On appeal from the New Jersey Department of Labor, Division of Workers' Compensation.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Before Judges Lintner and Sabatino.
Following a six-day trial, the Division of Workers' Compensation ("the Division") issued a final judgment on December 5, 2006 determining that petitioner, L.M., had sustained compensable total disabling injuries to her shoulders and hands of a permanent nature while employed at Church & Dwight Co., Inc. ("Church & Dwight"). L.M.'s injuries, which resulted in six separate surgeries, were found to have been causally related to her extensive and repetitive work on a computer at Church & Dwight over a seven-year period.
Based on the compensation judge's findings, the Division awarded L.M. 450 weeks of disability benefits, payable at $568 per week, subject to an offset for Social Security benefits. Church & Dwight now appeals the judgment on various grounds. We affirm.
These are the pertinent facts adduced before the compensation judge. L.M. began working for Church & Dwight in December 1993 at the age of forty-six. She continued to work for the company full-time until March 2000. She then briefly worked on a part-time basis through May 2000, when her persisting injuries forced her to stop.
L.M. testified that she had not experienced any pain or problems in either of her shoulders or wrists, nor did she suffer any accident or injury to those areas, prior to the start of her employment with Church & Dwight in 1993. She did not suffer from any psychological or psychiatric problems before working for the company.
At the time she left Church & Dwight, L.M. had been an "assistant to the vice-president of logistics," a title which she had held for one-and-a-half to two years. L.M.'s duties in that position consisted of "build[ing] [E]xcel spread sheets and graphs," requiring her to work on her computer an estimated "99 percent" of the fifty to sixty hours that she worked each week. Immediately before serving in that assistant's job, L.M. worked for two-and-a-half years in the inventory control unit of a Church & Dwight subdivision. While in inventory control, L.M. worked fifty to fifty-five hours per week, spending "between 95 and 100 percent" of her time using a desktop computer. The record reflects that Church & Dwight did not supply L.M. with an ergonomic computer keyboard.
In the early part of 2000, L.M., who is left-handed, experienced stiffness and tightness in both of her shoulders. She initially attributed those sensations to "getting old" and to the "number of hours that [she] had been working." L.M. also felt numbness in both of her hands.
Soon thereafter, while driving to work one day in March 2000, L.M. had difficulty lifting her arms and hands. That afternoon, she informed her supervisor, Ken Colbert, that she was having trouble lifting her arms. She consequently sought treatment at the Princeton Orthopedic Group ("Princeton Orthopedic").
L.M. was first treated at Princeton Orthopedic on March 14, 2000, when she complained of "severe right shoulder and elbow pain[,] . . . which she relate[d] to use of a computer mouse." On that date, Dr. Harvey Smires noted that L.M.'s "right shoulder demonstrates a . . . mildly positive impingement sign and . . . [h]er right elbow demonstrates mild lateral epicondyle tenderness." On the advice of another physician with the medical group, Dr. Michael Palmer, L.M. had massage therapy for both shoulders, and also received five cortisone injections.
L.M. returned to Princeton Orthopedic on April 4, 2000, at which time Dr. Smires observed that she had "continued impingement." He administered another injection to L.M.'s right shoulder. The injection did not, however, eliminate L.M.'s symptoms. A subsequent MRI study of L.M.'s right shoulder, as interpreted by Dr. Smires, showed "supraspinatus tendonitis without significant impingement," although without a cuff tear. During the course of this treatment, Dr. Smires noted that L.M. had "describe[d] her computer work as exacerbating" her right shoulder pain. He also determined that L.M.'s right shoulder pain "is related to her work with a computer."
On June 26, 2000, Dr. Palmer observed that L.M. had "continued cervical myofascial pain with trigger points and median nerve entrapment causing her to have radiation of pain into her forearm and into her hand[, which] is certainly exacerbated by typing and repetitive movements of her fingers." When L.M. saw Dr. Palmer again on September 6, 2000, she told him that her symptoms had returned when she worked on the computer.
To address her continuing pain, L.M. underwent two right shoulder surgeries. The first surgery, performed by Dr. Jeffrey Abrams on October 18, 2000, involved an arthroscopy and debridement, subacromial decompression, and what is termed a Mumford procedure. Dr. Abrams's operative findings included a notation that L.M. had exhibited "[i]nflammatory changes exterior of the rotator cuff [and] superior labral tear without destabilization." Dr. Abrams diagnosed L.M. with right shoulder rotator cuff tendonopathy, acromioclavicular joint arthritis, and impingement syndrome.
The second right shoulder surgery, which involved a capsular shift procedure and labral repair, was performed by Dr. Matthew Garfinkel on July 11, 2001. Dr. Garfinkel diagnosed L.M. with right shoulder anterior instability.
In addition to these right shoulder problems, L.M. also was having difficulty with her left shoulder. The left shoulder pain and injury was first documented by Dr. Abrams after he examined L.M. on November 13, 2000. Subsequently, Dr. Garfinkel diagnosed L.M. with left shoulder anterior-inferior instability. These findings resulted in Dr. Garfinkel operating twice on L.M.'s left shoulder, on November 19, 2001 and again on July 22, 2002. The first surgery consisted of a capsular shift procedure. The second surgery included another capsular shift procedure and a shoulder arthroscopy.
L.M. also underwent surgeries on each of her wrists. The first surgery, performed by Dr. Raymond Decker, Jr., on November 2, 2000, involved a carpal tunnel release on L.M.'s right wrist. Thereafter, on April 11, 2003, Dr. ...