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.

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.

When Are Workplace Injuries Not Covered by Workers’ Compensation?

Posted on Wednesday, December 16th, 2020 at 9:53 am    

Most people automatically assume if they are injured at work that they’re covered by their state’s workers’ compensation laws. And, for the most part, that’s true. If you slip and fall or suffer some other accident at work, in most cases, you should be covered. If you are loading very heavy items into a cart and wrench your back, you should be covered. If a forklift tips over or malfunctions, and you are injured, you should be covered.

In workers’ compensation cases, there is no need to prove fault. Generally, if you’re hurt while doing your job, you should be entitled to have all your medical bills paid by your employer’s insurance company and approximately 2/3rds of your wages while you are temporarily totally disabled for up to a maximum of 500 weeks, or if you become permanently or partially disabled. Permanent partial disability benefits are paid for a specific number of weeks. 

As with every rule, though, there are many exceptions. There are a few situations where your injuries will not be covered – in some cases, because your employer is not required to be insured, in other cases because of some misconduct on your part, and in others, because the injury you suffered is not considered to have arisen out of your employment.

The Employer is not Required to Carry Workers Compensation Coverage

Unless the employer has more than three employees who are regularly employed in the business, then they are not required to carry workers compensation coverage. 

The most common scenario where this issue comes up is with construction companies. The employer will actually have many more than 3 workers who regularly work for the employer, but the employer will claim that everyone is an independent contractor. Oftentimes, this is actually not the case. When you analyze the situation, you begin to realize that all of those “independent contractors” are treated no differently than an employee would be treated. They show up at a specific time every day. They are required to follow the rules and directions of the boss. They generally work nowhere else except the employer. The employer supplies all of the equipment for the job. No matter what they employer calls them, these workers are employees and must be covered. 

So what happens if the employer has no coverage? In North Carolina, unless the employer was somehow at fault, you are out of luck, unless there was a general contractor over the employer who was insured. Sometimes you can find coverage there. 

In Virginia, if there was no insurance with the general contractor, the Commonwealth of Virginia maintains something called the Uninsured Employer Fund which is designed for just such situations. They will stand in the place of the insurance company and pay the claim. Of course, after the fact, they will go after the employer and attempt to recoup their payments. 

NOTE: Just because your employer does not have more than 3 employees in the business DO NOT ASSUME that he does not have coverage. IF the employer ELECTS to purchase coverage, then even though the employer was not REQUIRED to carry coverage, that coverage will invoke all of the rights of the Workers Compensation Act and if you are hurt on such a job, you will be covered by the Act. 

We particularly tell construction workers who own their own business and do construction work themselves: Please, please buy coverage for yourself and your workers if you can find a way to afford it. We have seen too many lives ruined for failure to purchase coverage. 

Pre-existing conditions

If a pre-existing physical condition is the sole cause of your injuries and it’s the pre-existing condition that causes the injury, then you may not be covered. For example, if an employee has severe osteoarthritis, that condition can damage and cause pain in various joints such as the hands, hips, knees, and spine. If you are working and your knee buckles – even though you didn’t fall or didn’t come into contact with any object – then a physician may conclude that nothing at work caused your knee pain – your knee pain is due to your arthritis and nothing else. 

This situation is different than if you slip and fall because the floor is wet and then hurt your knee. A doctor might say that part of your pain in your knee is due to the osteoarthritis – but since the wet floor caused your fall, you can claim workers’ compensation benefits. The good news about pre-existing conditions is that it is rare that a claim will fail because of them. This is because in Virginia, so long as th the injury caused a sudden mechanical change in your body, then if any portion of your disability comes from that injury, no matter how slight, then the entire injury and treatment for it is compensable. 

Many other conditions may be caused by events at work that are personal to the worker and weren’t caused by work. In these cases, the employer will contest your right to workplace benefits.

Personal risk

There are some injuries that the workers’ compensation board or courts may consider non-compensable because they’re due to a personal risk that the employee assumes. For example, if a worker starts a fight with a co-worker, especially if it is over personal issues between them, then that worker will not be able to file a work injury claim for all the burn injuries and respiratory injuries he suffers. The victim of the assault, however, would normally have the right to file a workers’ compensation claim – provided that the reason for the fight was not personal, but work-related in some way. 

Deviations from work

Some employees who are working for their employer take time off to run personal errands. For example, a salesperson who is on the road may take time out to go shopping for something. If that worker is then injured (suffering bone fractures) by falling on the parking lot asphalt, the employee may not be able to claim worker’s compensation benefits to treat with an orthopedist to mend the broken bones– because he/she was injured while deviating from his/her work assignment. The trip to the retail store was not related to his/her work and thus would not be compensable.

Recreational injuries

Recreational activities include activities that are not generally considered part of a workers’ daily job requirements. These activities can include company softball games or outside picnics where workers mingle with other people. Injuries while playing a game or just serving food at a picnic do happen. 

Whether the injury is considered related to work often depends on a few factors such as:

  • Was the participation in the recreational activity mandatory? If everyone at work has to partake in the activity, that suggests that the employer should be responsible if you’re hurt while participating in the recreational activity.
  • Does the participation affect your employment? If the employer makes clear that participation makes you seem like a team player and that participation can help you be promoted, then those factors indicate that the activity was work-related
  • Did the employer provide the source of the recreational activity? These days, many companies offer gyms where employees can work-out. If the employer provides the ability to do the recreational activity – and encourages you to work out for your health – those factors suggest the activity is work-related.

If, on the other hand, a few workers decide to get together for a few beers after work and one worker trips and falls while carrying the beers, that would likely not be considered to be in the course of employment.

Virginia Claims: Failure to Prove the Injury Arose from a Risk Associated with Employment-No Such Requirement in North Carolina

Virginia, unlike North Carolina, has an additional requirement that the injury must be caused by a risk associated with employment. The most classic scenario is a fall down the stairs. In North Carolina, this would be considered a compensable work accident. 

In Virginia, a risk analysis is conducted. What was the employee doing at the time of the fall down the stairs that created a risk that was different from someone in the public who also fell down the stairs? If the answer is nothing, there is no risk of employment and no compensable case. On the other hand, if the employee had his or her hands full with work-related items that made it hard to see or grasp the railing? Or did the employee have some slippery substance on the bottom of his or her shoes that was from a factory floor? Were the stairs themselves somehow defective, such as worn out or missing anti-slip guards on the stairs? Those all would qualify as risks of employment.  

Another example would be someone who wrenches his or her back while performing work duties, such as picking up a light item off of a shelf, turning around and placing it in a box.  The worker is not lifting anything heavy, but suddenly feels a sharp, severe pain in the back resulting from that specific movement at work. In North Carlina, particularly with respect to back injuries, all that is required is that the injury occur as a result of a “specific traumatic incident” of the work required. Accordingly, it would likely be compensable. 

 In Virginia, such a case would not be found to be an “accident” or a result of a risk associated with employment. Anyone could lift a light item off of a shelf and suffer this same injury. It would therefore not be considered a risk of employment and therefore not a compensable accident in Virginia. 

Willful Misconduct, Intoxication and Violation of a Safety Rule

If you engaged in willful misconduct at the time of the accident such as intentionally inflicted injury, you may not recover. Also, if you were found to have been intoxicated at the time of the accident in either Virginia or North Carolina, you may not recover anything. Note that intoxication does not only mean being over the legal limit of .08 BAC in VA.  If fellow employees or supervisors testify that they smelled alcohol on your person on the day of the accident and you were exhibiting signs of intoxication, then that may be sufficient to say you were intoxicated. The intoxication must be found to have been a proximate cause of your accident. 

In North Carolina, the intoxication need only be found to have caused the employee to “lose the normal control of his or her bodily or mental faculties, or both, to such an extent that there was an appreciable impairment of either or both of these faculties at the time of the injury.” 

Insofar as violation of safety rules, to bar a claim in Virginia, the employer must show that the rule was one that was enforced across the board by the employer and that its violation was a proximate cause of the accident. So if the employer at a roofing company says you failed to follow the well-known rule about tying off with a safety rope and harness when working at heights, and yet that same morning your boss and co-workers also alighted and worked on the roof without tying off, that would be a rule that was not generally enforced. They cannot apply it for the first time to you, in order to prevent you from receiving benefits. Another commonly brought up rule is failure to wear seat belts in auto collision.  If the employer had such a rule but never informed the injured worker about it, and never enforced it, that rule may not be used selectively against an injured worker. 

In North Carolina, violation of safety rules by the injured worker will typically not bar or prevent a claim, but will reduce the weekly compensation payment to the injured worker by 10%. 

Each case is different. You should not assume that you don’t have a case. There may be good reasons why you can assert a claim. The best course of action if you are injured at work or doing anything that might be work-related is to speak with an experienced North Carolina or Virginia workers’ compensation lawyer. Often, there is a very fine line between having a viable claim and not having a claim. 

North Carolina and Virginia workers’ compensation lawyer Joe Miller Esq. understands when injury accidents at or related to work are compensable. He’s helped thousands of injured and ill workers get the compensation they deserve. Attorney Joe Miller has been fighting for injured workers for more than 31  years. For help with any work injury claim, speak with an experienced North Carolina and Virginia workers’ compensation attorney. You can reach attorney Joe Miller, Esq., at 888-667-8295. or complete our  online contact form to schedule an appointment. You 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 and submit a claim for consideration, even after hours. 

What is Maximum Medical Improvement?

Posted on Tuesday, December 15th, 2020 at 9:52 am    

When you’ve been hurt at work, there comes a time when continuing to treat with your doctors doesn’t improve your medical condition. When additional medical treatments won’t improve your medical condition and the healing process is stopped – you’ve reached the point of Maximum Medical Improvement (MMI). 

This does not mean that you no longer require medical treatment such as pain management. It just means that according to the opinions of your doctors, you are unlikely to improve your permanent outlook with additional treatment. 

Workers have the right to get medical treatment for any injuries they suffer due to a workplace accident. Most workers start with a visit to an emergency room doctor or they see a physician designated by the workers compensation insurance company, or in some cases, their personal physician. Depending on the type of injury and the severity of the injury, injured workers may need surgery. They often need to see a specialist; maybe several specialists to address their work injuries.  Injured employees often treat with physical therapists, occupational therapists, and/or rehabilitation therapists. Some workers also need to see a psychologist and/or psychiatrist.

Employees who are injured at work who suffer a compensable claim have every right to try to maximize their health and minimize the consequences of their injury at work. During the time they are working to improve their health, they are entitled to have the insurance company for the employer pay their medical bills and generally, 2/3rds of their average weekly wages for the time their authorized physician holds them out of work or for a maximum of up to 500 weeks.  Some injuries completely heal with time – such as many minor fractures. Other injuries never completely heal and may require the insertion of hardware or other drastic methods of repair. 

Maximum medical improvement is an important milestone in an injured worker’s case for a number of reasons: 

  1. It enables your doctor to refer you for a Functional Capacity Examination to determine whether you have any permanent, physical restrictions due to your injuries; 
  2. It enables your doctor to refer you for a Functional Capacity Examination to determine whether you have any permanent partial impairment in any specific body parts you may have injured in your accident;
  3. It is generally a signal to all parties that a potential settlement may be on the horizon; 
  4. It is generally a signal to the defense that they may want to engage you in a program of vocational rehabilitation after the results of your FCE come in. 

MMI evaluations

When workers reach MMI, several evaluations need to take place.

  • The first evaluation is whether you have reached the point of MMI. Often employers will argue that you’ve reached MMI in order to force an early settlement or try and force you back to work or to try to cut off your right to your 2/3rds share of your average weekly wages. You have the right to challenge any claim you’ve reached MMI if you still think medical treatment can improve your health. Normally, the doctor who is treating you makes the initial determination of when you’ve reached MMI. 
  • The treating doctor, in some cases, may be a “company doctor” meaning  he/she does have some bias towards getting you back to work per the insurance company’s wishes. 
  • In North Carolina, if you disagree with a determination that you’ve reached MMI, you have the right (with the help of an experienced North Carolina compensation lawyer) request an independent medical examination (IME). The IME is a medical review done by another physician of your choice. Unfortunately, there are no such provisions in Virginia; however, if you can afford to see a different physician, you can pay for the examination yourself. 
  • After the MMI determination by your physician, the second step is usually for that physician to order a Function Capacity Examination (FCE) by a licensed physical therapist’s office equipped for such exams. This evaluation is to determine if you can return to work with workplace restrictions. A typical workplace restriction is that you can work but you can’t lift or move any objects that weigh more than 20 pounds. 
  • After the FCE occurs, some employers may decide to adjust or accommodate your work routine so you can work with these restrictions. This way, you can earn your salary; however, this accommodation does not come without risks. Note that If the employer reduces your pay because of the workplace restrictions, you should be able to continue to receive pay loss benefits – but the benefits are adjusted to reflect 2/3rds of the difference in pay between your pre-injury wages and your new wages. 
  • If the employer doesn’t have a job for you that you can do based on your work restrictions, then you can continue to receive your 2/3rds per week disability payments. In Virginia, if you are not under an Award for benefits, or if your claim in in North Carolina, if your employer cannot accommodate your restrictions, you must look for a job you can do with those restrictions. If you are under an Award in Virginia, then you are under no obligation to look for other work. The burden shifts to the employer in cases of an Award to find you work and if they choose to do so, this is done via vocational rehabilitation. 
  • Oftentimes, the FCE also includes a portion of the exam which is designed to decide whether you are eligible for permanent partial disability or permanent partial impairment (PPI) benefits. When you’ve reached MMI, the treating doctor, after reviewing this portion of the FCE report, will normally also assign an injured worker a Permanent Partial Disability (PPD) or Impairment rating (PPI). Here, the physical therapist is performing tests on your injured body part to determine if you there exists a permanent disability in the injured body part. Based on that evaluation, the physical therapist— and later your doctor– will assign a percentage rating to that disability (called an impairment rating). 

 

An example of a permanent partial disability/impairment is the loss of function of a hand. An impairment rating is an assignment of the severity of that loss of hand such as 90%. This means you’ve lost 90% of the function of your hand. If you are entitled to permanent disability benefits, the amount of the benefits (a specific number of weeks such as the maximum of 200 weeks for the hand– what North Carolina law permits) is multiplied by the impairment rating. So, if you would normally be entitled to 200 weeks for a permanent disability and you have a 90% impairment rating, you will be entitled to 90% of 200 – or 180 weeks. Note that this is NOT in addition to any weeks you remain out of work. 

  • After you have reached MMI and these evaluations occur is typically a good time to determine whether you want to consider a lump sum settlement. If you are unable to return to your former job and so far you are unable to find alternate employment or the insurance company has not been able to find any for you, then you have the potential for a maximum of 500 weeks of payments ahead of you. These potential future weeks, along with the value of the medical side of your claim can then form the basis of a lump-sum settlement demand by your attorney. 

If, on the other hand, you have returned to work at a job at or higher than your pre-injury wages, and you have been determined to have a permanent partial disability and an impairment rating, then the number of weeks as determined by that percentage, plus your future potential medical treatment would be the basis of your attorney considering and possibly negotiating a lump-sum settlement (called a clincher agreement in North Carolina). In a lump-sum settlement, you’re a negotiated portion of what potentially is due to you in the future (the 2/3rds’ wages and medical bills) in one payment to you, so you control the money. The risk, of course, is that there is no do-over if your medical bills are more than you anticipated. On the other side, the risk to the insurance company is that you will, in fact, get better, require little further treatment,  and find a good job on your own, in which case would not have ended up paying you what they paid out in settlement. 

 

An experienced work injury lawyer will advise you about the pros and cons of a lump-sum settlement in your particular circumstance. 

It’s important to understand that you are still entitled to seek medical help – after you reach MMI – and to have the employer pay for that medical care. The key requirement is that the medical care must be needed to help ensure your medical condition doesn’t worsen. Many patients, for example, who have chronic back pain due to their workplace injury need pain management or orthopedic maintenance so their back pain doesn’t get worse.

You should also understand that if you are in an accepted claim or under an Award, the burden to switch from temporary total disability benefits to permanent partial disability benefits, or from temporary total disability benefits to a termination of benefits, is on the employer.

Talk with a seasoned North Carolina and Virginia workers’ compensation lawyer today

North Carolina and Virginia workers’ compensation lawyer Joe Miller Esq. understands that many employers try to push workers to return to work before they’re healthy. He works with your doctors and independent doctors to help assess your medical difficulties and concerns. When you reach maximum medical improvement, he also works to assist your doctors in determining whether you have a permanent partial or full disability as you look to your future.  To discuss your worker’s compensation case, call attorney Joe Miller, Esq., at 888-667-8295. or fill out our online contact form to schedule an appointment. You can also fill out our New Electronic Case Review. It’s a new way we’re offering so workers can contact us remotely.

CDC Recommendations for Hearing Protection During Your Lifetime

Posted on Monday, November 9th, 2020 at 10:39 am    

Several doctors published a report on the website of the Centers for Disease Control and Prevention (CDC) in 2018 explaining how hearing affects workers during their lifetime.

Across the globe, one in three people have a measurable loss of hearing. “1.1 billion young persons are at risk for hearing loss attributable to noise exposure.” Some of the occupations that place people at risk of hearing loss including manufacturing, construction, and mining. “Loud noises can cause permanent hearing loss through metabolic exhaustion or mechanical destruction of the sensory cells within the cochlea.”

Whether loss of hearing constitutes a disability is based on the worker’s communications needs and ability to perform his/her job tasks. Workers such as police and air traffic control workers need high and middle level frequencies to do their hearing-critical jobs.

Occupational Noise-Induced Hearing Loss

“A recent analysis of 2011–2012 National Health and Nutrition Examination Survey (NHANES) data estimates that approximately 14% of U.S. adults aged 20–69 years (27.7 million persons) have hearing loss. After adjustments for age and sex, hearing impairment was nearly twice as prevalent in men as in women; age, sex, ethnicity, and firearm use were all important risk factors for hearing loss. “

About 22 million workers are exposed to dangerous noise levels at work according to the CDC’s National Institute for Occupational Safety and Health (NIOSH). The prevalence of hearing loss can be as high as 25% of the workforce depending on the job types. Some sectors such as forestry, agriculture, warehousing, transportation, fishing, hunting, and utility work seem to have benefited from hearing protection where the risk decreased according to comparing studies from 2006-2010 to studies for 1986-1990.

Workers such as firearm and aircraft workers can be exposed to as much as 140 decibels above pressure level (dB SPL). They require noise reduction devices of 30-50 dB. Even though there are occupational guidelines for hearing protection, many workers suffer hearing loss because their earmuffs and earplugs don’t fit properly.

Nonoccupational Noise-Induced Hearing Loss

Insurance companies for the employers may argue that a workers hearing loss is due to non-occupational causes. Recreational hunting, shooting, personal music players, loud noises at concerts, woodworking, and motorsports are known to have high-risk noise levels. 

“Persons with normal hearing can detect sounds equally soft at all frequencies. When hearing is damaged by noise, the hearing test will show a loss of acuity in a narrow range of middle to high frequencies (3–6 kHz) with better hearing at both lower and higher frequencies. Often, the earliest sign is a notched configuration in the audiogram.”

Many workers and people with hearing loss due to non-work causes actually think their hearing is excellent or good – which means they’re not aware of their hearing loss. Sadly, while much hearing loss is preventable, many workers and nonworkers fail to take preventive steps. The report states that “70% of persons exposed to loud noise in the past 12 months had seldom or never worn hearing protection.”

Worldwide hearing loss statistics

According to the World Health Organization (WHO), about 360 million people have a disabling (unable to work) hearing loss. About 328 million adults are affected. 56% of males are affected. “It is estimated that approximately 320 million persons aged >65 years will have hearing loss by 2030 and approximately 500 million by 2050.”

American prevention efforts

The CDC report states that hearing loss programs should go beyond traditional services – such as diagnosis, treatment, and research.” The initiatives should also “focus on epidemiologic surveillance, health promotion, and disease prevention.” This type of approach can lead to better prevention strategies and better ways to manage hearing loss.

One such program is called: Dangerous Decibels. This program has helped people with both hearing loss and tinnitus (ringing in the ears). The program’s three main strategies are:

  • Turn it down
  • Walk away
  • Protect your ears

The program, which began for just youths, now works for adults and members of the military. A study of children in the US, New Zealand, and Brazil affirmed the effectiveness of the program. The program is used in all 50 states, the four US territories, and 41 nations. The program includes online games such as Jolene – a program which measures “music-listening sound levels and aids in educational outreach for hearing health.

The CDC has its own hearing loss and communication products. “NIOSH promotes the Buy Quiet and Quiet-by-Design programs, designed for employers to take an inventory of their potentially harmful loud tools and replace them with quieter ones.” NIOSH also developed the Safe-in-Sound Excellence in Hearing Loss Prevention and Innovation Award which recognizes individuals and companies for successful hearing loss programs. In 2015 United Technologies was one of the companies recognized – for reducing the rate of employee exposure to hazardous noise by 80%.

“NIOSH recommends an 85-dB limit for an average daily 8-hour exposure and a 3-dB exchange rate, which means that each increase of 3 dB in exposure level reduces the recommended exposure time by half. Thus, an 88-dB exposure limit is recommended for up to 4 hours and a 91-dB exposure limit for 2 hours.”

Two World Health Organization (WHO) hearing loss initiatives are:

  • World Hearing Day. This day is observed on March 3. It aims to increase the awareness of hearing loss amount professionals, communities, and policymakers.
  • Make Listening Safe Initiative. This initiative focuses on personal audio systems.

Some of the ways workers can protect themselves for noise include:

  • Lowering volumes
  • Taking breaks
  • Using better quality consumer products
  • Reductions in time of exposure to loud noises
  • Hearing protection devices which fit properly 

North Carolina and Virginia workers’ compensation lawyer Joe Miller Esq. has been fighting for workers who suffer occupational illnesses or workplace accidents for more than 25 years. He works with experienced hearing physicians to verify your inability to work due to hearing loss or your inability and/or your need to use hearing devices for work and for your daily activities. He’ll fight to ensure your hearing loss is fully compensated and the cost for medical care and protective devices is paid. To review your rights with an experienced work injury lawyer, call North Carolina and Virginia lawyer Joe Miller, Esq., at 888-667-8295. or complete my online contact form to or our online case evaluation form to see if you may have a compensable workers compensation claim. 

Factors in Selecting the Correct Hearing Protection at Work

Posted on Saturday, November 7th, 2020 at 10:38 am    

Many workers, especially those in construction, agriculture, and industry, work in conditions where it is extremely noisy. After months or years of exposure to loud sounds, workers may lose part or all of their hearing. This hearing loss is often covered as an occupational illness under the North Carolina and Virginia workers’ compensation laws. In some cases, just one loud explosion can cause a worker to have a justifiable workers’ compensation claim based on a workplace accident. 

In Virginia, under VA Code 65.2-503 (15), a total loss of hearing due to workplace conditions or accident can pay up to 50 weeks of temporary total disability compensation (2/3rds of the injured worker’s average weekly wage). The percentage of hearing loss is determined by the degree permanent loss in terms of decibels. This is set forth in the Hearing Loss Table. In Virginia, injured workers are not entitled to any compensation for hearing loss that is less than a reduction of 27 decibels. 

In North Carolina, under North Carolina General Statute 97-53 (23), a total loss of hearing in both ears can pay up to 150 weeks of compensation; however, the law relating to the percentage of compensation for less than 100% loss is somewhat complex. One rule that is different is that unless there was pre-existing hearing loss in one ear, hearing loss is only compensable if there is a hearing loss in both ears. Tinnitus, or ringing in the ears, is not compensable in North Carolina. 

It should be noted that this permanent partial impairment mode of compensation (the percentage of hearing loss x the maximum number of weeks) does not take into account an injured worker who suffers a severe hearing loss that would prevent him or her from returning to his or her pre-injury job. In that circumstance, one could conceivably negotiate a settlement based on based on the remaining weeks under an Award for benefits, which can be for up to 500 weeks. 

Whether loss of hearing constitutes a disability from work is based on the worker’s communications needs and ability to perform his/her job tasks. Workers such as police and air traffic control workers, for instance, need high and middle level frequencies to do their hearing-critical jobs. A severe hearing loss might accordingly prevent them from returning to that occupation and result in a potential significant recovery in a settlement scenario. 

There are numerous ways workers and employers can help reduce the risk of hearing loss or tinnitus which is a ringing in the ears. Choosing the right hearing protection device can be difficult when there are so many choices – by style, color, size, and materials. The doctors recommend that workers consider the following factors:

Several physicians posted a report on the Centers for Disease Control and Prevention website explaining hearing protection choices when the volume can’t be turned down or the time you’re exposed to the loud sounds can’t be limited.

In addition to hearing loss, difficulty communicating when its noisy can lead to communication errors which can lead to accidents. 

 

Understand how much notice reduction protection you need

Most exposures to industrial noise are lower than 95 dBA (a decibel level)– “which means most workers require no more than about 10 dB of noise reduction to meet the NIOSH Recommended Exposure Limit of 85 dBA.” Most hearing protection devices that fit correctly can meet this 10 dB requirement. Workers can measure the decibel levels at work with an app for their smartphone- such as the NIOSH Sound Level Meter.

If the noise level is more than 95 dBA, then greater noise reduction devices are required – though workers should be concerned about reducing the noise level too much. “Too little sound can make you feel isolated and less aware of your surroundings.” Workers who are overprotected may regularly feel the need to remove the hearing protection device just to hear a co-worker or supervisor speak. The aim should be to bring the noise level down to 75-85 dBA.

Workers should consider fit-testing their device. “If fit-testing is not available at your workplace, you can check the earplug fit by counting out loud while slowly cupping and uncupping your hands over your ears; if you have a good fit, your voice should sound about the same as you cup and uncup your ears. NIOSH QuickFitWeb can also be used to check if you are getting more or less than 15 dB of sound reduction.”

Some workers who work where the noise levels are more than 100 dBA should wear another form of hearing protection such as earmuffs over earplugs. Chainsaws and jackhammers have noise levels more than 100 dBA. Some devices such as nail guns or weapons exceed the 100 dBA level too. 

Understand your worksite and the task your job requires

Workers need to consider what other protective devices they need to wear and how they may interact or interfere with the chosen form of hearing protection they use. Examples include:

  • Eye protection
  • Hard hats
  • Other head-level personal protective equipment (PPE)
  • A respirator

Some of these other devices can interfere with the hearing protector. For example, earmuffs can interfere with how hard hats or helmets fit. The hearing protection device should be compatible with the other types of protective equipment you need.

Workers should also review whether the noise is continuous – or is active sometimes and quiet at other times. Some devices are easier to adjust if you stay in the same place all the time – as opposed to moving to different locations. Some hearing protection devices are designed to adjust to intermittent noise exposures.

If your hands regularly get dirty, then it helps to avoid devices that require you to use your hands before inserting the device – unless it’s easy to wash your hands before inserting the device.

Workers should think how often they need to hear while wearing the hearing protective device. For example, musicians may need to wear “flat attenuation hearing protectors” while playing their instrument with others. “Special communication headsets can also improve speech communication in very loud environments.”

 Decide which hearing protection device is both comfortable and convenient

Hearing protection devices only work “if you wear them consistently and correctly every time you are exposed to hazardous noise.”

Many workers prefer earplugs to earmuffs – especially if they have to wear the device for long lengths of time or when it’s hot. Earplugs are generally easier to store, lighter, and easier to keep around for unexpected noise exposure. On the other hand, earplugs are often tougher to fit properly. Earplugs may come in different sizes – so, it makes sense to try them out. Additionally, earplugs often need to be replaced often. Some are even designed to be worn just once and then thrown away.

Earmuffs or headphones are usually one-size fits all devices. “Many people find them easier to fit properly and consistently. Earmuffs are easier to remove and replace quickly, so they can be preferable for intermittent use.” They’re generally less comfortable though, because they’re bulkier than earplugs. On the plus side, earmuffs are more durable.

Workers should take the time to choose the right hearing protection devices for their workplace before they begin working. The main key is to find the hearing device though you’ll wear every time you are exposed to any noise level at work that is above 85 dBA. 

Your employer may have recommendations. Your general physician or an audio specialist will have their own set of recommendations.

  1. North Carolina and Virginia workers’ compensation lawyer Joe Miller Esq. is a premier workers’ compensation attorney. He’s helped thousands of injured and ill workers in North Carolina and Virginia get just recoveries for occupational illnesses and injuries such as hearing loss. He’ll work with your physicians to document the severity of your hearing loss. He’ll work to determine the cost of the hearing devices that you’ll need for the rest of your life. He’ll also explain what permanent damages workers who lose part or all of their hearing are entitled to – even if they can return to work. To speak with an experienced work injury lawyer, call North Carolina and Virginia lawyer Joe Miller, Esq., at 888-667-8295. or fill out my online contact form or our new online case evaluation form to start the process of having your claim evaluated by Mr. Miller and his team. 

The Occupational Injury and Illness Classification System (OIICS)

Posted on Tuesday, June 23rd, 2020 at 8:55 am    

According to the Centers for Disease Control and Prevention, “the Bureau of Labor Statistics (BLS) developed the Occupational Injury and Illness Classification System (OIICS) to characterize occupational injury and illness incidents.” There are been several revisions to the original system. The OICS breaks down workplace injuries and illnesses into the following four categories:

  • Nature of the injury or illness. The principal physical characteristic(s) of the injury or illness.
  • Part of Body Affected by the injury or illness. The part of the body directly affected by the previously identified nature of injury or illness.
  • Source and Secondary Source of the injury or illness. The objects, substances, equipment, and other factors that were responsible for the injury or illness incurred by the worker or that precipitated the event or exposure.
  • Event or Exposure. The manner in which the injury or illness was produced or inflicted by the source of injury or illness.

Each of the four categories is broken down into further subcategories. The categories include definition and examples. Some of the relevant sections, that may be used to assess workplace injuries and illnesses are the following. In many cases, an injury or illnesses may be categorized in another part of the OICCS

Event or Exposure

 

  • Violence and Other Injuries by Persons or Animals

 

    •  This category covers “violence and other injuries by persons or animals.” It includes intentional injuries, injuries with weapons (such as firearms and tools designed to be used as weapons) – regardless of intent. It also includes “injuries involving direct physical contact with persons, animals, or insects regardless of intent.” Unfortunately, this has become more of an issue these days, due to workplace violence and mass shootings. 
    • The category doesn’t include injuries due to overexertion or bodily reactions such as running after a suspect or being unintentionally hit by a box thrown or dropped by another person. It also doesn’t include unintentional drug overdoses and “exposures to infectious agents unless intentional or transmitted by an insect or animal bite.”
  • Transportation Incidents. The category includes transportation vehicles, powered industrial vehicles, powered industrial equipment involving at least one vehicle (or mobile equipment) –“and the injury or illness was due to collision or other type of traffic incident; loss of control – or a sudden stop, start, or jolting of a vehicle regardless of the location where the event occurred.”
    • There are additional requirements for transportation accidents involving pedestrians, roadway workers, and other non-passengers struck by a vehicle or other qualifying vehicles or powered equipment.
    • The category applies to many different vehicles including railway vehicles, animals and other non-motorized transportation, aircraft, water vehicles, roadway accidents, and pedestrian accidents. The category includes cars, trucks, RVs, motorcycles, buses, amusement park rail vehicles, canoes, fishing boats, Segways, snow mobiles, forklifts, and other listed vehicle types.
    • Falls “on or from vehicles are transportation incidents if the vehicle was in normal operation.”
    • This category doesn’t include events such as injuries due to the vibration of a vehicle, carbon monoxide poisoning, spilling hot drinks where there’s no collision, gear slips, and other specified incidents.
    • Vehicles that doesn’t fall into this category include, “dollies, carts, wheelbarrows Nonindustrial, non-roadway mobile equipment Wheelchairs–motorized and nonmotorized, stretchers, and wagons.”
  • Fires And Explosions. This category includes cases where a person falls or jumps from a burning building, inhales harmful substances, or is pinned or struck by objects due to the explosion or fire. The category also includes “incidents in which the worker was injured due to being trapped in a fire or whose respirator had run out of oxygen during a fire.” It doesn’t include fires or explosions caused by transportation accidents or intentional actions – which are covered elsewhere. It includes a variety of injuries to firefighters such as injuries from lifting hoses, arson and falls in a parking lot of a burning building. 
    • Injuries due to direct contact with flames from controlled sources such as stove tops that someone in a restaurant kitchen might suffer; and burns due to touching ovens, grills, and burners – are covered elsewhere.
    • In addition, many times folks who come through such experiences, as well as workplace violence will still suffer terrible psychiatric effects long after the physical injuries have healed. Our firm deals with many cases like this, which typically involve development of Post Traumatic Stress Disorder, or PTSD
  • Falls, Slips, and Trips. These include “falls on the same level, falls and jumps to lower levels, falls and jumps that were curtailed by a personal arrest device, and slips and trips that do not result in a fall.”
    • Falls that are covered in other sections includestepping to a lower level (such as, off a ladder, out of a vehicle, or off a curb), falls through openings in floors, or falling into a body of water. 
  • Exposure to Harmful Substances or Environments. Over time, long-term exposures to noise or other harmful substances such as asbestos, silica, or trichloroethylene (TCE) can result in severe impairments, such as asbestosis, cancer, brain damage, and death. 
  • Contact with Objects and Equipment. This category applies to contact between the injured person and the source of injury unless the contact is covered in another category such as a fall or a violent act. The category doesn’t include workplace contact with other people or animals. It also doesn’t include exposures to hot or cold objects or substances, contact with electrical currents, exposure to toxins or allergic substances, and exposures to infectious agents. Those contacts are generally covered in other categories.
  • Overexertion and Bodily Reaction. This category applies generally to non-impact injuries or illnesses that result from “free bodily motion, from excessive physical effort, from repetition of a bodily motion, from the assumption of an unnatural position, or from remaining in the same position over a period of time.”
    • Further subcategories include:
      • Overexertion and bodily reaction, unspecified. Examples include lifting, pushing, pulling, turning, holding, carrying, wielding, throwing, and catching
      • Overexertion involving outside sources
      • Repetitive motions involving microtasks 
      • Other exertions or bodily reactions 
      • Multiple types of over-exertions and bodily reactions 

North Carolina workers’ compensation lawyer Joe Miller Esq. has helped thousands of workers in North Carolina and in Virginia get just recoveries for a wide variety of workplace injuries. He’s been fighting for employees for more than 31 years. He has the experience and resources to fully document your medical expenses, your lost wages, and any other related work injury costs. He’ll fight to get you a strong recovery. To schedule an appointment with a respected work injury lawyer, is please phone Joe Miller, Esq., at 888-667-8295. or fill out my online contact form

Wounds, Bruises, and Workers Compensation Claims

Posted on Monday, June 22nd, 2020 at 8:46 am    

The Occupational Injury and Illness Classification System (OIICS) of the Bureau of Labor Statistics classifies surface wounds and bruises according to several categories. Surface wounds are a form of traumatic bruise or injury that occur on the surface of the body and “generally do not involve open wounds.” “Generally, a traumatic injury or disorder is the result of a single incident, event, or exposure over the course of a single shift.” 

The OIICS guide is a useful resource for classifying a wide range of workplaces injuries and diseases. Cases that are categorized as traumatic bruises or injuries don’t need to be “consistent with the Occupational Safety and Health Administration (OSHA) recordkeeping definition of an injury or whether the employer reported the case as an injury or illness on the OSHA log.”

Some surface wounds such as mosquito bites and foreign object in the eye are categorized elsewhere in the OICCS. The subcategories for surface wounds are the following:

 

  • Unspecified wounds and bruises. 

 

  • Abrasions and scratches. This group includes “traumatic injuries where the skin, mucous membrane, or superficial epithelium have been removed or marked, usually as a result of rubbing, scratching, or scraping.” 
  • Blisters. This category includes “the localized collection of fluid in the epidermis associated with friction or impact.” The category includes blood blisters and friction blisters but doesn’t’ include blisters associated with burns which are categorized elsewhere. 
  • Bruises and contusions. This category includes “injuries that produce capillary hemorrhaging with the skin remaining intact.” Examples include bruises and contusions (with or without swelling), hematomas, “black eye, ecchymosis, hyphema, and contusions resulting from nonvenomous animal bites, bruised bones.” It doesn’t include concussions, non-traumatic and traumatic cerebral hemorrhages, and other related injuries which are categorized elsewhere.
  • Multiple surface wounds band bruises. This category includes multiple injuries and disorders of equal severity.
  • Surface wounds and bruises, n.e.c. This category includes mosquito bites and other minor nonvenomous insect bites

Other wound injuries may be categorized as

  • Traumatic injuries to bones, nerves, spinal cord
  • Traumatic injuries to muscles, tendons, ligaments, joints, etc.
  • Open wounds
  • Burns and corrosions
  • Intracranial injuries
  • Effects of environmental conditions 
  • Multiple traumatic injuries and disorders
  • Other traumatic injuries and disorders 

Many workers in a variety of industries suffer surface wounds and bruises. While surface wounds and bruises may not appear serious on first inspection, they can become serious if not treated properly. Surface wounds and bruises can cause a worker to miss significant time from work.

What causes surface wounds?

Surface wounds and bruises are common work injuries. If they result from a workplace accident, an employee has the right to seek workers’ compensation benefits, in North Carolina and in Virginia. These benefits include ER care, follow-up medical care, and generally 2/3 of any income loss because the employee can’t do his/her job. Some workers may need to treat with a plastic surgeon. If the abrasions or wounds become infected or cause other related harm, the worker may need to treat with pain management doctors, infectious disease specialists,  nerve and ligament specialists, and other specialists. Workers may also need to treat with psychologists or mental health professionals if the wounds lead to scars or to unsightly physical damage which, in turn, cause emotional harm.

Some of the causes of surface wounds, bruises, abrasions, and related injuries include:

  • Car, truck, or vehicle accidents
  • Accidents due to handling or mishandling of machines, tools, and sharp objects. This includes machines that don’t have proper guards, tools, and machines that aren’t used properly, or if the safety equipment is faulty.
  • Accidents that cause a worker to slip and fall – causing the worker to hit/her head or to injury their arms or legs in an attempt to catch or reduce the impact of the fall

What jobs have a higher danger of causing surface wounds or bruises?

Some of the job categories that have a higher risk for traumatic injuries such as surface wounds or bruises include:

  • Police and security work
  • Firefighting
  • First responders and EMT responders
  • Workers in any type of construction trade
  • Agricultural workers
  • Workers who work in the oil and gas energy sector
  • Mining workers
  • Worker who work on assembly lines or work in manufacturing

Types of injuries that wounds and bruises may bring about or cause

Employees who suffer a wound or bruise may:

  • Develop infections
  • Suffer from internal bleeding
  • Go into shock
  • Develop a fever
  • Have nausea
  • Have some type of skin loss that will need to be treated
  • Have permanent scarring

Your rights if you have surface wounds or bruises

Generally, you must notify your employer or manager about any injuries of any kind as soon as possible. Workers with surface wounds and bruises normally begin their medical care by going to the local emergency room or by going to their family doctor. Whether the worker can return to work may depend on the type of job the employee has. Workers who have jobs that require a fair amount of physical labor may not be able to return to work promptly. Workers who have desk jobs often can return to work unless the wound prevents them from using their hands or eyes. A key factor is whether any complications result.

In all workers’ compensation cases, there is no requirement to prove the employer was at fault for the  injuries. Fault is not a factor in workers’ compensation cases. As long the accident happened at work, happened to an employee during the course of the employee’s job, and the accident caused the injuries – then they employee has the right to file a state work injury claim.

Scarring or Disfigurement

One thing that is important to note is that workers compensation does not compensate injured workers for pain and suffering. Compensation is generally limited to the effect the work injuries have on the injured worker’s ability to work and the medical bills. There may also be some recovery for permanent impairment in a particular body part. 

 One exception to those limits is if there is visible, permanent scarring on disfigurement on a body part that the injured worker hurt in the accident. It must be a body part that the injured worker is not otherwise claiming for impairment. For instance, if there is severe scarring from lumbar (back) surgery, and the injured worker wants to claim a permanent impairment in the lumbar spine in North Carolina (spine impairment is not available in Virginia), he or she would not also be able to claim scarring or disfigurement due to the surgical scars. 

What are the amounts that are available to be recovered? According to N.C.G.S. 97-31 (21) For serious facial scarring or disfigurement, an injured worker can recover up to $20,000.00.  For serious disfigurement to any other part of the body, up to $10,000.00. 

This may not seem like much, but it must be remembered that the workers compensation statutes are primarily concerned with how an injury affects one’s ability to work. So if someone is so severely injured that he or she is unable to return to work, that injured worker would be entitled to up to 500 weeks of benefits at 2/3rds of their average weekly wage, until he or she was able to return to work. 

If the injuries are sufficiently severe, and involve certain categories of injuries that prevent return to any gainful employment, depending on the nature of those injuries, the employee may qualify for lifetime weekly benefits. Even if the employee did not suffer injuries in those categories, if the employee can prove that the work injury has caused a total loos of wage-earning capacity, then after 425 weeks of benefits, that employee may apply for extended benefits, which is some cases may result in lifetime compensation. 

North Carolina workers’ compensation lawyer Joe Miller Esq. works with your doctors and independent doctors to help document your injuries. He fights to get full compensation for all medical expenses for all workplace injuries and illnesses. He also fights to get workers the amount they justly deserve for lost income, for vocational rehabilitation costs, and for any incidental expense. For help with any workers’ compensation claim, call North Carolina and Virginia lawyer Joe Miller, Esq., at 888-667-8295. or fill out my online contact form to speak with a skilled work injury lawyer.

Workers’ Compensation and Repetitive Stress Injuries

Posted on Friday, September 6th, 2019 at 3:11 pm    

Repetitive stress injuries, according to Medical News Today, can affect most every movable part of your body. They are generally associated with repeating the same task over and over again, vibrations, and forceful exertions. Some of the other names for repetitive stress injury (RSI) are repetitive motion disorder, cumulative motion disorder, repetitive motion injury, occupational overuse syndrome, and regional musculoskeletal disorder. 

Generally, in both North Carolina and Virginia, repetitive stress injuries do not constitute valid claims. If one claims, for instance, that due to years of heavy lifting one’s back has started to hurt, that claim will be denied by the insurance company as well as by both the Virginia Workers Comp Commission or the North Carolina Industrial Commission. 

There are, however, a couple of sets of exceptions carved out in the law.  

The first is if the repetitive stress injury is suddenly aggravated by a traumatic event. In Virginia, as long as the doctor can say that the traumatic event caused a “sudden mechanical change” in the injured body part, then this would be a valid injury. Similarly, in North Carolina, a slip, trip or fall that aggravates a repetitive injury would be compensable. 

The second set of exceptions relate to some specific injuries that are very common and generally accepted as either occupational diseases or ordinary diseases of life caused by repetitive work trauma.  

Carpal tunnel syndrome is perhaps the best- known form of RSI. It is treated as an ordinary disease of life that is an occupational disease. It is a condition, according to Orthoinfo, that occurs when a major nerve to the hand (the median nerve) “is squeezed or compressed as it travels through the wrist.” It can be quite painful and generally gets worse over time unless it is treated. For some patients, surgery may be required to take pressure off the median nerve.

CTS is very common in machinist occupations and electrical occupations where repetitive use of the hands is required. 

Some of the symptoms of repetitive stress disorder

Symptoms include:

  • A throbbing sensation or a pulsing sensation in the part of the body affected
  • Loss of sensation
  • Pain or tenderness in affected joints and muscles
  • Loss of strength
  • A tingling sensation
  • Reduced range of motion
  • Reduced flexibility

Symptoms often vary depending on the part of the body that is affected.

Many workers don’t’ realize they have an RSI until the damage to their body is significant. By the time they do feel the pain, they need to stop working and get medical help.

Causes of repetitive stress injury

Some of the general causes of repetitive stress injuries include:

  • Using the same muscle or group of muscles again and again
  • Working in temperatures that are cold
  • Equipment that vibrates
  • Not working in a sound ergonomic work environment
  • Poor posture or keeping the same posture for a long time
  • Tiredness
  • Carry of lifting heavy objects
  • Direct pressure on a certain part of the body

Psychological stress can worsen RSI.

Some of the causes of RSI that cause workers to lose time off from work and file a workers’ compensation claim include:

  • Computer work. This is one of the more common causes of RSI, more specifically carpal tunnel syndrome. Workers who type and type all day long are using the same muscles over and over again. Clicking a mouse, typing on a keyboard, using a smartphone while typing – all can lead to repetitive stress injuries that can make work difficult. Workers should routinely take breaks from typing, make sure their monitor is the right distance away from the keyboard, use keyboards and computer setups that are ergonomic, and try to mix up their work with other tasks.
  • Construction work also often requires that workers perform the same tasks. These repeat tasks including using a jackhammer, hammering nails, digging in the ground, operating a forklift or a crane, cutting tree branches, or other tasks. The repeat work can develop into an RSI over time. Employers and workers should consider rotating tasks so the same muscles aren’t used all the time. Positioning and work techniques can also help reduce the risk of an RSI.
  • Retail work. Most retail workers are on the feet all day long which leads to fatigue. While they’re working, they are doing repeat tasks such as putting clothes on hangers or removing clothes, organizing the inventory, or operating a cash register.
  • Waitressing. Most waitress do the same physical tasks every day. They take order, carry food on trays, take the food off the trays, and unless they have someone to help – clean the dishes and the tables.
  • Standing or sitting in one position all day. These tasks can be bad for the heart and bad for your joints, muscles, ligaments, and tendons. People who sit in a on office all day long should make an effort to get up, stretch, and walk around. People who stand all day are putting pressure on their whole body. It helps for standing workers to take regular breaks where they can sit for a while.
  • Nursing. Nurses are constantly giving patients medications, moving and turning patients, checking blood pressure and doing other tasks on a repeat basis.
  • Machinist work. Constant working with hand tools can often cause carpal tunnel syndrome. 
  • Electrical work. Using screwdrivers and other tools in tight spaces can often cause carpal tunnel syndrome. 

Other jobs that are known to cause RSIs include delivery work, plumbing, agricultural work, firefighting, stocking shelves, janitors, maid services, and food processors. Professional athletes and professional musicians also do a lot or work that involves repetitive motions.

Treatment for an RSI

The earlier workers begin treatment for an RSI, the better. Doctors will conduct a range of tests depending on the body part that hurts and other factors. These tests include:

  • Nerve conduction studies
  • Electromyogram (EMG) which measures the electrical activity in muscles.
  • X-Rays and MRIs may be used

Treatments for an RSI include:

  • Surgery on the affected body part
  • Medications to reduce the inflammation and the pain
  • Braces and splints may help
  • Steroid injections
  • Certain types of exercises

The recovery process for surgical and non-surgical treatments can take months or even up to a year.

Can you claim workers’ compensation benefits for a repetitive stress injuries?

Unfortunately, other than Carpal Tunnel Syndrome (CTS), or aggravation of pre-existing RTS injuries by a single traumatic event, Virginia does not recognize any other repetitive stress injuries as valid, compensable injuries or an occupational disease

In North Carolina, the legislature has carved out a few specific, repetitive stress injuries that are recognized as specific, valid, occupational diseases. 

In addition, in North Carolina, (not in Virginia) repetitive stress injuries can sometimes be classified as occupational diseases and be compensable IF they are proven to be caused by things that are characteristic and peculiar to the employment of the injured person and excluding ordinary diseases of life to which the public is equally exposed. An example is a cameraman who develops a rotator cuff injury over time. His job requires him to carry the heavy camera on his shoulder every day, and if the doctor supports it, this would be an example of a compensable RTS injury in North Carolina. 

One should proceed with caution, however. These types of North Carolina “ordinary disease of life” cases are notoriously difficult to prove. The doctor must not only say that the work caused the issue, but that it was NOT caused by exposure to repetitive stress outside of work. For some jobs, such as daily work with a jackhammer, the proof may be clear. For other jobs, such as computer work, an insurance company may argue that your off-duty typing or exposure to other, off duty activities caused the RSI. 

There are, however, some RTS diseases in North Carolina that are specifically listed by the legislature as an occupational disease. 

The RTS diseases that are specifically listed in North Carolina General Statute Sec. 97-53 as compensable occupational diseases are: 

  • Blisters due to use of tools or appliances in the employment
  • Bursitis due to intermittent pressure in the employment
  • Bone felon [a type of finger infection-ed.] due to constant or intermittent pressure in employment
  • Synovitis, caused by trauma in employment; 
  • Tenosynovitis, caused by trauma in employment 

Examples of repetitive stress injuries that might be compensable in North Carolina, (but not in Virginia) depending on the proof of facts, are:

  • Tendonitis
  • Shoulder and rotator cuff injuries 
  • Tennis elbow, more formally called epicondylitis
  • Muscle strains
  • Trigger finger
  • Many other types of RSIs

If you have a workers’ compensation claim because of a repetitive stress injury, Virginia and North Workers’ Compensation Attorney Joe Miller Esq., will explain your legal rights. In most cases, unless you fall into one of the exceptions listed above, there is a good chance you may not have a case. But if you have a valid work injury claim, he’ll work with your doctors to determine your full health condition.  In some cases, he may recommend that you see other doctors who are approved by the state workers’ compensation organizations. To learn if you have a claim, call attorney Joe Miller at 888-694-1671. or fill out my contact form to schedule an appointment. Joe Miller has been fighting for injured workers for more than 31 years.

Workers’ Compensation and Back Injuries

Posted on Wednesday, September 4th, 2019 at 3:11 pm    

According to the Occupational Health and Safety Administration (OSHA), there are numerous reasons why back injuries are a major cause of lost work days. Back disorders generally occur in one of two ways:

  • A single traumatic event
  • Repetitive actions over time
  • A combination of both

A single traumatic event or a combination of a single traumatic event that aggravates an accumulated problem both generally constitute compensable, valid injuries under workers compensation law in both Virginia and North Carolina; however, cumulative injuries by themselves are generally not compensable and do not constitute a valid workers compensation claim. 

Also, while usually in North Carolina, a “slip, trip, or fall” is required to prove an injury by accident, an exception is carved out in the law with respect to back injuries. Evidence of a single, traumatic event is usually sufficient to prove a back injury in North Carolina. 

Virginia also only requires a single, traumatic event, but there must also be a “risk of employment” associated with the accident. This means that if one is simply injured suddenly in the course of performing one’s duties in Virginia, unless there is something that is a “risk” posed by the employment, i.e. a very heavy weight being lifted, a defective piece of equipment, or a weight suddenly shifting, simply feeling sudden back pain will not rise to the level of a valid injury in Virginia. In North Carolina, with respect only to back injuries, it would, so long as the injured worker can point to a specific moment when the pain started during the performance of work duties.

Often, workers and employers fail to treat back problems which accumulate over time – until the symptoms become very so severe, so acute – that the cause a disabling injury. Some of the causes of back injuries include improper lifting techniques or lifting loads that are just too heavy for the  worker’s body.

Often, the single traumatic event is really due to “years of weakening of the musculoskeletal support mechanism by repetitive micro-trauma. Injuries can arise in muscle, ligament, vertebrae, and discs, either singly or in combination.”

Once again, unfortunately, these types of back injuries, if not precipitated or aggravated by a single traumatic event that the injured worker can point to, will not give rise to a valid workers compensation claim. 

OSHA states that back injuries from working aren’t known to cause fatalities. They do, however, cause a lot of pain and suffering and lost productivity. Back injuries affect nearly 600,000 employees on a yearly basis at a cot of nearly $50 billion annually. As the average age of employees increases, the cost to treat and pay disabled workers is likely to rise.

Some of the many reasons back disorders occur

Some of the workplace activities that cause deterioration of muscles, discs, joints, and ligaments – which in turn cause back injuries – include:

    • Poor posture. It’s important to sit and stand properly with good support. This means quality shoes and chairs. 
    • Staying in one position for too long. This means standing up occasionally if you have a desk job and sitting down occasionally if your job requires you to be on your feet all day long.
    • Reaching for objects at the same time you’re lifting. 
    • Using improper body techniques – when you lift, pull, push, or carry objects. There are standard ways, for example, that you should lift objects so the weight isn’t fully on your back.
    • Not being in good shape. Poor physical conditioning can affect your ability to use your back without experiencing pain.
    • Poor ergonomic equipment. Workstations should be designed to enhance your posture, to avoid the need to reach, and to help take pressure off your back. Your employer should consider having you wear a brace if you do a lot of heavy lifting.
    • Using your body instead of equipment. Employers should provide dollies, forklifts, and other equipment to help you mechanically lift and move anything that might be too heavy.

 

  • Twisting or bending while lifting.

 

  • Working while tired. It’s critical that workers be allowed to take periodic breaks. They shouldn’t work too many hours in any one day. Fatigue makes the muscles tired which can make movements harder. Additionally, tired workers are more likely to trip and fall which can result in acute back pain.
  • Not having proper footing. Workers shouldn’t lift, carry, push, or pull on uneven ground, on wet ground, or anywhere where their footing isn’t secured.
  • Working with machines that vibrate a lot. Truck drivers and delivery drivers are especially prone to back injuries if the cargo moves around or the truck can’t handle the load.

Some of the ways to help reduce back injuries

Some loads are much harder to lift or move than other loads. Generally, any load that is more than 50 pounds should be moved or lifted by using some of the following equipment or strategies:

  • Use hand trucks, pallet jacks, and forklifts
  • Try to break the load into smaller sizes and weights
  • Use ramps to load and move objects
  • Suction devices may help if they can carry the weight
  • Be aware that rolling items may help – but rolling may be dangerous if the motion can’t be stopped
  • Request that extra workers be used to lift, carry or move the load

OSHA states the employers and employees can help each other in the following ways:

  • Employers should ask employees what they think about how difficult task are and what their personal experience is with pain
  • Employers should observe first-hand the posture of their workers as they lift. They should also use video to analyze the motions
  • Employers should have a way to weigh objects and materials before lifting
  • Employers need to review how often and how long a worker is lifting
  • Workers should be rotated to different jobs so they’re not using the same muscles repetitively

“Principal variables in evaluating manual lifting tasks to determine how heavy a load can be lifted are: 

  • The horizontal distance from the load to the employee’s spine
  • The vertical distance through which the load is handled
  • The amount of trunk twisting the employee utilized during the lifting
  • The ability of the hand to grasp the load
  • The frequency with which the load is handled”

Other manual lifting variables include examining space constraints, the size of the load, and the stability of the load. 

Once all these variables are known, The National Institute for Occupational Safety and Health (NIOSH) of the US CDC – has a formula for determining whether a lift is safe or not.

Recommended OSHA safety tips

OSHA further recommends the following safety tips for manually handling objects to help avoid the risk of bank injuries:

  • Minimize the frequency of the activity, the range of motion, and the weight of the objects or materials.
  • Reduce the distance between the worker and the object being handled.
  • “Platforms and conveyors should be built at about waist height to minimize awkward postures. Conveyors or carts should be used for horizontal motion whenever possible.”
  • Pushing is generally better than pulling. 
  • It helps if the items being moved have handles that are easy to grasp.
  • Workstations should be configured properly so the worker doesn’t have to bend over. They should be designed to help the worker remain in a relaxed upright stance or fully supported, seated posture.
  • The worker shouldn’t have to bend his/her upper body and spine. Bins should tilted, elevated, or have collapsible sides– to improve access and avoid the need to bend.
  • Sustained twisting motions or leaning to one side should be avoided. 
  • Heavy objects should be stored at waist level
  • Employers should provide lift tables and lift-assist devices.

Virginia and North Workers’ Compensation Attorney Joe Miller Esq. understands back pain injuries. He workers with your doctors and independent doctors, when necessary, to diagnose your pain and prepare a full prognosis for your recovery. He’s helped thousands of injured workers get just recoveries. For help with your work injury claim, due to a back injury or for any reasons, call lawyer Joe Miller at 888-694-1671. or fill out my contact form to make an appointment.

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