THEORIES OF RECOVERY FOR WORKERS' COMPENSATION

 

1. SPECIFIC ACCIDENT OR TRAUMA—The claimant has to prove that a specific event or trauma (motor vehicle accident, slip and fall, lifting accident) at a fixed time and place caused the injury. Under the Delaware Supreme Court case of Reese v. Home Budget Center, the claimant needs to show that the injury would not have occurred “but for” the work event. This can have many different applications. For example: a claimant has degenerative arthritis in her knees. She has some ongoing treatment including injections but is able to function relatively normally and work full-time. She then has a fall at work on both knees. The symptoms in her knees increase and for the first time, total knee replacement is recommended. While she may have needed knee replacement at some point in the future, the trauma of the fall is the reason she needs it now. If the claimant would not have needed the surgery “but for” the fall at work, then the surgery is related to the fall at work and is compensable.

 

2. CUMULATIVE DETRIMENTAL EFFECT—The claimant has to prove that the repetitive use at work has resulted in a gradual deterioration over time. The claimant has to show that the work activities were a “substantial cause”. It is often crucial that the doctor has a detailed understanding of work activities. The statute on this type of case runs from when a reasonable person would have known what the injury is and that is was work related. We are often going by when the problem was first diagnosed in the medical records. Examples would be carpal tunnel, rotator cuff tears, and tendonitis.

 

ORDINARY STRESS AND STRAIN—Under Duvall v. Charles Connell Roofing, a claimant must prove that the “ordinary stress and strain” of employment was a “substantial cause” of an injury notwithstanding a preexisting condition. For example, a claimant has a prior hernia. It is repaired and doesn’t have any follow up treatment for several years. He begins a job performing heavy lifting on a regular basis. While there is no specific event, he develops new hernias which resulted in multiple surgeries. The Board held that the stress and strain of his usual work activities were a substantial cause of the hernias.