The Opinion of a Medical Expert in PA Workers’ Compensation Need Not Have Magic Words

To prevail in a PA workers’ compensation case, typically the successful party presents the testimony of a medical expert, whose opinion is accepted by a Workers’ Compensation Judge (WCJ).  This expert opinion must be “to a reasonable degree of medical certainty.”  What is encompassed by those words is a bit of an art.

A recent case from Commonwealth Court of PA, UPMC Pinnacle Hospitals v. Renee Orlandi (Workers’ Compensation Appeal Board) [albeit an unreported case], touched on this issue, which may be of some interest to our readers.  When we present the testimony of a medical expert, the opinion of that expert need not be to concrete one-hundred precent certainty.  Few things in medicine reach that level, as a practical matter.  Instead, the opinions must simply be to a “reasonable degree of medical certainty.”

Pennsylvania courts have specifically found that there are no “magic words” that must be uttered by a medical expert for the opinion of that expert to be competent and be a sufficient foundation for the WCJ to base findings.  A reviewing court, such as the Workers’ Compensation Appeal Board (WCAB), or the Commonwealth Court of PA, cannot pick a sentence here or there from a medical deposition, out of context.  Instead, the appellate court must see if the testimony, as a whole, contains “a requisite level of certainty necessary to deem it unequivocal.”

As the Court quoted from prior case law in the Orlandi decision:

“There is no requirement that every utterance that escapes the lips of a medical witness on a medical subject must be certain, positive, and without reservation, exception, or p[e]radventure of a doubt in order to be considered unequivocal.” Id. “Moreover, it is not necessary that the claimant’s medical expert rule out with absolute certainty other factors that may have caused or contributed to a condition.”

Essentially, as long as the medical opinion is not based upon incorrect facts, and represents what that physician believes to be correct, that opinion will likely be found competent.  The trick, of course, lies with convincing the WCJ that our doctor is more credible than the doctor offered by the workers’ comp insurance carrier!