www.vtbar.org
between the injury and the disability or
need for medical treatment. Furthermore,
claims examiners are now asking for an ex-
planation of how the job duty caused the
injury or the case will be denied. Although
not necessary for medical treatment, a
medical record must clearly indicate the
doctor’s opinion as to the relationship be-
tween the injury and the medical treat-
ment in order to be approved by OWCP.
A doctor’s opinions and conclusions on a
causal relationship must be supported with
reasoned analysis and objective findings.
Once again, not typically included in a doc-
tor’s medical records, but for treatment to
be approved by OWCP, a doctor must justi-
fy his or her opinions in the medical record
itself or separate narrative.
A doctor must conclude that his or her
opinions are to a “reasonable degree of
medical certainty” basis. A doctor does
not need to know definitively that a medical
condition was related to work, just that it is
more likely than not the result of a work-re-
lated injury or condition. A doctor’s opin-
ion should never be equivocal. He or she
should not use terms such as “appears” or
“might be” or “likely.” These words do not
meet the more probable than not basis and
will result in a denial of the injured worker’s
claim. We always advise doctors to include
the following magic words in their medical
records: “it is my opinion that to a reason-
able degree of medical certainty that the
(describe medical condition) was caused/
aggravated/accelerated by (describe work
injury).”
There are several types