Search Results

You are looking at 1 - 10 of 197 items for :

  • "Causation" x
  • Refine by Access: All content x
Clear All
Robert J. Barth
and
Christopher R. Brigham

Introduction “Does head trauma cause a pre-existing benign meningioma to become malignant ” Meningiomas are “slow-growing neoplasms that most likely derive from the meningothelial cells of the arachnoid layer.” 1 This question provides an excellent foundation for exploring the process of causation analysis. The baseless nature of claims of trauma causing cancer had long been highlighted in publications documenting United States (US) Supreme Court rulings from the 1990s regarding expert witness work. A prominent and quotable example is the work of Peter

in AMA Guides® Newsletter
Robert B. Snyder
and
James B. Talmage

, causation may be difficult to show because of the lack of accurate information and difficulty in meeting some of the criteria established by Bradford Hill. Two assessment examples are provided in the article to highlight some examples of known facts and formation of a medical opinion that is supported by reasonable explanations. This article will discuss how physicians can respond to requests for a causation opinion from workers' compensation insurers, or from administrative agencies. Critical Information The decision on whether a case is accepted for workers

in AMA Guides® Newsletter
Steven D. Feinberg

Introduction It is imperative for evaluators to understand how their jurisdictions define and assess critical workers' compensation issues. They must also understand the current science pertaining to occupational and nonoccupational risk factors for a condition. This information is reflected in the AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition. 1 Whether California is a bellwether of things to come nationally or just one state's approach to workers' compensation, there are specific definitions, unique to that state, of (1

in AMA Guides® Newsletter
Joel Weddington
,
Charles N. Brooks
,
Mark Melhorn
, and
Christopher R. Brigham

A worker who claims to have shoulder pain from years of pulling on grapevines or sorting laundry on hangers may have an occupational disease. On the other hand, if the job is limited to teaching or computer keyboarding, shoulder pain is unlikely to be work related. However, most cases are not so clear-cut and require detailed, thoughtful, and time-consuming causation analysis. Traditionally physicians have approached this in a cursory manner, eg, reporting, “In my opinion, the work activities caused (or did not cause) the patient's shoulder pain.” However

in AMA Guides® Newsletter
Christopher R. Brigham
,
Charles N. Brooks
, and
James B. Talmage

Causation analysis should always be based on current scientific evidence and the facts of a specific case. However, certain beliefs have evolved that lack scientific basis. One unsupportable myth is that “favoring” one lower extremity will often result in injury or illness of the opposite lower limb. This is exemplified by the case of a 40-year-old male long-shoreman who reportedly sustained an injury to left knee at work on September 1, 2009. His past history is remarkable for prior knee problems bilaterally, including high school football injuries that

in AMA Guides® Newsletter
J. Mark Melhorn
,
James B. Talmage
,
Charles N. Brooks
, and
Christopher R. Brigham

Workers’ compensation and personal injury claims often become embroiled in debates over the cause of the clinical presentation. The deliberation stems in large part from an administrative need to determine if an employer, insurer, or some other potentially responsible party is financially liable for the evaluation and treatment of the condition. Such causation issues can also play a role in determining whether any disability compensation or permanent impairment rating is warranted. When the primary claim involves an extremity, afflicted individuals

in AMA Guides® Newsletter
J. Mark Melhorn
,
Christopher R. Brigham
, and
James B. Talmage

extension osteotomy, arthroscopic partial trapeziectomy, implant arthroplasty, and trapeziectomy with or without ligament reconstruction and tendon interposition and occasionally fusion. Causation Analysis The AMA text Guides to the Evaluation of Disease and Injury Causation 4 provides a protocol for assessing causation, which was reviewed in the May – June 2012 issue of the Guides Newsletter . 5 Causation analysis should be conducted in an independent context, based on fact rather than opinions. The protocol includes: Definitively establishing a diagnosis

in AMA Guides® Newsletter
J. Mark Melhorn

Prevalent Perceptions of Causation Physicians are often asked to opine on causation. The concept of work-relatedness is complex and may not be intuitively obvious. Though work-related disorders by any definition affect workers, the disorder may not necessarily have been caused by work. 11 Furthermore, work-relatedness, in the context of industrial injuries, involves concepts of both medical and legal causation. The two may be mutually exclusive. Definitions of medical causation and legal causation arise from different sources — one from science and the

in AMA Guides® Newsletter
Lorne Direnfeld
,
David B. Torrey
,
Jim Black
,
LuAnn Haley
, and
Christopher R. Brigham

Editor's Comment In this article, we provide physicians and other stakeholders with insights on how causation is assessed in the workers' compensation arena. Although courts often base decisions on expert opinions and precedents, causation analysis should be based on a science. Science provides new understandings that may refute historical precedents. Robert J. Barth, PhD, presented the scientific approach to determining injury relatedness, work relatedness, and claims relatedness in the May/June 2012 issue of the AMA Guides Newsletter. That article

in AMA Guides® Newsletter
Frederick Fung

Introduction There are several issues to consider in evaluating toxic exposure-related illness, including diagnosis, causation, and permanent impairment. The goal of this article is to provide a roadmap to the evaluation of individuals who have or are suspected to have toxic exposure-related medical conditions. Cases involving toxic exposure-related illnesses often are more challenging to evaluate than other types of injuries or illnesses. Furthermore, many toxin-exposed patients may become dysfunctional and chronically disabled. Mis-diagnosis and

in AMA Guides® Newsletter