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Background Workers' Compensation is a no-fault, administrative system designed to provide injured workers with medical care and wage replacement benefits without the delay, expense, and uncertainty of civil litigation. The system evolved from common law at the beginning of the twentieth century and was designed as a compromise between workers and employers in which each group surrendered certain legal rights and privileges in exchange for a speedier and more certain outcome. Compensation for occupational diseases like occupational asthma, rhinitis, or dermatitis is often complicated by the difficulty of proving that the condition "arose out of and in the course of employment." Physicians play an important role in these determinations through their expert opinion. Results Physicians must develop a consistent model to address these issues, and then present their findings and conclusions in a clear, well-reasoned, and compelling manner. In the end, the causation analysis should not solely depend on unsupported "opinion" or proceed from the conscious or unconscious biases of the physician. Conclusion Biased, illogical, scientifically unsupported, or even incompletely explained conclusions damage the credibility of physicians in the community and undermine the purposes of the workers' compensation system itself.