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OWCP terminology
Casual Relationship: To a physician,
“cause” ordinarily means only the direct
or principal medical cause. However,
under workers’ compensation law the
physician must establish the
contribution employment causes. Under
the FECA a medical condition or
disability is compensable only when it
is proximately caused or materially
aggravated by the conditions of
employment. A proximate cause is that
workplace factor which in a natural and
continuing sequence (unbroken by and
other cause) produces the medical
condition or disability and without
which the problem would not have
occurred. However, simply the natural
progression of a disease while a person
is working does not constitute a causal
relationship. Before conditions of
employment can be considered as “casual”
in regards to an underlying or
pre-existing medical condition the
employment factors must aggravate,
accelerate, or precipitate that
underlying medical condition. These
terms are defined as follows:
Aggravation: A documented medical
process by which a single employment
incident, or series of incidents, can be
shown to have worsened or intensified
the severity of the physical or mental
condition which pre-existed the
employment incident. There are two kinds
of aggravation:
Temporary: A worsening or increase in
severity of the pre-existing condition
for a specific period of time with no
residual alteration of the underlying
condition, and without leaving any
impairment or disability continuing
beyond the time of the temporary
aggravation. The employee ultimately
returns to his or her previous medical
status.
Permanent: A continuing and irreversible
change in the underlying condition
adversely altering the medical course of
the physical or mental problem. The
employee’s condition does not return to
its previous medical status.
Acceleration: A Documented
medical process by which a single
employment incident, or series of
incidents, can be shown to have
increased the expected speed of the
progression of a pre-existing condition
established as progressive in nature.
Such medical progression carries no
limit on its duration or severity.
Precipitation: A documented
medical process by which a single
incident, or series of incidents, can be
shown to have hastened the occurrence of
a condition; or caused it to happen or
come to crisis suddenly, unexpectedly,
or sooner than normally would have been
expected. Such medical precipitation
could be either temporary in nature of
could have no time limit on duration.
Medical Rational: A logical and
through explanation of the physician’s
underlying medical opinions including
the physician’s clearly stated reasons
and beliefs concerning casual
relationship. To the degree possible the
statement of causality should be
expressed as a medical certainly and not
simply expressed as a “possibility” or
supposition.
Consequential Injury: This type
of medical condition occurs because of a
weakness or impairment that has been
caused by an accepted work-related
injury or illness. It can involve the
same part of the body as the original
injury, or it can be to an entirely
different part of the body. This type of
injury does not have to occur at work to
be compensable. For example, if you have
an accepted foot condition which
requires the use of crutches, and the
crutches cause a shoulder condition,
then the shoulder condition could be
claimed as a consequential injury. No
special CA Form is required. Just submit
a full medical report from the physician
that explains the connection.
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