Smith v. Maine Coast Healthcare Corp.

Insurance Company

Cross Insurance, TPA

Date Decided

January 10, 2020

Panel Members

Bryan Chabot

Timothy Collier

Sue Jerome


Medical Evidence


Expert Witness Medical Evidence Low Back

File Size

108 KB


Summary from the Troubh Heisler Attorneys

Ms. Smith was a medical technologist who in 2009 had injured her back outside of work and required fusion surgery at L4-5, after which she returned to work full duty. In 2017 she had back and leg pain after bending over a patient for a few minutes. Her doctor took her out of work and got an MRI scan that showed a ruptured disk at L5-S1, requiring surgery, after which she again returned to work full duty. She filed petitions alleging that her work injury caused her lost time and medical bills, but at hearing she offered no expert opinion to establish medical causation. Instead, she argued that Judge Hirtle should find causation based solely on her testimony and the medical records.

Judge Hirtle concluded that, without an expert opinion, she failed to meet her burden of proof on medical causation, and he denied her petitions. Ms. Smith appealed, but the appellate panel affirmed the decision. The panel held that, unless causation is clear and obvious to a reasonable person with no medical training, an employee must provide a expert medical opinion supporting causation. Ms. Smith argued that causation was clear because her new injury was at a level below her prior injury, but the panel disagreed. It noted that the two injuries were close enough to render the matter “complicated” and to require expert testimony supporting work-causation.

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