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Reasonable Degree of Medical Probability

As a follow up on my last post, I, Chad Snow of Snow, Carpio, and Weekley, want to discuss the burden of proof that applicant’s have in their hearings before the Industrial Commission of Arizona.  At the end of almost every hearing involving a medical witness at the ICA, the attorney performing the direct exam will ask a question like “do you hold the opinions you’ve given today to a reasonable degree of medical probability?”  All this means is that the doctor must feel that it is more likely than not that his opinions are correct.  In other words, is the doctor 51% or more sure that what he has testified to is correct.  For example, a doctor can never say with absolute certainty that a herniated disc on an MRI is without any doubt related to an industrial injury.  But he can say that, if the applicant never had low back pain before the injury, had a mechanism of injury that could cause a herniated disc, and has had low back and leg pain ever since in the appropriate distribution, that it is more likely than not related to the injury.  If a doctor testifies that something is a mere possibility as opposed to a probability, then the applicant has not met his or her burden. 

This is a lower burden than, for example, what many people are used to hearing in criminal cases:  beyond a reasonable doubt – which is with almost certainty.