1. CAUSATION Who Wants to Be a Millionaire?

2. RULES Answer A, B, C or D You can have – –1 lifeline –1 50/50 –1 audience vote Who Wants to Be a Millionaire?

3. The term “causation” and its derivatives (“caused by”, “proximately caused”, “cause”) in the Colorado workers’ compensation system are: c. Defined in the AMA Guides, Third Edition (revised), but are largely unknown or are disregarded b. Inconsistently defined in case law a.Not defined at all in the Workers’ Compensation Act CAUSATION d. All of the above

4. “Arising out of … employment” (See Section 8-41-301(1)(b) and (c), CRS: d. Must be proven by medical evidence b. Means “caused by work conditions or events” a. Is as close as we get to a reference to causation in the Workers’ Compensation Act CAUSATION c. Is the sole test for determining compensability of an injury

5. When reaching a decision about the compensability of a back injury, an ALJ (Administrative Law Judge) MUST rely on: c. Credible lay testimony plus b above b. A medical opinion based on peer-reviewed studies, objective data, or other evidence beyond the subjective impression of the physician a. A medical opinion of some sort CAUSATION d. None of the above

6. When choosing to rely on one doctor’s opinion over another’s when determining causality of a back injury, the ALJ MUST CHOOSE: c. The opinion of the doctor who has more expertise in back injuries b. The opinion that is more credible a. An evidence-based opinion over a subjective impression CAUSATION d. The opinion of a treating physician over an independent medical examiner

7. When it comes to a compensability decision early in a case, an ALJ must apply which standard of proof with respect to causation: c. Preponderance of the evidence b. Clear and convincing evidence a. Beyond a reasonable doubt CAUSATION d. Substantial evidence

8. To overcome an ALJ’s decision that a back injury is caused by employment, the respondents must show (see Section 8-43-301, CRS): d. The ALJ is biased c. Conflicting evidence in the record b. Lack of substantial evidence to support the decision CAUSATION a. No evidence to support the decision

9. When an ALJ is determining whether a back injury is caused by work, which of the following is NOT TRUE: d. The ALJ can disregard all lay testimony and medical evidence in this particular case in favor of his or her knowledge of back injuries gained from other cases b. The ALJ can disregard an evidence- based opinion in favor of an opinion based on the subjective opinion of the doctor a. The ALJ can disregard the opinion of an IME doctor in favor of a treating physician CAUSATION c. The ALJ can choose a doctor’s opinion which is poorly articulated, whether in writing or in live testimony

10. When it comes to traumatic back injuries, compensability can be proved by showing: c. Evidence of an aggravation of a symptomatic, pre-existing condition or injury b. Evidence of an aggravation of an asymptomatic, pre-existing condition or injury a. Evidence of a new injury CAUSATION d. All of the above

11. When it comes to traumatic back injuries, compensability can be proved by showing: c. Evidence of the need for treatment which is new, different or increased b. Evidence of the need for restrictions, time off, assistive devices, or other negative effects on working a. Evidence of an acceleration of a pre-existing degenerative process CAUSATION d. All of the above

12. The carrier or self-insured employer at risk for an occupational disease claim is the one where the place of employment: c. Has conditions which have definitely caused the disabling condition b. Is the place where the employee suffers a substantial and permanent aggravation of the condition which causes his/her disability a. Is the place where the employee is last injuriously exposed to the work conditions which caused his/her disability CAUSATION d. Is the place where the employee suffers a last injurious exposure AND a substantial, permanent aggravation of his/her disabling condition

13. When interpreting the “last injurious exposure” requirement to prove liability for an occupational disease, Colorado courts have told us that the phrase means: c. The employee’s last exposure to the work condition, period b. The employment did cause the disabling condition a. The employment could have, if prolonged, caused the disabling condition CAUSATION d. The date that the employee first demonstrates reduced efficiency at work

14. When proving “substantial permanent aggravation” in an occupational disease case (see Section 8-41-304, CRS): c. A party must present evidence- based medical testimony or report(s) b. A party must present medical evidence a. The parties have to wait until the claimant is at MMI CAUSATION d. A party can rely on the subjective impressions of the claimant

15. When it comes to proving causation in mental impairment cases (see Section 8- 41-301, CRS): c. The claim cannot be based, in whole or in part, on conditions of employment which are common to all fields of employment b. The condition cannot be self- inflicted a. The claimant must show that the disabling impairment is “primarily caused” by then conditions at work CAUSATION d. All of the above

16. When it comes to proving causation under the heart attack statute (Section 8- 41-302(2)): c. The exertion causing the heart attack must be unusual for the employee experiencing the attack, rather than unusual for any worker in his/her job category b. The heart attack must be proximately caused by unusual exertion a. The condition must be a myocardial infarction CAUSATION d. All of the above

17. When it comes to proving the “intoxication” penalty (see Section 8-42- 112.5, CRS): c. Causation must be proven by clear and convincing evidence b. Causation can be proved by competent evidence of impairment at the time of the injury a. The injury is presumed to be caused by to the intoxication CAUSATION d. If respondents prove intoxication, then the claimant cannot avoid the penalty

18. When it comes to proving causation of hepatitis C in a firefighter (see Section 8- 41-208, CRS), it shall be presumed that the disease was contracted at work as long as which one of the following conditions is satisfied: c. The employee is determined to have hepatitis C with 24 months of exposure b. The employee complies with reasonable and necessary medical procedures under the Workers’ Compensation Act a. The employer performs a baseline test within 5 days of report of claim that shows the employee does not have hepatitis C CAUSATION d. All of the above

19. When it comes to proving cancer in a firefighter (see Section 8-41-209, CRS), it shall be presumed that the cancer is work related as long as which of the following conditions are met: c. The firefighter contracts a cancer of the brain, skin, digestive system, hematological system or genitourinary system b. The employer conducted a pre- employment or subsequent test which showed that claimant was cancer-free or at least not impaired at time of hire a. The firefighter has completed 5 years or more of service CAUSATION d. All of the above

20. When it comes to disability beginning 5 years after injury (see Section 8-41-206, CRS): c. The presumption of no causation can be overcome by clear and convincing evidence b. The presumption of no causation can be overcome by preponderance of the evidence a. Any disability, without exception, is conclusively presumed not to be caused by the injury CAUSATION d. The presumption does not apply to conditions resulting from exposure to radioactive materials or uranium, or to asbestos, silicosis or anthracosis

21. When it comes to death after 2 years post-injury (see Section 8-41-207, CRS): c. The presumption can be rebutted by competent evidence b. The presumption does not apply to cases involving exposure to radioactive materials or uranium, or to asbestosis, silicosis or anthracosis a. There is a prima facie presumption of no causation CAUSATION d. All of the above

22. When it comes to apportionment (see Section 8-42-104, CRS), causation determinations are important in which one of these scenarios: c. Apportionment of permanent partial disability where there is a previous non-industrial condition or injury b. Apportionment of permanent partial disability where there is a previous industrial injury a. Apportionment of medical care between carriers CAUSATION d. Apportionment of permanent total disability where there are two or more industrial conditions allegedly causing total disability