Elfath immigrated to the United States in 2001 at the age of 18 after winning a diversity visa lottery.
[6] Elfath, along with American assistant referees Corey Parker and Kyle Atkins, was selected by FIFA to officiate the final of the tournament, which Ukraine won 3-1 over South Korea.
[8] Later that year Elfath took charge of the semi-final match at the FIFA Qatar 2019 Club World Cup.
[12] Elfath was chosen as one of the two referees from CONCACAF for the 2021 Africa Cup of Nations held in Cameroon from January 9 to February 6, 2022.
[13][14] In the 2022 FIFA World Cup in Qatar, Elfath refereed two group stage games, the Round of 16 match between Japan and Croatia, and was the fourth official for the Final between Argentina and France.