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Sather v. SAIF: Workers’ Compensation and Preexisting Conditions

Sather v. SAIF, a workers’ compensation appeal from the Supreme Court of Oregon, involves a claimant who filed for benefits in 2009. Prior to the date of claimant’s on- the-job injury, he suffered from a preexisting degenerative disc disease. He also had a prior medical history of lower back pain with bilateral radiation to his legs. It is common for back pain to essentially spread to other parts of the body such as the legs though a process known to doctors as radiation.

1314902_medical_doctor.jpgClaimant then suffered a lumbar strain resulting from an on-the-job injury. Claimant applied for workers’ compensation benefits and employer’s workers’ compensation insurance company agreed to pay his claim in connection with the lumber strain. At this point, claimant filed another petition for workers’ compensation in connection with the combined condition of this preexisting back problem and his lumbar strain. This time, employer’s workers’ compensation insurance company denied his claim. The basis for denial of his claim was their belief his work-related injury was no longer a major contributing cause of the combined condition.

Under relevant state law, claimant was authorized to challenge insurance company’s denial and requested a hearing before the workers’ compensation commission. Following a hearing, the board upheld insurance company’s denial of claimant’s workers’ compensation benefits applications for the combined condition. Once the board denied his appeal, claimant filed a timely appeal before the state intermediary court of appeals.

During this appeal, claimant admitted, or rather accepted, worker-related lumbar strain was no longer the cause of his combined condition. His new argument was that the workers’ compensation board had made an error when making its calculations. While this appeal was still pending, claimant died from a cause not related to his workplace injury. Claimant did not have a surviving spouse or children at the time of his death.

When claimant was determined to be entitled to a death benefits award, there was nobody who had survived claimant to claim the disability benefits payment, so the person the court had appointed as personal representative to his estate moved to be made the real party at interest in decedent’s estate. In response to this, employer, moved to dismiss the case on grounds claimant’s estate was the owner of a disability benefits payment and not any individual living person.

As it turns out, the court agreed with employer and dismissed the case. Claimant’s personal representative and filed an appeal of this ruling to the state supreme court. In this appeal, the court noted estate’s beneficiaries are only entitled to unpaid workers’ compensation which had already been awarded, but there since there was no party who could step into decedent’s role and serve as a named party in the case, future benefits will not be calculated and awarded.

As our Boston workers’ compensation attorneys can explain, in a typical case where claimant died a result of an on-the-job injury prior to or during the process, his or her surviving spouse or children can represent the estate in the case and continue his or her fight for disability death benefits.

If you are injured on the job in Massachusetts, call the Law Offices of Jeffrey S. Glassman for a free and confidential consultation to discuss your workers’ compensation claim: 1-888-367-2900.

Additional Resources:

Sather v. SAIF, Apr. 9, 2015, Oregon Supreme Court

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OSHA Fines Welding Company in Connection with Deadly Boston Fire, October 15, 2014, Boston Workers’ Compensation Lawyers Blog