Greetings,

Sometimes a doctor’s narrative medical records are not clear as to their opinion on whether the accident is the Major Contributing Cause of the need for treatment.  While yes, we may have the DWC-25 form completed by the doctor’s office…I am not always so certain those rapidly completed check-marked forms can be relied upon entirely.

The statute is very clear on what is needed to prove MCC:

440.13(1) states in part:

The injury, its occupational cause, and any resulting manifestations or disability must be established to a reasonable degree of medical certainty, based on objective relevant medical findings, and the accidental compensable injury must be the major contributing cause of any resulting injuries. For purposes of this section, “major contributing cause” means the cause which is more than 50 percent responsible for the injury as compared to all other causes combined for which treatment or benefits are sought. 

What happens when a doctor does not use the exact words Major Contributing Cause or greater than 50%?

Well this was addressed by the 1^st DCA in Hunt v. Exxon, 747 So.2d 966 (Fla 1^st DCA 1999).  In this case, the doctor used the words “more likely than not” and “most probable cause” but he was somewhat vague in testimony. Here are some key quotes from the DCA:

“When a single medical expert testifies concerning a particular medical question such as causation, and that expert’s opinion appears vague or conflicting, it is incumbent upon the judge of compensation claims to consider all of the testimony so as to distill the essence of the expert’s opinion.”

“The applicable legal standard may be established without pronouncement of the magic words, provided the totality of the evidence demonstrates a causal relationship between the claimant’s injury and employment with the appropriate quantum of proof. In this regard, expert medical testimony that an injured worker’s employment is “more likely than not” the cause of injury conveys the same meaning as the term “major contributing cause.””

So a Judge can infer from the language the doctor uses that the accident is the Major Contributing Cause.  The doctor does not have to use the “magic words” for a claim to be compensable.

Sincerely,

Morgan Indek | Managing Partner