Opinion ID: 2612452
Heading Depth: 1
Heading Rank: 1

Heading: the claimant's medical evidence lacks probative value

Text: The employer had argued before the trial judge and on review that the claimant's medical opinion lacks probative value because her physician 1) failed to comply with the AMA Guides, 2) formed his opinion from an incomplete history and 3) could not, during his deposition, identify (or describe the nature, concentration or source of) the air pollutants to which the claimant had been exposed at her workplace. The Guides state that the examiner (or physician) should question the employee about exposures to dusts, gases, vapors and fumes. The specific information required involves (1) the year he or she was first exposed to an agent; (2) the extent of the exposure; (3) the total number of years of exposure; (4) his or her estimate of the hazard that the agent posed; and (5) the number of years since exposure ceased. [3] (Emphasis added.) The claimant's medical expert had based his opinion on her history, the extent of which we view as less than the minimum required by the Guides (excerpted above). As we conclude, the deficiency nullifies the opinion's probative value. According to the physician, the claimant had worked for the employer eleven years, during which she did assembly work and operated a machine that sprayed a mist into the air. No other facts about the extent of the employee's exposure to airborne contaminants at the workplace were included as a basis for the physician's opinion. During his deposition the physician denied knowing each exposure's duration (in hours). He also admitted not knowing whether the employee's exposure to the emission actually persisted throughout the eleven-year employment period; he only assumed that it did. From these answers we conclude the physician must have failed to question the claimant about the frequency of her exposure. In the absence of the specific information required for inclusion by the Guides, the claimant's history must be considered deficient and the physician's opinion regarded as devoid of probative force. [4] The Court of Appeals notes in its opinion several other cross-examination questions asked of the physician. The answers reveal his lack of knowledge about the general source of air pollution at claimant's work station. His responses also show he lacked familiarity with the employer's plant premises. Contrary to the appellate court's view, this part of cross-examination alone did not destroy the opinion's probative value. The physician need not have known the chemical content or names of the contaminants, the size of the building or the results of any environmental studies. [5] The AMA's Guides do not require that those facts be known and considered in evaluating respiratory impairment. [6] While a physician need not predicate his opinion on a chemical analysis of the toxic substances claimed to have caused the employee's respiratory impairment, the medical expert must have enough information to show that the claimant had inhaled some particles known to be harmful. [7] Here, the physician referred to the machine's emission as merely a spray, a mist, and as various respiratory particulates. From his descriptions it is apparent the physician could not have known the substance claimed to have been injurious. For all we know from the history he considered, the spray could have been composed merely of water. Although he had drawn a causal nexus between the claimant's condition and some agent he called a respiratory irritant, we conclude that the described source of functional loss is too indefinite for a probative medical assessment of causation. The claimant's history  as recited in the employer's medical report  indicates that for six or seven years she had worked on a machine, drilling holes into plastic parts. In that task she had been exposed to a red lubricant type spray which the machine injected onto the drill. [8] This description both amply indicates the employee inhaled some chemical ingredient which could have been pathogenic and, if assumed by her physician, would have been enough identification. The employee's history  as shown by her own physician's opinion  does not include these facts. [9] The claimant argues on certiorari that because the employer failed to provide her with requested information on the chemical composition of the spray as well as on any environmental studies done at the plant premises, the employer is now estopped from arguing that her physician's medical opinion lacks probative value for not ascribing the harm to some specific toxic ingredients of the inhaled mist. Because there is nothing in this record to indicate that the claimant, at the hearing before the trial judge, complained of the employer's resistance to requested disclosures or that she had earlier sought an order compelling the data's production, we need not pass on this argument. Nor do we intimate that chemical analysis of the air was a necessary part of claimant's proof.