December 2025
Can a Treating Doctor’s Medical Opinion on Causation Be Incorrect—and Potentially Hurt Your Case?
When a Treating Opinion Misses the Mark
We recently discussed a case that illustrates how a treating physician’s opinion on causation—though well-intentioned—can unintentionally weaken a legal claim.
A 49-year-old woman employed in a department store sustained bilateral leg injuries when several boxes fell from an overhead shelf. Although she remained ambulatory, she developed persistent aching in her left calf that gradually progressed to swelling. Within three weeks, she presented to the emergency department with severe pain and was diagnosed with a deep vein thrombosis (DVT) in the popliteal vein behind the knee.
The Treating Opinion
At the same time, the client was being evaluated by her gynecologist for large uterine fibroids. The gynecologist concluded that the clot was the result of venous compression from the fibroids. A hematologist, referencing that note, later echoed the same opinion: that the DVT was “likely related to massive uterine fibroids.”
The Timeline Told a Different Story
The client, however, recognized a clear sequence, leg trauma followed by persistent pain, swelling, and eventual clot formation and believed her DVT was work-related. She filed a Workers’ Compensation claim, asserting that the clot stemmed from her on-the-job injury.
What the Evidence Shows
Our discussion and literature review found that DVTs directly caused by uterine fibroids are extraordinarily rare—rare enough to appear in isolated case reports. When fibroid-related thrombosis does occur, the clot typically originates in pelvic, iliac, or femoral veins, where fibroids can compress major vessels.
In contrast, trauma-related DVT in the lower extremity is well documented. Direct leg trauma can injure the venous endothelium, creating a local environment conducive to clot formation. The timing of symptoms, the anatomic location of the clot, and the absence of hereditary or systemic risk factors all supported a traumatic, work-related mechanism.
Key Takeaway
Not all treating-physician opinions on causation are correct, and an inaccurate opinion can misdirect a case. A clear, evidence-based medical analysis helps attorneys distinguish coincidence from causation, protect case integrity, and ensure fair outcomes for clients.
