...Steven D. Feinberg, MD This article describes special aspects of addressing and defining substantial medical evidence, causation, and apportionment in the California Workers' Compensation system. Substantial medical evidence is framed in terms of reasonable medical probability, and the opinion must...

...Robert B. Snyder, MD; James B. Talmage, MD The decision about whether a case of documented COVID-19 illness is accepted as occupationally acquired and thus work compensable is made by insurers, or if contested, by judges or administrative bureaus. Causation for COVID-19 may be difficult to show...

...Joel Weddington, MD; Charles N. Brooks, MD; Mark Melhorn, MD; Christopher R. Brigham, MD In most cases of shoulder injury at work, causation analysis is not clear-cut and requires detailed, thoughtful, and time-consuming causation analysis; traditionally, physicians have approached...

... state makes its own laws, the answer depends on what caused the loss of consciousness, and the second asks specifically what happened in the fall that caused the injury? The first question speaks to medical causation, which applies scientific analysis to determine the cause of the problem. The second...

... edition of a superb monograph, edited by J. Mark Melhorn, James B Talmage, William E. Ackermann, and Mark H. Hyman, entitled AMA Guides to the Evaluation of Disease and Injury Causation , Second Edition has been published by the American Medical Association. The purpose of the book is to offer health...

... This article presents the current science regarding the causation for herniated lumbar discs, taken from the second edition of the AMA Guides to the Evaluation of Disease and Injury Causation . Sciatica is a relatively common disorder; point prevalence population estimates range from 2% to 5...

..., and arthritis may appear in localized or systemic forms. A diagnosis of thumb-CMC arthritis is based on symptoms of localized pain, tenderness, and instability on physical examination and radiographic evaluation. The AMA Guides to the Evaluation of Disease and Injury Causation provides a protocol for assessing...

... in injury to or illness in the other is not based on scientific evidence and instead is an unsupportable myth. Determining relationships between risk factors or exposures and medical conditions is a complex process that is outlined in the Guides to the Evaluation of Disease and Injury Causation ( Causation...

...Christopher R. Brigham, MD; Charles N. Brooks, MD; James B. Talmage, MD Causation analysis always should be based on current scientific evidence and the facts of a specific case rather than common opinions or beliefs, eg, the myth that “favoring” one lower extremity often results in injury...

... to the Evaluation of Disease and Injury Causation, has been published by the American Medical Association. The purpose of the book is to offer health care providers a cogent framework in which to opine whether a condition is work-related or attributable to a specific event. Any Independent Medical Examiner...

...J. Mark Melhorn, MD Medical evidence is drawn from observation, is multifactorial, and relies on the laws of probability rather than a single cause, but, in law, finding causation between a wrongful act and harm is essential to the attribution of legal responsibility. These different perspectives...

...Frederick Fung, MD, MS A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American...

... currently available regarding causation of the condition(s) in question, ie, generic causation; the facts of the individual case, ie, specific causation; and the legal threshold in the applicable jurisdiction for acceptance of a condition as work related. The AMA Guides to the Evaluation of Disease...

... several issues, including causation, are primarily determined by the history. Focus on the portions of the history pertinent to the impairment rating. This passage from the AMA Guides repeatedly emphasizes the importance of healthcare record review for developing an adequate understanding...

...Robert J Barth, PhD The American Medical Association's Guides to the Evaluation of Disease and Injury Causation ( Causation ) is an important component of the AMA Guides library and delineates a type of evaluation that is distinctly different from a diagnostic evaluation, a treatment planning...

... standpoint (ie, how to prevent recurrent injury or eliminate the cause of an illness). In workers’ compensation, causation analysis extends beyond diagnosis, prophylaxis, and treatment and must consider whether the condition is attributable to the workplace. The terms cause, effect, exacerbation...

...Christopher R. Brigham, MD; J. Mark Melhorn, MD; Charles N. Brooks, MD; Steven D. Feinberg, MD; James B. Talmage, MD Causation analysis involves determining what conditions are related to a compensable injury or illness; apportionment is the allocation of responsibility among two or more probable...

... causation analysis. Arbitrary or opinion-based unscientific apportionment estimates that amount to little more than speculation should be avoided. The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fourth and Fifth Editions, are similar in their assessment of orthopedic impairment...

..., with the exception of an accepted causal relationship, it is necessary to determine if the impairing condition resulted from the alleged injury. The process of assessing causation was presented in the May – June 2012 issue of the AMA Guides Newsletter. 2 This article references the approaches defined in the AMA...

... may differ when an evaluator assesses issues such as causation and apportionment. A condition is not necessarily a ratable impairment, nor do symptomatic conditions necessarily prevent an individual from working. Attorneys may pose very specific apportionment questions based on laws unique to a given...