Opinion ID: 2182990
Heading Depth: 1
Heading Rank: 5

Heading: Cumulative Trauma and Time of Injury

Text: If on remand the examiner finds that King did not suffer an aggravating injury on April 11, 1994, but that he did become disabled on that date as the result of cumulative work-related trauma, then coverage depends on the rule that is selected for fixing the time of injury in such a case for purposes of D.C.Code § 36-303(a). We recognize that a specific time of injury may be difficult to pinpoint for a cumulative trauma injury; however, given the statutory language, it is necessary to develop a consistent approach to that issue. In this and other jurisdictions, courts and agencies have confronted the issue of specifying the time of injury in various contexts. Different rules have been proposed and adopted, with the choice depending in large part on the policies to be served and the costs and benefits attendant on each alternative  which we consider a strong reason in favor of directing the agency to grapple with the matter and to articulate a rule in the first instance. According to Professor Larson, The practical problem of fixing a specific date for the accident has generally been handled by saying simply that the date of accident is the date on which disability manifests itself. Thus, in the Ptak [ [9] ] case, the date of a gradually acquired sacroiliac strain was deemed to be the first moment the pain made it impossible to continue work, and in the Di Maria [ [10] ] case, the date of accident for gradual loss of use of the hands was held to be the date on which this development finally prevented claimant from performing his work. However, for certain purposes the date of accident may be identified with the onset of pain occasioning medical attention, although the effect of the pain may have been merely to cause difficulty in working and not complete inability to work. A. LARSON, 3 LARSON'S WORKERS' COMPENSATION LAW, § 50.05, at 50-9-10 (1999) (footnotes omitted). King argues that the time of injury in a cumulative trauma case should be fixed in accordance with the so-called manifestation rule. There is case support for King's argument in this jurisdiction, though the precise question presented in this case has not been settled. [11] Moreover, as the quoted passage reveals, there is no single manifestation rule; rather, there are several variant rules. The Department of Employment Services utilized a manifestation rule in at least one cumulative traumatic injury case prior to the 1991 amendment of D.C.Code § 36-303. In Franklin v. Blake Realty Co., H & AS No. 84-26, OWC No. 25856 (August 18, 1985), the claimant had sustained a cumulative traumatic injury to her shoulder and arm during June 1983, but that injury did not manifest itself in debilitating pain and discomfort until some time in July 1983. The employer had changed insurance carriers at the end of June, and so one of the issues in the case was which carrier was liable on the claim. That dispute turned on whether the date of injury was considered to be before or after the employer switched carriers. For this purpose the Director conclude[d] that the date of injury for a cumulative traumatic injury is the date on which the injury manifests itself. The date on which the injury manifests itself is (1) the date on which employee first sought medical attention for his painful symptoms, whether or not he ceased work or (2) the date of disability, whichever first occurred. Id. at 4. [12] A few years later, in a case involving an occupational disease (hearing loss) caused by long-term exposure to noisy machinery, this court held that where the exposure occurred before the effective date of the WCA, but the employee did not become aware of the injury and its job-relatedness until after that date, the injury is presumptively covered by the WCA rather than by the Longshore and Harbor Workers' Compensation Act (LHWCA). Railco Multi-Construction Co. v. Gardner, 564 A.2d 1167, 1168 (D.C.1989). [13] Thus, the court adopted a rule that the time of injury is normally deemed to be when the employee is first aware of the injury and its relationship to the employment. In its focus on the extent of the employee's awareness, this is a different manifestation rule from the rule that the Director announced in Franklin (which did not concern itself with the employee's state of mind). Our opinion in Railco cited Franklin as having previously adopted the manifestation rule for cumulative traumatic injury, without, however, remarking on the difference in the content of the Franklin rule. Railco, 564 A.2d at 1174 n. 21. The Railco court adopted its version of a manifestation rule with a significant qualification. The court realized that (former) D.C.Code § 36-303 limited the jurisdiction of the WCA to cases in which, at the time of the injury, the employment was principally located in the District of Columbia. Some workers whose injuries did not become manifest until after the WCA took effect might be deprived of coverage entirely if the principal locus of their employment was outside the District at that time. To avoid a total loss of coverage, the court held that in such cases, if coverage would also be unavailable under any other state statute, the LHWCA would continue to apply. Railco, 564 A.2d at 1176. Although Franklin and Railco adopted a manifestation rule in one form or another for the purposes of choosing between two insurers or two statutory schemes, we do not think they definitively resolve the question presented in this case of how to fix the time of a cumulative traumatic injury for purposes of determining under D .C.Code § 36-303(a) whether the injury occurred in the District or outside the District. Neither Franklin nor Railco addressed that specific question. Both cases preceded the 1991 amendment of § 36-303(a), and hence did not purport to construe the precise statutory language now before us. Moreover, the court did not explain in Railco why its formulation of the manifestation rule differed from the agency's formulation in Franklin. Indeed, the court took no notice of the difference. For these reasons alone we would hesitate to treat Franklin or Railco as having decided the time of injury issue that is presented in the case now before us. Moreover, the issue addressed in Railco was a narrow one. Railco answered the specific question of which statute should apply where the claimant was last exposed to the harm that caused his occupational disease prior to the effective date of a new statute but the disease was not manifest until after that statute went into effect. In choosing a manifestation rule to answer that question, the court did not necessarily consider all the implications of such a rule in other factual contexts. We are not convinced, for example, that Railco necessarily would foreclose coverage under the WCA where the disease was manifest prior to the effective date of that Act but the last exposure occurred after that date. D.C.Code § 36-310 specifically provides that in the case of occupational diseases, liability for compensation rests with the employer of the last known exposure. This statutory provision would seem to imply that where the last exposure to a harmful working condition occurred after the effective date of the Act, the occupational disease should be covered by the Act even if that disease began manifesting itself before the Act took effect. This latter possibility, which is not addressed in Railco, illustrates why it is appropriate that we not read the holding of that case too broadly. In cases such as Railco, involving a long period of latency between exposure to harmful working conditions and the manifestation of the resulting disease or injury, a manifestation rule serves the beneficent purposes of the WCA. See Railco, 564 A.2d at 1172-73 (quoting, inter alia, Judge Learned Hand's observation in Grain Handling Co. v. Sweeney, 102 F.2d 464, 466 (2d Cir.), cert. denied, 308 U.S. 570, 60 S.Ct. 83, 84 L.Ed. 478 (1939), that the LHWCA is not concerned with pathology, but with industrial disability; and a disease is no disease until it manifests itself.). But it is arguable that in other cases, such as where a cumulative traumatic injury becomes manifest long before it becomes totally disabling, and the employee continues to work in the interim, alternatives to the manifestation rule would better fulfill the goals of the WCA. The potential drawbacks to a manifestation rule in such cases have persuaded courts in some other jurisdictions to adopt alternative rules for specifying the time of injury in cumulative trauma cases. The most common alternatives are the last exposure rule and the last day worked rule. See, e.g., Lawson v. Lear Seating Corp., 944 S.W.2d 340, 342 (Tenn.1997); Berry v. Boeing Military Airplanes, 20 Kan.App.2d 220, 885 P.2d 1261, 1267-68 (1994); McKeever Custom Cabinets and Lumberman's Mut. Cas. Co. v. Smith, 379 N.W.2d 368, 374-75 (Iowa 1985); Fidelity Mut. Life Ins. Co. v. Workmen's Compensation Appeal Bd., 126 Pa.Cmwlth. 188, 559 A.2d 84 (1989); LARSON'S WORKERS' COMPENSATION, § 50.05, at 50-9-10. These cases fix the time of injury on the date when the employee is last exposed to the trauma or is last able to work. For instance, the courts in Lawson and Berry adopted a last day of work rule fixing the date of injury in cases of carpal tunnel syndrome caused by repetitive stress over a long period of time. Those courts reasoned as follows: [I]f we were to adopt either the date on which the injury manifests itself or the date on which the injury is diagnosed, we would set a potential trap for the individual who, despite pain and discomfort, continues to work long after his or her carpal tunnel is diagnosed or has manifested itself. ... It seems to us that we should adopt the rule that causes the least potential prejudice and upholds the spirit of our Workers Compensation Act. We believe use of the last day of work accomplishes both of those purposes. Lawson, 944 S.W.2d at 342 (quoting Berry, 885 P.2d at 1267-68). See also Oscar Mayer & Co. v. Industrial Comm'n, 176 Ill.App.3d 607, 126 Ill.Dec. 41, 531 N.E.2d 174, 176 (1988) (By their very nature, repetitive-trauma injuries may take years to develop to a point of severity precluding the employee from performing in the workplace. An employee who discovers the onset of symptoms and their relationship to the employment, but continues to work faithfully for a number of years without significant medical complications or lost working time, may well be prejudiced if the actual breakdown of the physical structure occurs beyond the period of limitation set by statute.). Adoption of a manifestation rule may have other drawbacks that might be weighed against its undoubted benefits. The rule that this court approved in Railco requires an evidentiary inquiry to determine when the employee first knew (or perhaps should have known  a point not clearly addressed in Railco ) of the work-relatedness of her injury. For example, on remand in this case, if the hearing examiner finds that King sustained a work-related, cumulative traumatic injury to his back, adoption of a Railco manifestation rule will require the examiner to determine when King first knew (or should have known) that his job was causing him back pain. The need to pursue such a potentially time consuming and difficult factual inquiry might well be thought a disadvantage of the manifestation rule. We make no judgment about the wisdom of adopting any particular time of injury rule with respect to the issue in this case. The choice of rule implicates many considerations bearing on the implementation of the WCA. The agency charged with administering the Act should make that choice in the first instance, after carefully analyzing the precedents discussed above  which, in this jurisdiction, plainly support, if they do not compel, adoption of some version of a manifestation rule  and the language, structure and purpose of the statute. See Mushroom Transp., 698 A.2d at 433.