DWC’s Online Causation Letter Training

An injured worker has the burden to prove that a compensable injury caused damage or harm to the physical structure of the body in order to recover workers’ compensation benefits for that injury. The causation standard that must be applied is the “producing cause” standard. Proof of medical causation must be established within reasonable medical probability.

Injured employees oftentimes need injury causation analyses from their treating doctors when there is a dispute – particularly when the dispute involves MMI and impairment. A treating doctor may be asked to provide a report that explains how and why the claimed accident or injury was a substantial factor in causing the work-related injury or illness within a reasonable degree of medical probability.

The Division of Workers’ Compensation has created new training materials for treating doctors to help them understand the role of a causation analysis in resolving a dispute, and to educate them on what information is most helpful in these analyses. The new materials for treating doctors include a:

• seven minute educational video;
• sample treating doctor report;
• summary of best practices for preparing analyses; and,
• other resources for treating doctors.

While the materials listed above merely represent Division staff’s view of what is required to prove causation, the information is helpful to carriers in evaluating the adequacy of a doctor’s opinion on causation.