Specific Event, Multiple Specific Events or Cumulative Trauma
One interesting issue when first filing your workers’ compensation claim is determining whether the injury was caused by a specific event, several specific events or a cumulative trauma. In some cases, there are both cumulative trauma and several specific events involved.
Under the Benson Doctrine, two separate injuries cannot be combined to form one big permanent disability award. The doctor must determine what portion of the disability is caused by each specific event and what portion is caused by a cumulative trauma. Since a larger disability percentage would cause a larger award, the worker must determine if one combined injury can be justified from many small specific events at work.
Example: If Alex has a job at a plant nursery where he is lifting plants every day for years, it may be that on several occasions he hurt his back while lifting. Perhaps Alex even went to the doctor or chiropractor to get treatment after each specific incident. Many years later, when the injury becomes completely disabling, Alex may be better served by pleading a big cumulative trauma injury instead of several specific injuries. Just to show you how this works:
Four 5% injuries ⇒ $17,400
One 20% injury ⇒ $21,895
Four 10% injuries ⇒ $35,090
One 40% injury ⇒ $58,290
It is really up to the doctor to make the final determination as to how many injuries there are. The worker is allowed to highlight the reasons why she thinks that it would be more accurate to add all the specific injuries together as opposed to separating the main specific injuries and lowering the award. This would be especially clear if the specific injuries were so minor that medical care was not needed and time from work was not lost.
Another Complex Issue
A more complicated issue arises when trying to determine whether there is one cumulative trauma claim or more. In a 1994 case entitled Western Growers Insurance Co. v. WCAB, the court discussed when there is one cumulative trauma claim versus two or more cumulative trauma claims. The court held that when there is no break in receiving medical care and/or disability payments between the injurious periods, there is but one cumulative trauma claim. If, on the other hand, there is a period of time when the worker does not receive any medical care and/or disability payments, then suffers a later period of injurious exposure, two cumulative trauma injuries can be justified.
Choose Your Attorney Carefully
As you can see, there are many complicated issues that arise as soon as you have your work injury. Hiring the right advocate to protect your interest from the beginning could be the difference between a small award and a large award. Call my office today to set up an appointment to meet with me. I am here to help!