A firefighter can’t collect workers’ compensation benefits after an appeals court upheld a decision which found his diabetes was the larger contributing cause to his toe being amputated than a work injury was.
An Aug. 22, 2022, decision from the Oregon Court of Appeals came down to two conflicting medical opinions in a case involving a diabetic firefighter and a work-related blister that resulted in an amputated toe.
Developed blister on left foot while working
In the Matter of the Compensation of Guillermo Torres, the employee was a firefighter for Torres Farms. His work duties included walking on steep mountain terrain, while wearing boots, for several hours per shift. Before beginning this job in early August 2017, the employee had been diagnosed with diabetes.
On Aug. 20, 2017, the employee noticed a blister on his left foot. He worked until Sept. 12, 2017, when the pain in the affected foot became intolerable. A visit to a local medical clinic one month later revealed a possible infection.
Doctors couldn’t agree on cause
The employee was referred to “Dr. Stevens, a podiatrist, … but the infection did not abate and, ultimately, on Dec. 13, 2017, Stevens amputated” a toe on the worker’s left foot.
While he was still undergoing treatment, the employee filed for workers’ compensation benefits, claiming the blister on his left foot as the injury and attributing it to his work as a firefighter.
Torres Farms denied the claim, arguing the injury wasn’t compensable since it wasn’t related to his employment. An independent medical examination by “Dr. Curosh, an endocrinologist,” found that the employee’s work activities didn’t significantly contribute to the injury. Instead, Dr. Curosh said the major cause of the injury was:
- poorly controlled diabetes
- ill-fitting shoes
- failure to check the feet for blisters
- failure to treat the blister and change shoes
- continuing to work with a worsening blister, and
- failure to seek timely medical care.
Dr. Stevens, however, continued to insist the major cause of the injury and eventual amputation was the employee’s work activities as a firefighter. He also claimed the employee’s diabetes made him more susceptible to an infection.
Board’s opinion based on ‘substantial evidence, reason’
In Oregon, “when an otherwise compensable injury combines with a preexisting condition to cause or prolong a disability or the need for treatment, the combined condition is compensable only if the otherwise compensable injury is the major contributing cause of the disability or need for treatment.” While the employee had the burden to prove he had a compensable injury, the employer had the burden to prove that the injury was caused in larger part by the pre-existing medical condition rather than the work activities.
The claim went before the state’s workers’ compensation board, which reviewed the medical opinions of both Dr. Stevens and Dr. Curosh. The board found both opinions supported the finding that the employee’s work injury “was at least a material contributing cause” for treatment.
But the board found Dr. Curosh’s opinion was more convincing since “it was Dr. Stevens’s opinion that claimant’s diabetes did not actively contribute to claimant’s foot condition, but only made him more susceptible to injury.” Further, Dr. Stevens initially described the foot condition as a diabetic ulcer, not as a blister caused by work activities.
On appeal, the court found the board’s conclusion was logical and supported by “substantial evidence and reason,” so it upheld the decision.