Occupational Injury Causation

What WCB’s consulting physicians look at when determining the work-relatedness of an injury

In most cases, injury causation is straightforward—but when it’s not, WCB adjudicators seek the help of consulting physicians who conduct a causation analysis. The analysis considers the following:

• The mechanism of injury,
• Exposure to tasks or substances,
• Published medical evidence (primary reference: the AMA Guides to the Evaluation of Disease and Injury Causation, 2nd Edition)
• Other relevant information

When the consulting physician does a causation analysis, it will be documented in their opinion memo. These are available to your patient through their claim owner, if requested.

WCB is also introducing a new way to engage treating physicians in evaluating research. Details on the process for grading and submitting new research is now available online. New evidence for consideration can only be submitted by the worker’s treating physician and must be graded in accordance with the endorsed process.

Questions?

Call WCB’s Physician Help Line toll-free at 1-855-498-4919 to speak with a clinical consultant today.