by ama andy on Sun Nov 21, 2010 7:11 pm
The word "direct" means pertaining too, proceeding without interuption, having no intervening cause.Trauma comes from the Greek and means "wound" or "injury."I have also been around workers' compensation long enough to remember when cumulative trauma injury was referred to repetitive microtrauma. In the Blackledge case, the rater tried, unsuccessfully, to substitute his lay judgment for the physician as to whether there was direct trauma to the knee.
My point is that the bar for "direct trauma" is pretty low. About all the doctor needs is a knee injury to assert that this criterion has been met and it is the doctor's call. I believe that the defense asserting that a direct trauma must be a direct blow on the knee cap rather than a twisting injury is not a winning argument. Neither do I believe that direct trauma is a differentiation between a specific and a cumulative trauma injury.
One should keep in mind that there are three criteria that must be in place for the footnote on Table 17-31 to apply - direct trauma, pain and crepitation. Also, this is an arthritis impairment table so those three criteria should signify the beginning of arthritis that cannot yet be measured by cartilage interval.
Of course as the defense you can assert what you wish, just remember to reserve your case properly.