The Problem of Causation and How to Solve It


The Problem of Causation and How to Solve It

A worker complains of lumbar strain. He says it happened while he was lifting something at work. He’s been out of work now for 12 days and doesn’t seem to be improving. Sound familiar?

Low back strains are one of, if not the most common ailment involved in workers’ compensation claims. Determining causation is the biggest challenge for claims managers. The good news is technology available right now goes a long way to answering the question: how did the injury occur.


One of the problems with low back strains is that the cause is often elusive, or it is a combination of factors. While there are a number of work-related factors that can cause low back pain, more often than not, clinical evidence shows it has to do with the aging process and other non-work factors, such as:

  • Previous back injuries

  • Obesity

  • Psychosocial factors

Treating physicians are concerned with helping their patients to the best of their abilities. Until recently, the technology available to them has been less than adequate to pinpoint the cause so they have no choice but to use their best judgement and rely on the patient’s description.


A key to identifying if and when a soft tissue injury has occurred is comparing the area of the body before and after the ‘injury.’ When there is no change, there is no new injury. That doesn’t mean the worker is not experiencing pain. But it means the underlying cause existed before the complaint.


Enter the Electrodiagnostic Functional Assessment, or EFA. The EFA combines range of motion and functional capacity testing with electromyography sensors placed on different muscle groups. This FDA-cleared technology collects data while the muscle is at rest and in motion. It objectively evaluates musculoskeletal and soft-tissue pathology and functionality. If there is a change of condition, the test helps establish the location, nature, age and extent of an injury, or lack of.

Our company developed the EFA technology and created the EFA-Soft Tissue Management (STM) Program specifically to help employers determine causation and direct best treatments.

Here’s how the program works: baseline assessments are conducted on new or existing employees. The results are left unread in a stored, secure database. If and when a workplace injury is reported, a post-injury assessment is conducted and compared with the baseline testing data.

The cutting edge technology and the EFA-STM program are game changing for the workers’ compensation system. Companies using the program report significant savings and better outcomes for their injured workers.


Workers who are truly injured at work deserve the most appropriate medical care delivered as quickly as possible. On the other hand, employers should not be funding a plethora of treatments for conditions unrelated to work. Employers and payers can accomplish both by using the very latest technology to evaluate a claim upfront in the claims process.