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.