201911.11
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Medical Testimony and Workers’ Compensation: What You DON’T Want Your Doctor to Say on the Witness Stand

As we have previously discussed in this blog, in workers’ compensation cases, employees must prove that their injury occurred during the course and scope of their employment. Generally, this requires the employee’s physician to testify to a “reasonable degree of medical certainty” that the employee’s injury is causally related to the workplace accident. So, what happens when the doctor fails to make this connection?

Unfortunately, as demonstrated by a recent decision by the Commonwealth Court of Pennsylvania, the results are devastating to the employee’s claim.

A ‘Presumption’

In PetSmart v. Workers’ Compensation Appeal Board (Sauter), an employee filed for workers’ compensation benefits, claiming to have sustained a low back injury at work. The employee’s doctor testified that he sustained discogenic low back pain and nerve symptomatology of an “indeterminate etiology.”

When the employee’s lawyer asked the doctor on the witness stand whether it was his opinion to a reasonable degree of medical certainty that the diagnosis was causally related to the employee’s alleged work injury, the doctor responded: “That was my presumption, yes.”

Notwithstanding the doctor’s testimony that the symptoms were of “indeterminate etiology” and that it was his “presumption” that they were work-related, the workers’ compensation judge awarded benefits to the employee. The Workers’ Compensation Appeal Board affirmed the ruling.

The employer then appealed to the Commonwealth Court of Pennsylvania.

No ‘Magic Words

On appeal, the Commonwealth Court reversed the ruling of the Workers’ Compensation Appeal Board. Although the court noted that there are no “magic words” that a medical expert must say to establish causation, the court found that the doctor’s testimony was insufficient to meet the employee’s burden of proof:

This Court is constrained to conclude that [the doctor’s] statements do not unequivocally establish that the back pain or nerve symptomatology Claimant suffered was in fact a result of the alleged work injury.

Conclusion

Unfortunately, the employee will not receive workers’ compensation benefits. The doctor’s language ― whether an unfortunate slip of the tongue or a true inability to link the injury with the workplace accident ― was fatal to this case.