Diabetic condition increased susceptibility to infection, but did not cause it
Case name: Murdoch v. SAIF Corp. and SB, Inc. - Sherman Bros., No. A135297 (Or. Ct. App. 10/15/08).
What it means:
In Oregon, if the major contributing cause of a claimant's need for treatment is a preexisting condition that is unrelated to his employment, the treatment is not compensable. However, if the preexisting condition merely makes the claimant more susceptible to the disease or condition that requires treatment, it cannot be considered a "cause" for purposes of determining major contributing cause.
Summary: The claimant worked as a lube technician for the employer. For safety reasons, he wore steel-toed boots while working. The boots caused him to develop a blister on the big toe of his right foot, which became infected and ultimately led to the amputation of the toe. The claimant was not aware of the infection because he had a preexisting, nonwork-related diabetic condition that affected his sensory perception. The board ruled that the amputation was not compensable because the claimant's diabetes was the major contributing cause that necessitated the amputation. The court reversed, finding that the claimant's diabetes did not cause the infection.
In reviewing the medical evidence, the court noted that if the claimant had not suffered from diabetes, as well as microvascular disease and diabetic neuropathy, his blister would not have become "so severely infected as to require amputation." The microvascular disease may have rendered the claimant "unable to mount as strong of a response" to the infection, his attending physician opined. Further, the claimant's diabetic neuropathy "made it less likely that [he] would notice the progressive infection ulcer until it was quite advanced." However, neither condition caused the infection and resulting amputation -- they merely made him more susceptible to it.
November 17, 2008
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