This is frequently the most difficult step in establishing a valid claim, especially in occupational disease cases. The term causally related as used in workers compensation means proximately caused, which in turn is defined as closely related, as a result of, following in addition to direct cause. The crucial element in proving causal relationship is the submission of reliable and substantial medical evidence. Such medical evidence must be in writing and the Office of Workers Compensation Programs will consider only that which appears in the individual s case file. Quality, not quantity, is essential and a claim will be denied unless there is appropriate medical evidence to establish that the claimed medical condition and resulting disability are employment-related.
Probative value means value in serving to prove a particular factor contention.
A medical report containing a physician s opinion as to whether the disability is employment-related, with medical reasons for that opinion, has more probative value than a report that contains an opinion but does not contain any supporting medical reasons. Weight of the evidence does not refer to the quantity of evidence but refers to quality. Thus, a medical report from an appropriate medical specialist has more weight than a report from a general practitioner. Medical evidence must be based on an accurate history of injury in traumatic injury cases and an accurate description of the conditions of employment in occupational disease cases. Definitive means conclusive and a diagnosis preceded by probable is inconclusive.