Physician may qualify as expert on issue of causation

In Texas, a trial court does not abuse its discretion by allowing a physician to testify as to the cause or progression of a workers' compensation injury.

Case name: American Casualty Co. of Reading, Pa. v. Zachero, No. 11-07-00183 (Tex. Ct. App. 12/11/08).

Ruling: The Texas Court of Appeals held that the evidence supported a finding that the employee's compensable knee injury included osteoarthritis and chondromalacia conditions. The court also found that the trial court did not err in admitting a treating physician's testimony, as the physician was qualified as an expert witness and his testimony was relevant and reliable regarding the issue of causation.

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What it means: In Texas, a trial court does not abuse its discretion by allowing a physician to testify as to the cause or progression of a workers' compensation injury. Even though he has not previously testified as an expert on causation, the physician may be permitted to offer an opinion based on reasonable medical probability where he has reviewed the employee's medical records, conducted a physical examination of the employee, and examined objective data.

Summary: The employee injured her knee when she fainted and fell at work. She was diagnosed with a medial meniscus tear in the left knee and osteoarthritis and chondromalacia. Her orthopedic surgeon determined that the osteoarthritis was related to the work injury and was "traumatic in nature."The employee underwent a total knee replacement. A jury found that the employee's compensable injury included osteoarthritis and chondromalacia, and the carrier appealed. The carrier asserted that because osteoarthritis is an ordinary degenerative joint disease, it is not a compensable condition under Texas workers' compensation law.

The carrier also argued that the testimony offered by the employee's medical expert was inadmissible because the expert was not qualified, his testimony was not reliable, and it was not based upon reasonable medical probability. The doctor testified that the employee's osteoarthritis and chondromalacia were directly related to the removal of the meniscus because it caused her arthritis to progress.

The appeals court found that the doctor was qualified to testify because, among other things, he had been an orthopedic surgeon for 17 years, had performed approximately 200 knee replacements a year, had examined the employee, and had examined her X-rays and previous treatment. It found the doctor's testimony established that he had the requisite knowledge, skill, experience and training to qualify him to render an opinion on the cause of the employee's chondromalacia and osteoarthritis, regardless of whether he had previously testified as an expert on causation.

January 29, 2009

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