| Q: Does your job have to be the sole
cause or main cause of compensable injury? |
|
A. Causation. . . is the
gravest error of the OWCP. The case law makes it clear that to prove causation , the
medical opinion need only indicate that on a "more probable than not basis"
(that a 51/49% balancing of the evidence in favor of the worker) that the on the job
injury contributed "in any way" to the disabling condition. |
| Q: So just how much does the job have
to contribute to the injury? |
|
A. Note in Rudy C. Sixta,
Jr., 44 ECAB 727, 731 at n. 3, ECAB restated the standard for aggravation. When the Board
pointed out that the Office did not address the issue of whether a delay in treatment of
appellant's condition hastened the progression of his condition materially affected
appellant's condition or aggravated it in any way, ECAB reemphasized its previous
decisions noting that it is not necessary to prove a "significant contribution"
to a condition for the purpose of establishing causal relationship.(emphasis added) citing
John a Lattany.
Also look at Arnold Gustafson, 41 ECAB 131,133-34 (1989) quoting
with approval from Henry Klaus, 9 ECAB 333(1957) , that " '[w]here a person has a
preexisting condition which is not disabling but which became disabling because of
aggravation causally related to employment, then regardless of the degree of such
aggravation, the resulting disability is compensable. . . the employee's disability is
compensable regardless of the precise quantum of such aggravation directly attributable to
work.' "Arnold
Gustafson, supra at 41 ECAB 133-34; John A. Lattany, 37 ECAB 129, 141 (1985) (stating that
to hasten disability or death is to cause it, as far as the right to compensation is
concerned).
See also Arnold Gustafson, 41 ECAB 133 (1989) (noting that it is
not necessary to prove a significant contribution to a condition for the purpose of
establishing causal relationship); Beth Chaput, 37 ECAB 168(1985) ECAB remanded to the
Office stating that "
' [i]t is not necessary to prove a significant contribution of factors of employment to a
condition for the purpose of establishing causal relationship. If the medical evidence
revealed that [a work factor]. . . .contributed in any way to [the employee's] . . .
condition, such condition would be considered employment related for the purpose of
compensation benefits under the FECA.' "(emphasis added) Thus the case law explains the rule on causation
in a manner that is not apparent in the regulation and manual.
Therefore encourage the readers to go beyond the regulation and read
the cases to understand what causation means. |
| Q: But do doctors understand what
they're being asked? |
|
A: To complicate matters,
the OWCP will send its List of Questions to be answered to a consulting or IME physician
and ask if the injury caused the disabling condition. Because all state workers' comp
statues require that the injury be a "significant factor", the physician will
usually say no because the request does not state the causation issue correctly. The
correct question on causation to be addressed by any physician is this: "Did the on
the job injury contribute or cause, precipitate, accelerate, or aggravate " in any
way" or "to the slightest degree" ?
Workers should request the CE to phrase the question in this
manner. Some CEs will. If the CE ignores the request, it is an excellent issue for appeal.
Also request the CE to send the list of questions and the SOAF to the worker's physician. |
|
