Your Workers’ Comp Medical Report Is Hard to Follow: Find the Missing Explanation

A report can name every body part and still leave the medical reasoning hard to follow. Before treating an abbreviation or a final percentage as the explanation, find the sentences connecting the work, medical findings and particular injury. Understanding that connection is a different task from checking whether the doctor omitted an issue.

In Read v. Mobile Home Communities of America, the judge criticized extensive abbreviations, but the comparison went further: One opinion lacked a cogent explanation of the claimed cumulative injury, while another rested on a comprehensive history and review of the records. Technical language and inadequate reasoning were related concerns, rather than the same defect.

Separate the label from the proposition it is meant to prove

A diagnosis identifies a medical condition. A history describes what the worker or records reported. A causation opinion explains a relationship between that condition and the claimed work. A disability rating addresses another question. Finding a diagnosis beside a work-history abbreviation does not show which connection the physician actually made.

Write the conclusion in ordinary language without adding to it: “The doctor attributes the shoulder condition to this incident,” or “the doctor attributes it to this period of repeated work.” Then locate the explanation supporting that exact proposition. If the report never makes the distinction, mark the uncertainty rather than supply your own answer.

Compare two reports that list similar findings

Consider a hypothetical worker with a shoulder diagnosis and imaging described in both reports. One report concerns a particular fall; another concerns months of repeated overhead work. Even if both mention the same imaging, they are not necessarily answering the same injury question. Look for the event or work period each doctor evaluated, the history accepted and the reasoning connecting the findings to that event or period.

The useful comparison is not which report contains more medical terms. Does one explain why the timing of symptoms, particular duties or examination findings support its conclusion? Does the other provide a conclusion without that explanation? An imaging description may document a condition without, by itself, explaining when or why it developed. The physician must supply the medical judgment; the reader should identify where the explanation appears or remains unclear.

Distinguish an unfamiliar word from a missing causal step

If a term is unfamiliar, record the exact abbreviation and surrounding sentence for an explanation. Do not guess that it means the condition is permanent, work-related or caused by a different injury. Sometimes a definition makes the sentence understandable. Sometimes translating every term still leaves the reasoning incomplete.

For the latter problem, make the question specific: “I can identify the diagnosis and the work period, but which finding connects the condition to repeated work rather than the single event?” That describes a gap without asking the reader to choose a diagnosis or a preferred outcome.

Read the foundation before comparing the final numbers

Check what history and records each physician actually used. In Read, the favored opinion drew on more than three years of medical records, including the competing physician’s reports, and a comprehensive injury history. The judge found that foundation and reasoning more persuasive.

The Board applied the principle that one physician’s relevant, considered opinion can support findings even when another doctor disagrees. Counting reports or selecting the higher number therefore misses the inquiry. Keep impairment, permanent disability and apportionment conclusions tied to the question each addresses; they should not be treated as interchangeable percentages.

Bring the unclear passage and its context for review

Keep the complete reports, record lists and supplements. Identify the exact passage, the conclusion it supports and what remains unexplained. If a factual premise is wrong or a record was missing, distinguish that problem from unclear reasoning; our missing-history guide addresses that separate task.

Have counsel assess the permitted way to seek an explanation or challenge an opinion. Communications with a QME or AME and trial-evidence deadlines have separate rules. Our Read case analysis explains both the medical comparison and the excluded supplemental report. This guide focuses on finding the medical explanation already needed, rather than prescribing a supplemental-report procedure.