant's rights to obtain benefits on the claim." 
The essence of that rule is that responsibility must be denied
"on the basis of injury or exposure with another employer." 
Here, employer's denial was not based on claimant's injury during
his prior employment.  Rather, employer's denial was based on the
conclusion that the lumbar strain no longer represented the
"major contributing cause" under ORS 656.262(7)(b).  Therefore,
we reject claimant's argument that the denial was defective.
	For the foregoing reasons, we conclude that the board
erred in overturning employer's denial.
	The decision of the Court of Appeals is affirmed.  The
order of the Workers' Compensation Board is reversed.



1. 	The term "strain," in this context, commonly is defined
as "a hurt or injury of a body part or organ resulting or such as
results from excessive tension, effort, or use * * *; usu: an
injury resulting from a wrench or twist and involving
overstretching of muscles or ligaments * * * ." 
Webster's Third New Int'l Dictionary, 2255 (unabridged ed 1993).

2. 	ORS 656.005(7)(a)(B) explains how a "combined
condition" limits a "compensable injury":
		"If an otherwise compensable injury combines at
any time with a preexisting condition to cause or
prolong disability or a need for treatment, the
combined condition is compensable only if, so long as
and to the extent that the otherwise compensable injury
is the major contributing cause of the disability of
the combined condition or the major contributing cause
of the need for treatment of the combined condition."

3. 	ORS 656.262(7)(b) provides: 
		"Once a worker's claim has been accepted, the
insurer or self-insured employer must issue a written
denial to the worker when the accepted injury is no
longer the major contributing cause of the worker's
combined condition before the claim may be closed."

4. 	ORS 656.308(1) provides:
		"When a worker sustains a compensable injury, the
responsible employer shall remain responsible for
future compensable medical services and disability
relating to the compensable condition unless the worker
sustains a new compensable injury involving the same
condition.  If a new compensable injury occurs, all
further compensable medical services and disability
involving the same condition shall be processed as a
new injury claim by the subsequent employer.  The
standards for determining the compensability of a
combined condition under ORS 656.005(7) shall also be
used to determine the occurrence of a new compensable
injury or disease under this section."

5. 	ORS 656.262(6)(c) provides:
		"An insurer's or self-insured employer's
acceptance of a combined or consequential condition
under ORS 656.005(7), whether voluntary or as a result
of a judgment or order, shall not preclude the insurer
or self-insured employer from later denying the
combined or consequential condition if the otherwise
compensable injury ceases to be the major contributing
cause of the combined or consequential condition."

6. 	As noted, ORS 656.262(7)(b) provides:
		"Once a worker's claim has been accepted, the
insurer or self-insured employer must issue a written
denial to the worker when the accepted injury is no
longer the major contributing cause of the worker's
combined condition before claim may be closed."