Did you hurt your shoulder or tear your rotator cuff at work?
An injury to a shoulder is very common in the workers’ compensation field. Shoulder injuries can occur in a variety of different ways, and can be very debilitating. Despite the commonality and seriousness of these types of injuries, they are often disputed by the insurance company, which leads to litigation.
In this article we will explore why insurance companies fight shoulder injuries and what an injured worker can do to prevent this from happening.
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Common types of shoulder injuries
The shoulder is a complex joint that is prone to various types of injuries in the workplace. These injuries can result from repetitive tasks, heavy lifting or sudden trauma, and they can significantly impact your ability to perform your job effectively. Below are some of the most common work-related shoulder injuries.
Rotator cuff tear
A rotator cuff tear is a common shoulder injury that involves the tearing of the tendons connecting the muscles of the rotator cuff to the upper arm bone. This injury can result from sudden trauma or degenerative changes over time.
Symptoms may include pain, weakness, a limited range of motion and difficulty with daily activities. Treatment options can range from rest and physical therapy to surgical repair, depending on the severity of the tear.
Shoulder impingement syndrome
Shoulder impingement syndrome occurs when the rotator cuff repeatedly rubs against the upper edge of the shoulder, causing swelling and narrowing of the space. This leads to pain, irritation, weakness and a limited range of motion.
It typically occurs due to repetitive overhead activities or poor shoulder mechanics. Treatment options include rest, ice, anti-inflammatory medications, cortisone injections, physical therapy and surgical intervention.
A shoulder dislocation happens when the upper arm bone pops out of its socket in the shoulder joint. It’s often caused by a sudden impact or excessive rotation of the arm. Symptoms include intense pain, swelling and an obvious deformity of the shoulder.
Treatment involves relocating the shoulder joint, immobilizing the arm with a sling and undergoing rehabilitation to regain strength and stability in the shoulder. In some cases, surgery may be necessary to repair damaged ligaments or tissues.
Frozen shoulder, or adhesive capsulitis, is a condition that results in stiffness, pain and a limited range of motion in the shoulder joint. It occurs when the shoulder capsule becomes thickened and tight, restricting movement. The exact cause is unclear, but it can be associated with injury, prolonged immobility, or certain medical conditions like diabetes.
Treatment typically involves pain management, physical therapy and stretching exercises to restore mobility. In some cases, corticosteroid injections, hydrodilatation (a process by which sterile water is injected into the joint to help stretch the tissue and make it mobile), or surgery may be necessary.
A shoulder fracture is a break or crack in one or more of the bones that make up the shoulder joint, such as the collarbone, shoulder blade (scapula) or upper arm bone (humerus). It can occur due to a fall, direct impact or a high-energy trauma.
Symptoms include severe pain, swelling, deformity and difficulty moving the shoulder. Treatment depends on the severity and location of the fracture, ranging from immobilization with a sling or cast to surgical intervention for realignment or fixation. Rehabilitation is often necessary to restore strength and function to the shoulder.
A labral tear refers to a tear or injury in the labrum, which is a ring of cartilage that surrounds the shoulder joint socket and helps to keep it in place. It can occur due to acute trauma or repetitive shoulder motions, such as overhead throwing or lifting heavy objects.
Symptoms include shoulder pain, instability, a limited range of motion and a popping or clicking sensation. Treatment options may include rest, physical therapy, pain management and, in rare cases, surgical repair to restore stability and function to the shoulder joint.
Can a torn labrum in the shoulder heal itself?
Depending on the severity of the injury, a torn labrum shoulder may go unnoticed as it doesn’t always result in pain or instability. In these cases, it may not necessitate any treatment. In fact, due to the ample blood flow to the labrum, in many cases, it may be able to heal naturally on its own if given sufficient rest.
A labral tear that is frayed may exhibit minimal or no symptoms and may not necessitate any medical intervention. Given the well-supplied blood flow to the labrum, it often has the capacity to self-heal with proper rest and care.
Why work-related shoulder injuries are complicated
Shoulder injuries can be complicated from a medical perspective. Sometimes people who are hurt on the job complain of pain in their neck, when they actually have an injury to their shoulder. The reason for this could be because of pain radiating from the shoulder to the neck. There are ways to avoid using one’s shoulder in daily activities, but it’s much harder to avoid turning and twisting your neck, which is a reason for the misappropriation of the actual injury.
Furthermore, shoulder injuries occasionally occur in conjunction with an injury to another body part, such as an arm. Many times, the arm is treated before the shoulder because the injury is more obvious.
Take this example that happened to a client of ours:
Our client was working in a warehouse pulling items to stack on a pallet. This was her regular job. One day, as she was stacking product, her arm got stuck between two large items. She instinctively and immediately attempted to pull her arm out of the way. Unfortunately for her, she fractured her arm.
The immediate pain was in her arm where the fracture was and that was treated at the emergency room. But because the pain of the fracture was so intense, she didn’t realize the serious injury she also sustained to her shoulder. In fact, she had torn her rotator cuff as well.
The insurance carrier initially fought against covering the shoulder injury because the injured worker didn’t report a shoulder injury at the time of the accident.
Repetitive stress shoulder injuries at work
Another type of shoulder injury that occurs on the job is the result of repetitive use. Some jobs require frequent overhead lifting or movement of the arm. Doing this repeatedly for long periods of time can lead to pain in the shoulder joint. Sometimes this pain may only be muscle soreness and will go away. Other times it may be a more serious rotator cuff injury.
For this reason, it’s important to note and report all complaints of pain to your supervisor.
Reasons why workers’ comp insurers regularly deny claims
One of the many reasons why an insurance company might decide to deny a shoulder injury claim is that the injured worker reported the injury after a weekend or being off for a period of time.
Often, rotator cuff injuries don’t always begin as a sharp pain. Sometimes they feel like a muscle strain and the injured worker believes that the pain will go away with rest. However, the pain may not go away, or it may recur the moment the injured worker performs work again with that shoulder.
As you can see, this may run smack into the theory of insurance companies denying claims after a weekend or a period of time off. Unfortunately, litigation is very common in these circumstances.
Another important fact about shoulder injuries is that they are difficult to diagnose with an X-ray and an MRI. Often an MRI with dye contrast is required to see a rotator cuff tear. These MRIs aren’t common and are rarely requested by industrial clinics.
Presently, industrial clinics are the favored first point of medical treatment for injured workers. Injured workers in Georgia DO NOT have to treat at an industrial clinic, but they are frequently steered there by the employer.
What to do if you think you’ve suffered a workplace shoulder injury
We have seen numerous clients sent to industrial clinics after a shoulder injury. An X-ray is ordered but doesn’t show any type of fracture so the injured worker is returned to the job without restrictions. When they return to work, they still experience pain and they report this to the general practitioner at the clinic. The doctor then prescribes a normal MRI, which also shows nothing and the injured worker is told that there is no real injury and it is all in their head, or that they are exhibiting signs of symptom magnification.
It is extremely important to contact an attorney at this point, if not earlier so they can assist injured workers in getting to appropriate doctors.
There are doctors who specialize in shoulders and know what to look for. They are also knowledgeable and can order the MRI with contrast to properly diagnose and treat your injury.
Shoulder injuries and your workers’ compensation benefits
One final important aspect of a shoulder injury that should be addressed is how you are treated from a permanent partial disability (PPD) benefits perspective. The common practice is to treat it as an injury to an upper extremity. As a result, according to Georgia law (O.C.G.A. 34-9-263), it is worth compensation for up to 225 weeks.
However, because your shoulder injury can also affect your neck, it may be necessary to explore if the injury isn’t really to the body as a whole, and therefore worth 300 weeks’ compensation. As you can see, there is quite a discrepancy between these two positions.
If you have any questions about a work-related shoulder injury, don’t hesitate to contact the Athens workers’ compensation attorneys at Gerber & Holder.