Hopkins: House Bill 3022 in Light of Ruling in Elvia Garcia-Solis

Thursday, June 13, 2019 | 0

Oregon House Bill 3022 recently passed the state House of Representatives and now awaits Senate action. 

Caroline Hopkins

HB 3022 proposes to amend ORS 656.245(1)(c) to make diagnostic services compensable if they are reasonable and necessary to identify the nature or extent of a medical condition that may be related to a work injury or occupational disease. The necessity of HB 3022 is now potentially questioned in light of the recent Oregon Supreme Court ruling in Garcia-Solis v. Farmers Ins. Co.

The proposed amendment would enact changes to the workers’ compensation scheme that were initially denied with the Oregon Court of Appeals ruling in Garcia-Solis. The appellate court held that a diagnostic psychological referral was not compensable because the worker failed to show it was related to any of the medical conditions that had been accepted.

The Court of Appeals reasoned precedent established that medical services under ORS 656.245(1)(a) had to be for a “compensable injury,” and “compensable injury” meant only those conditions previously accepted.

The Supreme Court disagreed and recently overturned the court of appeals. The court noted that ORS 656.245(1)(a) reads, “For every compensable injury, the insurer … shall cause to be provided medical services for conditions caused in material by the [work accident]." The Supreme Court held the term “injury” as used in ORS 656.245(1)(a) means the “work accident.”

On its face, this ruling appears to be a broader reading than the proposed amendment in HB 3022. It should be noted, however, that Garcia-Solis involved the compensability of a diagnostic medical service.

Future litigation regarding the breadth of the Garcia-Solis ruling will undoubtedly define the case’s impact. In the meantime, the Supreme Court ruling negates the necessity of the proposed amendment to ORS 656.245(1)(c) in HB 3022. It remains to be seen if the Senate agrees.

Caroline Hopkins is an attorney with Reinisch Wilson Weier PC, headquartered in Portland, Oregon. This column is republished with permission from the firm’s website.