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CAAA: How Allostatic Load Affects a Worker's Injuries and What Impairment May Result

  • State: California
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Allostatic load may sound like an abstract medical concept, but at its most basic, it describes something every applicants’ attorney has seen play out many times over.

For decades, researchers have studied how the body responds to stress through a system designed for survival, what scientists call allostasis. In short bursts, this system is remarkably effective. It sharpens reflexes, increases heart rate and floods the body with energy to respond to immediate threats.

But unlike the zebra that escapes a predator and quickly returns to baseline, humans often carry that stress into the next shift, the next day, and sometimes over the course of an entire career. When that switch never fully turns off, the result is cumulative wear and tear on the body called allostatic load.

In a workers’ compensation setting, this framework helps explain patterns that might otherwise appear disconnected. The construction foreman who develops cardiovascular disease after years of relentless deadlines is not an isolated story. Nor is the injured worker whose initial injury triggers a cascade of secondary conditions like hypertension, diabetes and chronic pain. They are examples of the body absorbing the biological cost of prolonged stress.

Understanding allostatic load allows attorneys and doctors to better articulate the “how and why” behind these conditions, particularly in cases involving cumulative trauma or consequential injuries.

This issue was explored in depth at the 2026 CAAA Winter Convention in a presentation titled, "How Does Allostatic Load Affect a Worker’s Injuries and What Impairment May Result." The session was moderated by attorney Alan Gurvey and featured Drs. Martin Schlusselburg, Lori Harral and Aaron Coppelson. The panel walked attendees through the underlying science, practical application in workers’ compensation cases and strategies for raising and explaining the concept in doctor depositions, even in situations where the evaluating physician may not initially be familiar with the terminology.

This is the kind of practical, forward-looking education you can expect at CAAA’s conventions. Sessions like this one take complex medical and legal concepts and translate them into tools you can immediately use in your practice.

If you missed this presentation or want to revisit it, all convention recordings are available on our website’s MLCE On Demand Catalog.

As emerging concepts like allostatic load continue to shape the landscape of workers’ compensation, staying engaged with CAAA’s educational programming ensures you remain equipped to advocate effectively for your clients. Registration for our 2026 Summer Convention opens on April 7.

This opinion by the California Applicants' Attorneys Association communications team is republished, with permission, from the CAAA website.

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