Types of Knee Injuries

Posted on Thursday, March 11th, 2021 at 12:21 pm    

Knee injuries happen at work for many different reasons. Workers may be injured in a car accident, they may be hurt if something falls on their leg, they slip and fall, or they may be hurt through for many different reasons such as twisting, pulling, or moving their leg in the wrong direction at the wrong time. Knee injuries may be due to chronic issues or they may be due to an acute injury. 

The knees have four primary components: bones, cartilage, ligaments, and tendons. The femur, called the thighbone, is located at the top of the knee joint. The shinbone, the tibia, is at the bottom of the knee joint. The patella, kneecap, is the part of the anatomy that covers the point between the femur and tibia meeting point. Cartledge is the tissue that helps cushion the knee joint bones. Ligaments protect the bones from impact. 

According to Medical News Today, the ligaments act like ropes holding the bones together and stabilizing the knee joint. The “tendons connect the muscles that support the knee joint to bones in the upper and lower leg.”

Some of the many types of knee injuries that workers need treatment for include the following. 

Fractures

The bone in the knee joint that is most commonly broken is the patella. Other bones in the joint may break too. Breaks are usually due to some type of forceful trauma. Surgery may be required to treat the fracture. 

Anterior cruciate ligament (ACL) injuries

These injuries are fairly common for athletes.  They can also make life very difficult for employees. The ACL provides stability for the knee joint. Injuries often require surgery which can take months or even up to a year to properly heal and that’s only with extensive physical therapy.  A grade one ACL sprain is a mild injury. A grade three ACL is a complete tear. 

Dislocation 

A knee dislocation occurs when the knee bones are not properly aligned. For example, a bone slips out of place. Falls in construction accidents and car accidents are common causes of knee dislocations.

Meniscus tear

This refers to torn cartilage in the knee. Cartilage helps provide a cushion between the bones such as the thighbone and the shinbone. Usually, when there is a sudden meniscus tear, the worker will hear or feel a pop followed by pain, tightness, and swelling. 

Bursitis 

The bursae are “small fluid-filled sacs that cushion the knee joints and allow the tendons and ligaments to slide easily over the joint.” When the sacs swell and become inflamed, that condition is known as bursitis. 

In general, bursitis can be treated with self-help-care. In some cases, an antibiotic is required. In some cases, a procedure to withdraw the excess fluid, called an aspiration, is required. 

Tendonitis

Tendonitis (inflammation) is called patellar tendonitis when it affects the knee. The knee-tendon connects the shinbone to the kneecap. A properly functioning patellar tendon allows the worker to perform physical activities including running and jumping. For that reason, tendonitis is also called jumper’s knee. While it affects athletes, it can also affect any active person including employees. 

Tears of the tendon 

Tears or overstretching of the tendon may occur when a worker falls or is struck by an object in or around the knee.

Collateral ligament injuries 

Collateral ligaments connect the shinbone to the thighbone. While they are also a common athletic injury, collateral ligament injuries can occur at work. 

Posterior cruciate ligament injuries

The posterior cruciate ligament is located at the back of the knee. It is one of the many ligaments that connect the thighbone to the shinbone. This ligament keeps the shinbone from moving too far backward.” This type of injury occurs when there is a forceful impact while the knee is bent.

Knee injury treatments

Medical News Today recommends seeking medical care for any knee injury as soon as possible. While you’re waiting -the RICE method of rest, ice, gentle compression, and elevation is suggested. You should especially seek medical care if:

  • You can’t move your knee
  • You have a limp
  • You hear a popping noise when your knee gives out
  • You have terrible pain in the knee

Some of the many types of treatments for knee injuries that workers need, according to Orthoinfo, include the following. 

  • Nonsurgical treatments. Nonsurgical treatments vary depending on the severity of the injury and your general health condition. Sample treatments include:
    • Physical therapy. This treatment generally consists of exercises to help strengthen the knee and the muscles around the knee. You may need to immobilize your knee with a brace or a cast. You may also need to learn how to use crutches so you don’t put weight on the injured knee. 
    • Drugs like aspirin, ibuprofen, and other nonsteroidal anti-inflammatory medications or in some cases, narcotic medications may provide some relief. 

 

  • Surgical treatment for knee injuries. Many knee injuries require surgeries. Some are done arthroscopically, meaning the surgeon typically makes three small holes in the knee through which instruments, including a camera, are inserted to conduct the surgery. This is advantageous as it is minimally invasive compared to open knee surgery. 
  • Should more conservative treatments and surgeries fail, ultimately what may be required is a partial or total knee replacement. Knee replacements are essentially artificial joints comprised of titanium and plastic parts that are surgically inserted to take the place of the knee portions being replaced. Many of our clients report good pain relief as well as restored function after recovery from such surgeries. The disadvantage is that it is irreversible. Once your natural knee parts are cut out and removed, there is no putting them back. 

The time to recover from a knee injury can range from a few weeks to a few months depending on the severity of the injuries. Some workers never suffer a permanent injury because they never regain the full use of their knee.

North Carolina and Virginia workers’ compensation lawyer Joe Miller has been fighting for injured workers for 32 years. He works with your physicians to fully document and verify your medical condition and the types of treatment you need. He’s helped thousands of employees obtain full recoveries including payment of their medical expenses includes visits with physical therapists and other therapists. He fights to get you all the lost income benefits the law allows. To discuss your knee injury workers’ compensation case with a seasoned workers’ compensation lawyer, call lawyer Joe Miller, Esq., at 888667-8295 or complete my online contact form to schedule an appointment. 

Employees in North Carolina and Virginia can also now fill out our New Electronic Case Review. The link is a new way of communicating with clients that we’re offering – to allow workers to contact us remotely during the pandemic.

Types of Shoulder Injuries

Posted on Wednesday, March 10th, 2021 at 12:17 pm    

Workers are constantly using their shoulders in many jobs such as industrial work, construction work, and agricultural work. Nurses, waitresses, and many other employees also regularly use their shoulders at work. Injuries to the shoulders generally happen either through some sort of acute incident such as a fall, tear, a forceful blow to the shoulder, or another immediate event. Shoulders can also be damaged over time through constant wear and tear. That one extra movement at work can affect a weak shoulder by causing a lifetime of chronic pain. 

The different kinds of shoulder injuries that are work-related

The shoulder consists of a ball and socket joint. There are many different types of injuries that can happen according to the Mayo Clinic. Some of these types of injuries are the following: 

    • A broken clavicle or collarbone. The clavicle bone connects your shoulder blade to the upper part of your breastbone. Fractured collarbones can take months to heal after they are properly set by your physician. In some cases, surgery is required to repair the fracture. 
    • Brachial plexus injury. A brachial plexus injury. According to the Mayo Clinic, this injury happens when the shoulder nerves are compressed, stretched, or there is a tear from the spinal cord. 
  • A shoulder dislocation. This painful injury happens when the “upper arm bone pops out of the cup-shaped socket that’s part of your shoulder blade.” With prompt medical treatment, many workers do recover from a shoulder dislocation. However, once a shoulder is dislocated it becomes likely that the employee may suffer subsequent dislocations. 
  • Tears of the rotator cuff. This part of the shoulder is composed of muscles and tendons. Rotator cuff injuries may require surgery. Workers generally need to take a fair amount of time off to work with physical therapists to manage the continual pain. Workers who have a rotator cuff injury will have difficulty lifting objects and using their shoulder in any way until the rotator cuff injury is repaired. 
  • A separation of the shoulder. The ligaments effectively hold the shoulder blade and the collarbone together. There are different types of separated shoulder injuries that are graded based on their severity. The least severe separated shoulder injury consists of stretched ligaments. The most severe type of separated shoulder injury is when the ligaments are torn. A common self-help treatment is rest, ice, and the use of pain relievers. 

 

Another common type of shoulder injury that may occur through work is called a tear of the labrum, fibrous tissue.  Other types of shoulder injuries include impingement syndrome, otherwise known as frozen shoulder and avascular necrosis (death of bone tissue due to limited blood flow), and sprains.

Treatments for shoulder injuries 

Employees who suffer any type of shoulder injury should save seek medical help. If an accident causes the shoulder injury, then workers should go to their nearest emergency room to obtain a diagnosis and an initial treatment plan. Some of the doctors that employees with shoulder injuries treat with after the initial review at the emergency room are the following: 

  • Orthopedic surgeons. These physicians diagnose injuries to bones, muscles, ligaments, and other parts of the shoulder. They repair fractures and tears, treat dislocations and separated shoulders, and provide medical help for the full range of shoulder injuries. 
  • Pain management doctors. Workers who suffer shoulder injuries may also seek help from pain management physicians to treat their pain, typically after the surgeon has done everything he or she can do, but there remains residual pain. 
  • Physical therapists. Most workers who have a shoulder injury, whether or not they’ve had surgery, will normally need to spend numerous sessions with a physical therapist. The therapist provides exercises that helped to strengthen the shoulder and the muscles around the area of the injury. Treatments can take weeks or months before the worker is able to return to his/her job. In some cases, workers may need to trade for a longer period of time. 

Workers with any type of shoulder injury will often have difficulty performing routine personal tasks such as eating, sleeping, brushing their hair, driving, or any type of household activity. The same thought applies for their ability to do their work. Most workers who have a shoulder injury need to stop working until their pain and shoulder injury are properly treated. Even when workers do return to work, they may need to work subject to physical restrictions such as not lifting objects that weigh more than 20 pounds.

Some shoulder injuries, particularly in older workers, may not be amenable to repair, or the repairs may not provide sufficient relief or restoration of function, and accordingly may require what is known as a reverse shoulder replacement

Workers who suffer shoulder injuries are generally entitled to the following benefits in North Carolina and in Virginia:

  • Payment for all reasonable and necessary medical bills;
  • 2/3rds of their average weekly wages until their injury reaches the stage of maximum medical improvement (MMI);
  • Workers who return to work with restrictions are normally entitled to 2/3rds of the difference between their average weekly wage before their injury and a lower wage after they return to work – that they may be paid because of their job restrictions, otherwise known as temporary partial disability payments;
  • If there is a permanent injury, there may be additional possible benefits the injured work may be entitled to for permanent partial impairment to the injured body part, which insofar as the shoulder would be called either the  right or left upper extremity. 

As a recent case shows, attorney Miller fights aggressively for his clients. This fight includes efforts by the physicians hired by the employer’s insurance company who may argue your shoulder injury is due to a pre-existing condition.

North Carolina and Virginia workers’ compensation lawyer Joe Miller has helped thousands of injured workers obtain just recoveries. He understands just how life-altering a serious shoulder injury can be. He works with your physicians to ensure that you get the medical help you need – and that your employer does not force you back to work before your injuries have been treated and healed. To review your shoulder injury claim or any other work injury claim with a seasoned workers’ compensation lawyer, call lawyer Joe Miller, Esq., at 888-667-8295. or use my online contact form to schedule an appointment. 

Employees in North Carolina and Virginia can also now fill out our New Electronic Case Review. The link is a new way of communicating with clients that we’re offering – to allow workers to contact us remotely during the pandemic.

Light Duty and Awards

Posted on Thursday, March 4th, 2021 at 3:46 pm    

Virginia and North Carolina Workers Compensation Attorney Joe Miller explains the importance of making sure you get under an Award in Virginia, particularly if you are about to be released to light duty. Until you obtain that Award, you essentially have no rights at all and you are living in a house with no roof. All that rain is going to pour down on you if you don’t get that roof up to protect you by getting under an Award.

Virginia Legislature FINALLY Passes Laws Making it Easier for COVID-19 Health Care Workers and First Responders to File a Workers Compensation Claim for COVID-19 Illness

Posted on Thursday, March 4th, 2021 at 3:40 pm    

On Saturday, February 27, 2021, The Virginia General Assembly passed several bills that will allow health care workers and first responders to receive workers’ compensation benefits if they are disabled or die due to COVID-19.

House Bill 1985 expanded workers’ compensation benefits for health care workers “directly involved in diagnosing or treating persons known or suspected to have COVID-19,” including doctors and nurses. The bill provides coverage from March 12, 2020, until Dec. 31, 2021. The bill expands presumptions for occupational disease provided under VA Code 65.2-401.1 for these classes of workers in include healthcare workers who become ill from COVID-19. 

The health care worker must have been treated for COVID-19 symptoms and been diagnosed by a medical provider with COVID-19 to qualify for compensation if the illness occurred before  July 1, 2020. For COVID-19 illness that occurs after that date, there must not just be a clinical diagnosis, but also an actual positive COVID-19 test to be eligible for compensation under this new amended section. 

The bill also said health care workers who refuse or fail to get vaccinated for COVID-19 will not be eligible for workers’ compensation. But if a physician determines vaccination will risk the worker’s health, that exclusion does not apply. 

I have been saying for months that it was a mistake for the Virginia Legislature to attempt to be too broad and include too many occupations into this proposed presumption provision. It would prove too expensive for the tastes of our politicians and end up defeating the legislation, which is precisely what happened in the last 2020 session. 

Fortunately, the legislative negotiation process worked, and lawmakers were able to work out a compromise that protects those who are most at risk, namely, those heroes among us who are directly involved in treating or diagnosing COVID-19 patients. In correspondence with several  members of our General Assembly, I suggested this type of language. I am not saying they listened to me specifically, but I am certainly glad we were of like mind on this issue. 

In addition to the bill on COVID-19 Healthcare workers, Senate Bill 1375 and HB 2207 cover workers’ compensation for first responders who were diagnosed with, or died from COVID-19 on or after September 1, 2020.  The measures include firefighters, police officers, correctional and regional jail officers, and emergency medical services workers. The bills require an official diagnosis through a positive COVID-19 test and symptoms of the disease.

Kudos to all those lawmakers who sponsored these bills and worked hard to get them through. As someone who represents injured workers in Virginia and North Carolina, it is heartening to know that our elected officials are finally looking out for those who are looking out for us during this terrible pandemic. 

As noted in previous posts, under current law, COVID-19 is considered an “ordinary disease of life,” and accordingly subject to the very high “clear and convincing evidence” standard of proof, making it extremely difficult for anyone to bring a claim for benefits due to COVID illness or death. 

Once the new bills become law on July 1, 2021, COVID-19 will be included as an enumerated occupational disease, meaning that health care providers who got sick from COVID-19 who treated COVID-19 or suspected COVID-19 patients as well as first responders will have a much easier time of successfully pursuing a worker’s compensation claim for that illness. The same applies to the families of such workers who may be attempting to bring a worker’s compensation claim due to the tragic death of such persons from COVID-19. 

If you or a loved one have suffered from COVID-19 or a loved one has passed away from COVID-19 and you or your loved one were either a healthcare worker who directly treated or diagnosed COVID-19 patients, or a firefighter, police officer, correctional or regional jail officer, or emergency medical services worker, please do not hesitate to give our office a call. Our lawmakers have now made it much easier to successfully proceed with a claim for benefits for COVID-19 illness under the Virginia Workers Compensation Act for these classes of citizens in our Commonwealth. Please contact us by calling us at 757-694-1671 or reaching us via our website at www.joemillerinjurylaw.com 

Reasons Workers Treat with Orthopedists

Posted on Wednesday, February 17th, 2021 at 11:06 am    

Orthopedists are medical specialists who help to correct bone and muscle deformities such as fractures. They treat the musculoskeletal system. Orthopedists are surgeons who also provide a range of non-surgical medical care. Workers often need the help of orthopedists when they fall, when a body part is crushed (such as in a forklift accident), when something drops on them such as tools from a scaffold, or due to a host of other reasons. In some cases, there is some overlap as between orthopedists and neurosurgeons, most typically in the case of spinal injuries. This is because in addition to bones, the spinal processes that make up the spinal column contain, surround, and protect the spinal cord, which is the main “trunk” or nerve which provides the body with feeling and function. Then again, there are orthopedists who specialize in spinal surgery. 

In any event, some of the common reasons workers need orthopedic care include the following:

  • Carpal tunnel syndrome. According to the Mayo Clinic, “the carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. When the median nerve is compressed, the symptoms can include numbness, tingling, and weakness in the hand and arm.”
  • Dislocated shoulder. A shoulder dislocation is called a subluxation. While rare, shoulder dislocations do occur. Surgery may be required in severe cases.
  • Osteoarthritis and bursitis. Osteoarthritis happens when your cartilage wears down as you age. Bursitis involves the part of your body that cushions your muscles, and other body parts – near your joints. Bursitis is the inflammation of these cushions (called bursae). Despite the fact that these conditions may exist without any trauma, in the context of a workers’ compensation case, it is often a trauma that aggravates these dormant or asymptomatic conditions that are now very painful. 
  • Plantar fasciitis. The Mayo Clinic defines plantar fasciitis as heel pain which “involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia).”
  • Sprains. Most people sprain some part of their body during their lifetime. Standard treatments include rest, ice, and compression. 
  • Stress fractures. These breaks usually aren’t as painful as traditional bone breaks. They normally occur through wear, tear, and stress instead of due to a single accident. The most common parts of the body that suffers stress fractures are the ankle and feet.
  • Tennis elbow. This injury is normally due to repetitive motions that damage the tendons near the elbow. Unfortunately, unless aggravated by a trauma, other than carpal tunnel syndrome, repetitive stress injuries are generally not covered by workers compensation. 
  • Torn ligaments and the meniscus in the knee. These injuries, which are common to athletes, also happen to workers. According to the Mayo Clinic, a torn meniscus can be due to any activity that causes a worker to forcefully rotate or twist a knee. The anterior cruciate ligament (ACL) may tear requiring surgery an extensive rehabilitation. The meniscus is the cartilage around your knee. A healthy meniscus allows your knee to move freely. If the knee does not respond to less invasive surgeries, depending on your age and the condition of the knee, a total or partial knee replacement may be an option. 
  • Torn rotator cuff. This injury involves the tendons and muscles near the shoulder joint. The rotator cuff keeps “the head of your upper arm bone firmly within the shallow socket of the shoulder”
  • Ankle Injuries/fractures. During falls from heights, these injuries can be severe and debilitating. One of the worst is known as a pylon fracture, where essentially the leg bone smashes down into the foot bones and almost completely destroys them. Usually, an orthopedic doctor who specializes in foot and ankle surgery will perform an internal fixation surgery with plates and screws. Fortunately, medical technology has improved in recent years to the point that many foot and ankle specialists are now doing ankle replacements. 

Fractures that happen due to workplace accidents

The human body has more than 200 bones. The human hand, alone, has 27 bones. 

Bone fractures, such as leg fractures, are generally categorized in the following ways according to the Mayo Clinic:

  • Open (compound) fracture. Here, the broken bone pierces the skin. Surgery is normally required for several reasons including reducing the risk of an infection.
  • Closed (simple) fracture. Here, the broken bone does not penetrate the skin.
  • Incomplete fracture. “This term means that the bone is cracked, but it isn’t separated into two parts.”
  • Complete fracture. Here, the broken bone snaps “into two or more parts.”
  • Displaced fracture. “In this type of fracture, the bone fragments on each side of the break are not aligned. A displaced fracture may require surgery to realign the bones properly.”

Another type of fracture, called a greenstick fracture, is more common in children who are less likely to be employees. With this type of fracture, “the bone cracks but doesn’t break all the way through.”

What are the treatments for fractures?

Doctors will normally conduct an oral and physical examination if they suspect a fracture. They’ll use X-Rays to locate where the break is, the type of break, and the severity of the break. In some cases, an orthopedist may order a CT scan or an MRI.

The treatments vary depending on the type and severity of the break. A common initial step, according to the Mayo Clinic, is to use a splint to immobilize the leg. If a worker has a displaced fracture, the orthopedist may need to “manipulate the pieces back into their proper positions before applying a splint — a process called reduction. Some fractures are splinted for a day to allow swelling to subside before they are casted.”

A splint or cast helps to immobilize the broken bone. Broken bones, such as broken legs, may require six to eight weeks to heal. During this time, the worker may need to work with a physical therapist to learn how to use a cane or crutches. It’s important not to put any weight on the broken bone and to restrict the movement of the bone so the bone can heal properly.

An orthopedist may recommend over-the-counter pain medications, “such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) or a combination of the two. If you’re experiencing severe pain, your doctor might prescribe stronger pain medications.”

Depending on the location of the break, the type of break, and the severity of the break; workers will likely need physical therapy after the cast or splint is removed. The full rehab process can take months or longer.

Possible surgery for broken bones

Orthopedists may need to use rods, screws, plates, or other devices to ensure the bones stay in the proper position while the fracture heals. Usually, this type of surgery is known as an “Open Reduction Internal Fixation” (ORIF) surgery. Many of our clients undergo these types of surgeries. The recovery period after these surgeries can be long. These devices, according to the Mayo Clinic, are generally used for:

  • “Multiple fractures
  • An unstable or displaced fracture
  • Loose bone fragments that could enter a joint
  • Damage to the surrounding ligaments
  • Fractures that extend into a joint
  • A fracture that is the result of a crushing accident
  • A fracture in particular areas of your leg, such as your thighbone”

Joe Miller Esq. has been fighting for injured workers for more than a quarter of a century. He works with and reviews detailed medical records experienced orthopedists, physical therapists, and other healthcare provides to properly assess your workplace injuries, the need for surgeries or other medical care, and the time and treatments you’ll need to return to good health. To discuss y our North Carolina or Virginia work injury case, call me at 888-667-8295. or fill out my online contact form to make an appointment. 

Workers can also complete our New Electronic Case Review. It’s a new type of communication method for our clients that we’re offering – to allow workers to reach us remotely.

Your Guide To Medicare Set Asides

Posted on Tuesday, February 16th, 2021 at 10:51 am    

Virginia and North Carolina Workers Compensation Attorney Joe Miller here breaks down, in simple, easy-to-understand terms, the basics of Medicare Set-Asides (MSA’s)–What is it and why do you need one in your workers comp settlement? You just received some kind of authorization for a company you have never heard of that you are being asked to sign. The Authorization gives this company the authority to obtain all of your medical records and submit them to something called CMS. What the heck is going on? Joe Miller explains all in this comprehensive explainer video on MSA’s.

The Benefits of Physical Therapy After a Workplace Accident

Posted on Monday, February 15th, 2021 at 11:04 am    

Most employees who suffer a workplace accident begin their medical treatment with a visit to their local ER. Workers who suffer a spinal cord injury, a traumatic broken injury, compound fractures, and other serious injuries often need immediate surgery. Workers with chronic pain or acute pain often need to visit with a pain management doctor. In addition to treatment by physicians, these workers and most injured workers also need to treat with physical therapists.

One of the aims of physical therapy is to strengthen some parts of your body to minimize the pain in other parts of your body. Experienced physical therapists can workers select the correct exercises for their injuries and help workers manage their pain and recover from their injuries.

What is physical therapy?

Physical therapy is a rehabilitation process in which therapists evaluate your physical abilities and limitations. Physical therapists generally have some medical training but they are not physicians. Physical therapists respond to your concerns by developing a plan of exercise, massages, and other methods to help you recover from your injuries.

In addition to addressing your pain issues, physical therapists focus on your range of movement and your ability to functionally use various parts of your body. Physical therapists also focus on helping you regain strength and endurance. Once there’s a clear plan (which may be adjusted as you work with the therapist) – you may work with the therapist as his/her location. You will likely also be able to do some exercises and activities at your home.

Many therapists include stretching exercises among other exercises. The therapist may also provide hands-on treatments in addition to continually encouraging you to stay with the treatment plan.

How does Physical therapy help injured workers?

According to Medical News Today, physical therapy is used to treat many different types of conditions (many of which may be due to work) including:

Some of the benefits of physical therapy include:

  • Better mobility. Many workers have difficulty with simple tasks. They find it hard to stand, move, walk, or sit – prerequisites for doing most jobs. Some activities like driving may not be possible if, for example, one of your arms or legs is in a cast. The inability to perform routine tasks also affects your home life too.

Physical therapists help you regain movement and functionality through exercises that generally strengthen your joints and muscles and stretch them so you can move more freely. While you’re exercising and receiving treatments, your physical therapist may also help you with assistive devices. For example, a physical therapist may help you walk using a cane or crutches.

Physical therapy is often used when workers suffer chronic pain or repetitive stress injuries. 

  • Helping you avoid surgery. Many employees who suffer workplace accidents understand that their options for managing their pain generally include medications and physical therapy. If these treatments still cause an unbearable amount of pain, the employee will likely review whether there are any surgical solutions to their pain. Surgeries include risks. Most people prefer to avoid surgery if at all possible. One aim of physical therapy is to help reduce your pain so you can live with the exercise and treatment routine instead of having surgery.

According to Medical News Today, other benefits of physical therapy include:

  • Improving your balance
  • Pain management
  • Preventing falls
  • Age-related disorders

Physical therapists may also help with arthritis.

Insurance companies and physical therapy

Most employers understand that workers do need physical therapy to help them recover – so workers can do their job again. Unfortunately, most insurance companies for employers often fail to appreciate just how many sessions an employee needs with a physical therapist to see improvement. Many insurance companies, after a specific number of visits (such as 10 visits) or a specific period of time (such as 3 months) will request that the worker undergo a defense independent medical examination (IME). Usually, the doctor who conducts the IME is a company doctor who will quickly say that your injuries have healed well enough that you should be able to return to work.

Experienced workers’ compensation lawyers help injured workers who need continual physical therapy when employers try to terminate their medical care and force them back to work – in two ways.

  • First, we advise workers on what to expect at the IME. For example, we review which questions are likely to be asked and what physical tests the physician is likely to conduct
  • Second, we work with your authorized treating physician. Normally, a doctor recommends that you receive physical therapy. We show your physician the report from the doctor who conducts the IME. Often, your doctor can point out the flaws in the medical report. Often, your doctor will be able to explain why you still need to treat with your physical therapist. In any event, both the Virginia Workers Compensation Commission and the North Carolina Industrial Commission typically favor the reports of your treating doctor over the defense IME doctor. 

In some cases, your physician may allow you to return to work – but with restrictions. These restrictions can include such things as not being required to lift items that weigh more than 20 pounds. The restrictions may also be conditioned on your right to continue your physical therapy visits.

One of the things that can ruin a workers’ comp case is where an injured worker treat his or her  prescribed physical therapy in a casual way, by missing physical therapy appointments and failing to re-schedule. This is a huge mistake and could lead to an Application to Terminate Benefits in Virginia or a Form 24 in North Carolina from the defense due to your failure to follow your doctor’s medical treatment plan and that could mean the end of your case.  Accordingly, please make sure you attend all of your PT appointments to the best of your ability. 

North Carolina and Virginia workers’ compensation lawyer Joe Miller has been fighting for injured workers for 31 years. He’s helped thousands of employees obtain full recoveries including payment of the medical bills they need to recover. In many of these cases, the workers need to treat with a physical therapist. To discuss your work injury claim with a seasoned workers’ compensation lawyer, call lawyer Joe Miller, Esq., at 888-667-8295. or fill out my online contact form to schedule an appointment. 

Employees in North Carolina and Virginia can also now fill out our New Electronic Case Review. The link is a new way of communicating with clients that we’re offering – to allow workers to contact us remotely during the pandemic.

Always Get A Work Note

Posted on Wednesday, February 3rd, 2021 at 3:55 pm    

Virginia and North Carolina Workers Compensation Attorney Joe Miller explains why it is so critical to your case to obtain a current work note or disability slip after each and every appointment with your primary, authorized treating physician. Failure to present valid work notes at your hearing could mean you will be unable to prove you are entitled to weekly checks.

Hand Injuries and Workers’ Compensation

Posted on Friday, January 8th, 2021 at 12:17 pm    

Hand injuries are common in many different types of jobs. Workers who do outside labor such as construction or agricultural work often suffer injuries due to the machines/tools they work with and thy types of tasks they do. Workers who work inside can suffer injuries due to repetitive use. Workers in almost every field from industrial workers to healthcare workers at some point in their career are likely to injure their hand – often severely enough that they can’t work until (and if) their hand mends.

Some of the machines that can cause severe hand injuries include saws, hammers, and assembly equipment.

Types of hand injuries

Some of the common types of hand injuries that occur during work include:

  • Carpal tunnel syndrome. This injury is a repetitive stress injury that we’ve written about before – Carpal Tunnel Syndrome and Workers Compensation (joemillerinjurylaw.com). Carpal tunnel syndrome normally affects the wrist and the hand. Many officer workers and restaurant workers (such as waitresses) are likely to develop carpal tunnel syndrome.
  • Burn injuries. Workers, such as kitchen workers and restaurant workers, are regularly exposed to flames, steam, boiling liquids, and other terms of thermal burns. Electric burns can occur when an electrical current runs through an electrician’s hand. Chemical burns can occur when industrial, construction, agricultural, or other workers handle hazardous substances which spill on or seep into the skin of the hands as the worker uses their hands to manipulate the or use the chemicals.
  • Fractures and other types of blunt trauma injuries bones. Orthopedists regularly need to provide medical care (including surgeries and setting the fractures) for workers who break a finger of any one of the 27 bones in the human hand. Breaks or crushing injuries can occur if a heavy object falls on the worker’s hands, if the worker’s hands are pinned between two objects, or due to improper use of tools and machines.
  • Lacerations. Cuts to the hand can be due to working with any type of sharp object, when glass sprays into their hands during a collision, or for many other reasons.
  • Punctures. Doctors, nurses, and anyone who works with a sharp object (such as carpenters who work with hammers and nails on a regular basis) may suffer a puncture to the skin of the hand – when the sharp object penetrates their skin.

Other hands injuries include rashes and irritations of the skin

According to MedExpress:

  • 44% of hand injuries involve lacerations and cuts – accounting for over 60,000 injuries in 2017. Many victims require stitches and other treatments.
  • “Crushes caused almost 27,000 hand injuries in 2017, making them the third most common cause of hand injuries.”
  • Fractures, sprains, and tears “accounted for 21 percent of all reported workplace hand injuries in 2017.”

Employer safety suggestions to help minimize the risk of hand injuries

There is no requirement that an injured worker prove that an employer was negligent or that the employer failed to follow federal, state, or local safety protocols. If you are injured at work, you have the right to seek work loss and medical benefits – whether the employer was at fault or wasn’t at fault.

Still, nobody wants to lose time from work and seek medical help if they can avoid it. Some of the many ways employers can help ensure the safety of their employees – when it comes to avoiding hand injuries include:

  • Providing quality safety equipment. Gloves with the proper amount of insulation (or gloves made out of the proper materials such as latex) can help reduce the risk of certain types of hand injuries – such as lacerations, punctures, and some types of burn injuries. Employers should review what types of gloves could help workers who regularly are in danger of any type of hand injury.
  • Educating the worker about safety issues. Often, education is needed for workers who work with specific types of machinery or equipment. These courses can help explain the dangers of each type of machine or tool. The courses can explain when their hands are in the most danger and what steps can be taken to reduce those risks. Workers should be taught which chemicals can cause severe burn injuries, for example, or how to properly work with certain types of sharp instruments.
  • Explaining the importance of communication. Many hand injuries could be avoided if supervisors and co-workers communicate with you – so you know when to get out of the way, when to stop working so they can work, and when other workplace factors increase the risks of hand injuries.

Workers’ Compensation for Hand Injuries

All workers who suffer hand injuries are entitled to work loss benefits if you injury you hand due to a workplace accident or due to an occupational illnesses. Your North Carolina or Virginia workers’ compensation lawyer can explain when you can file a claim for a repetitive stress injury to your hand.

Temporary work loss benefits for hand injuries generally include payment of all your medical bills and about 2/3 of your average weekly income while you can’t work.

If you can’t use your hand (or any fingers or your thumb) at all, or in part, after you’ve reached the point of maximum medical improvement (no additional medical care is likely to improve your hand) – you may be entitled to permanent disability benefits according to North Carolina or Virginia law. For example, if your hand is amputated, you can seek permanent disability benefits in both states.

An experienced work injury will work with you and your doctors to help ensure that the employer doesn’t force you back to work before you can do your job.

Virtually every worker needs functioning hands in order to do their job. Our experienced North Carolina and Virginia work injury lawyers have been fighting for employees for more than 25 years. We’ll explain your rights and fight to get you all the compensation and medical care you deserve. To reach lawyer Joe Miller, Esq., call me at 888-667-8295. or fill out my online contact form to schedule an appointment. Workers now can also complete our New Electronic Case Review. It’s a new way of communicating with clients that we’re offering – to allow workers to contact us remotely.

What Workplace Rules Apply to COVID Vaccines?

Posted on Wednesday, January 6th, 2021 at 12:17 pm    

There’s good news finally about the COVID-19 pandemic which has affected workers and everyone in numerous ways. More than 350,000 Americans have died due to the disease and nearly 20 million Americans have become infected. 

The good news is that the Food and Drug Administration has approved two COVID-19 vaccines developed by Pfizer and by Moderna. The vaccines use mRNA technology. Everyone who receives these two vaccines which helps their immunity system fight the disease – will require two doses.

According to the Raleigh News & Observer, North Carolina health officials are setting the priorities for when different classes of people (depending on their work activities, health risks, and age) should be eligible for the vaccine. The December 31, 2020 article outlines the priorities. Dr. Mandy Cohen, the secretary of the North Carolina Department of Health and Human Services, stated at a press conference, that the state will have a four-part rollout of the vaccines. The plan, which was developed through North Carolina Governor Roy Cooper’s office, will prioritize older people and frontline essential workers.

The North Carolina priorities match the vaccination priorities set by the Centers for Disease Control and Prevention. 

  • Phase 1a rollout. In this first phase, priority is given to “health care workers in direct contact with COVID-19 patients, and also long-term care residents and staff.”
  • Phase 1b rollout. Here, three groups of North Carolina residents will receive the next two million sets of vaccination. There are sub-priorities in these phases as follows:
    • Group 1: People 75 years and older, no matter what underlying conditions they have or don’t have
    • Group 2: Health care workers who work with patients and frontline essential workers who are 50 or older.
    • Group 3: Health care workers who work with patients and frontline essential workers of any age who have not been vaccinated yet.

How are “frontline essential workers” defined

North Carolina uses the CDC definition of a frontline essential workers. These people are employees who are at the “highest risk for being exposed to the coronavirus” “This phase is expected to begin in early January.” Frontline workers, according to the published article, include:

  • First responders like firefighters and police officers
  • Grocery store workers
  • Childcare workers
  • Teachers and education support staff
  • Corrections officers
  • Food and agricultural workers
  • U.S. Postal Service workers
  • Manufacturing workers
  • Public transit workers

 

  • The Phase 2 rollout. This phase includes the following categories (in the following order) of North Carolina residents:
    • People ages 65-74
    • People ages 16-64 with high-risk conditions
    • People incarcerated and living in other group settings
    • “Essential workers.”

How are essential workers defined?

“Essential workers are defined by N.C. DHHS and the CDC as”

  • Transportation and logistics workers
  • Water and wastewater workers
  • Food-service workers
  • Shelter and housing workers, including construction
  • Finance workers, like bank tellers
  • Information technology workers
  • Media workers
  • Public safety workers like engineers
  • Public health workers
  • Communications workers
  • Energy workers
  • Workers in the legal field

 

  • Phase 3 rollout. This phase includes college and university students and students 16 years-of-age and older.

 

The vaccines are being given to residents just as North Carolina announced likely increases in “COVID-19 cases and hospitalizations expected due to Christmas and New Year’s gatherings.”

Can Employers mandate that employees take the vaccine?

According to the Fayetteville Observer, the issue of whether employers can or can’t mandate that their workers be vaccinated is fast becoming a reality – and not a hypothetical. Health officials in North Carolina expect that the general adult population will have enough vaccines during the first half of 2021.

“The N.C. Department of Health and Human Services told the USA Today Network it has no plans to mandate vaccinations. But private sector employers can require workers to get them, labor law experts say.”

 

According to UNC School o f Law professor, Jeffery Hirsch, the private sector can manage employee vaccinations because the “private sector is at-will employment.” 

Already, health care providers do mandate that members of the provider’s staff get immunizations for mumps, polio, the yearly flu, and other preventable diseases. According to Duke University School of Law professor, Dan Bowling, “jobs that feature significant customer and coworker interactions often have vaccine requirements.”

Generally, employers need to show that mandating the vaccine is a job-related necessity and “would pose a ‘direct threat to the health or safety of others’ if skipped according to the Americans for Disabilities Act.”

Workers whose job is terminated for noncompliance to these mandates may file EEOC (Equal Employment Opportunity Commission) complaints – but “experts say the law favors employers, even when workers seek medical or religious exemptions.” “While Title VII of the Civil Rights Act says employers must reasonably accommodate workers’ religious practices, the law allows employers leniency if these accommodations pose an ‘undue hardship’ on their business. “

Employers are likely to mandate the vaccines for two reasons. The first reason is to help prevent the spread of COVID-19 within the employer’s business. The second reason is because a large number of people (about 60 to 90%) need to have the vaccines or have been infected – to reach herd immunity. There are concerns that many people will not get the vaccine – even when it becomes clear the vaccines are working.

Health officials in North Carolina are working to assure residents that the COVID-19 vaccines are safe. Some employers are expected to offer financial incentives (similar to company incentives for insurance rate breaks for non-smokers) to encourage workers to take the vaccines.

So far, hospitals have been hesitant to mandate the vaccines for their staff. “Given the limited experience with the vaccine, there are no current plans to make the COVID-19 vaccine mandatory for UNC Health employees,’ a UNC Health statement said.”

According to the president of the N.C. Nurses Association, most health care workers are welcoming the vaccine.

All employees are valuable workers. It’s critical that all workers have access to vaccines so they can work on-site instead of remotely. Once workers do return to work at their regular job locations, they will still be at risk for many types of physical injuries and occupational illnesses. If you’re hurt at work for any reason, our experienced North Carolina and Virginia workers’ compensation lawyers are ready to help you jet the benefits you deserve. Call attorney Joe Miller, Esq., at 888-667-8295. or fill out my online contact form to schedule an appointment. Employees can now also complete our New Electronic Case Review. It’s a new way of communicating with our clients that we’re providing this service to allow workers to contact us remotely.

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