ADJ15099173 · January 17, 2023

The court affirmed the WCJ's finding of a cumulative trauma injury ending on 8/5/2021 based on Dr. Sclafani's medical opinion and rejected defendant's argument that the date of injury under Labor Code section 5412 should define the cumulative trauma injury date, as that is a separate legal issue related to statute of limitations and compensation rate, not the definition of cumulative trauma.

From the decision · page 3Applicant alleges injury to her left upper extremity, left shoulder, left elbow, left wrist, and left thumb during a continuous trauma ending on 8/5/2021; defendant denied the injury. The sole issues presented to the Court was if the injury arose out of and in the course of employment and need for further medical treatment. Defendant did not deny the injury based upon statute of limitations. The parties utilized Dr. Sclafani as the PQME to resolve their issues.

Dr. Sclafani diagnosed cumulative trauma injury to left upper extremity ending on 8/5/2021 and opined work duties contributed causally

Favours Applicant prevailed

This medical opinion supported the finding that the injury arose out of and in the course of employment, favoring applicant's compensability claim

From the decision · page 3As noted in the Opinion on Decision Dr. Sclafani examined the applicant and provided a report dated 12/27/2021 (Exhibit 1) Applicant gave a history of pain in her left upper extremity, elbow, hand, and wrist pain beginning in 2007. Applicant underwent carpal tunnel surgeries on 7/12/13 and 3/18/2015. An ulnar nerve decompression occurred on 8/13/2015 followed by another surgery on 11/3/2016. In 2019, applicant experienced an increase in workload as well as an increase in symptoms. Applicant's employment ended on 8/5/2021. In his reporting, Dr. Sclafani diagnosed injury to applicant's left elbow, wrist, and left thumb and opined that they were due to a cumulative trauma injury ending on 8/5/2021. He found that applicant was not yet permanent and stationary.

Diagnosed injury to left elbow, wrist, and left thumb due to cumulative trauma ending on 8/5/2021; found applicant not yet permanent and stationary; testified cumulative trauma arose from repetitive administrative duties over ten years contributing to left cubital tunnel and carpal tunnel diagnoses; confirmed work activities through 8/5/2021 causative or contributory to left upper extremity issues.

Dr. Sclafani's medical report and deposition testimony provided the basis for affirming the cumulative trauma injury and its end date, supporting applicant's claim and causation.

From the decision · page 3As noted in the Opinion on Decision Dr. Sclafani examined the applicant and provided a report dated 12/27/2021 (Exhibit 1) Applicant gave a history of pain in her left upper extremity, elbow, hand, and wrist pain beginning in 2007. Applicant underwent carpal tunnel surgeries on 7/12/13 and 3/18/2015. An ulnar nerve decompression occurred on 8/13/2015 followed by another surgery on 11/3/2016. In 2019, applicant experienced an increase in workload as well as an increase in symptoms. Applicant's employment ended on 8/5/2021. In his reporting, Dr. Sclafani diagnosed injury to applicant's left elbow, wrist, and left thumb and opined that they were due to a cumulative trauma injury ending on 8/5/2021. He found that applicant was not yet permanent and stationary.

Labor Code section 3208.1

Definition of cumulative trauma under Labor Code section 3208.1

The court applied the statutory definition of cumulative trauma as repetitive activities causing disability or need for medical treatment over time, distinguishing it from the date of injury under section 5412.

From the decision · page 4Defendant argues that the Court erred because it did not "apply the correct legal definition of cumulative trauma injury." (Petition for Reconsideration p. 2 lines 3-4). Specifically, Petitioner argues that Labor Code § 5412 is the correct legal definition to utilize to determine causation of a cumulative trauma. This is an incorrect legal theory. A cumulative trauma is defined under Labor Code § 3208.1 as a "repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment." Here, the combined effects of applicant's job duties played a causative or contributory role in her left upper extremity issues pursuant to Dr. Sclafani's testimony. According to the Petition for Reconsideration, an analysis under Labor Code § 5412 is essential to the definition of a cumulative trauma. Labor Code § 5412 determined the date of the cumulative trauma; it is not the definition of a cumulative trauma. The date of injury under the cumulative trauma has several legal ramifications such as compensation rate, statute of limitations, and dependency status; however, it does not effect if applicant's injury arose out of and in the course of her employment.

Labor Code section 5412

Date of injury determination under Labor Code section 5412

The court noted that section 5412 determines the date of injury for cumulative trauma claims but does not define cumulative trauma itself; the date of injury affects compensation rate and statute of limitations but not compensability.

From the decision · page 4Defendant argues that the Court erred because it did not "apply the correct legal definition of cumulative trauma injury." (Petition for Reconsideration p. 2 lines 3-4). Specifically, Petitioner argues that Labor Code § 5412 is the correct legal definition to utilize to determine causation of a cumulative trauma. This is an incorrect legal theory. A cumulative trauma is defined under Labor Code § 3208.1 as a "repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment." Here, the combined effects of applicant's job duties played a causative or contributory role in her left upper extremity issues pursuant to Dr. Sclafani's testimony. According to the Petition for Reconsideration, an analysis under Labor Code § 5412 is essential to the definition of a cumulative trauma. Labor Code § 5412 determined the date of the cumulative trauma; it is not the definition of a cumulative trauma. The date of injury under the cumulative trauma has several legal ramifications such as compensation rate, statute of limitations, and dependency status; however, it does not effect if applicant's injury arose out of and in the course of her employment.

Dr. Sclafani's testimony and report on cumulative trauma causation and timeline

From the decision · page 3As noted in the Opinion on Decision Dr. Sclafani examined the applicant and provided a report dated 12/27/2021 (Exhibit 1) Applicant gave a history of pain in her left upper extremity, elbow, hand, and wrist pain beginning in 2007. Applicant underwent carpal tunnel surgeries on 7/12/13 and 3/18/2015. An ulnar nerve decompression occurred on 8/13/2015 followed by another surgery on 11/3/2016. In 2019, applicant experienced an increase in workload as well as an increase in symptoms. Applicant's employment ended on 8/5/2021. In his reporting, Dr. Sclafani diagnosed injury to applicant's left elbow, wrist, and left thumb and opined that they were due to a cumulative trauma injury ending on 8/5/2021. He found that applicant was not yet permanent and stationary.