LEGAL STANDARD FOR MEDICAL CAUSATION AFFIRMED

by | Oct 17, 2024

In Prinz v. Omaha Operation LLC, the Supreme Court of Nebraska affirmed a workers’ compensation award where the legal sufficiency of the medical opinions was the issue.

The employee claimed that she suffered pulmonary injuries (asthma) as a result of donning an N95 mask which was required at work. Her expert wrote: “I think there is a reasonable degree of medical certainty that the two are associated as there were no other triggers identified.”

A medical causation opinion from a physician must be reasonably definite and certain in order to be legally sufficient to support an award. The Court has found that opinions using phrases like “may be”, “possibly”, “could be”, “consistent with”, etc. do not have the certainty to support an award.

Neither the trial judge nor the Supreme Court addressed the difference between the definitions of “causation” and “association”. Instead, the trial judge and the Supreme Court found that the expert’s opinion was sufficient based on the opinion as a whole, rather than just one sentence.

The Supreme Court said:

[A]n appellate court examines the sufficiency of a medical expert's statements from the expert's entire opinion and the record as a whole. Having considered the entire evidentiary records, we cannot say that the compensation court was clearly wrong in finding that Prinz met her burden to prove causation.

Notably, other than having the expert admit on cross examination that “people can develop asthma at any time for no reason”, Defendant offered no alternative explanation for plaintiff’s onset of asthma.  In the absence of any other explanation, both the Nebraska Workers’ Compensation Court was willing to attribute the same to the employee’s wearing of the N95 mask.

The decision is a good reminder that although a defendant does not have the burden of “disproof”, not offering alternative explanations as to why an employee developed physical problems is fraught with risk.

If you have questions about the sufficiency of the medical causation opinion in your case or any other questions regarding Nebraska Workers’ Compensation, please reach out to Dallas Jones or Micah Hawker-Boehnke at (402) 475-1075.

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