Category: Medical Conditions (Page 8 of 19)

In L&I claims, it’s sometimes challenging to identify the root cause for certain medical symptoms after a work injury. Many times, doctors write their initial diagnosis as a sprain or strain. It’s easy for them to just label L&I claim sprain in your file. But how does that impact your claim and condition?

 

Soft tissue work injury in L&I claims

We frequently see L&I claim sprain or strain diagnosis in chart notes in soft tissue injuries. These workplace injuries usually resolve quickly without permanent effects. As a result, medical treatment for sprains and strains is fairly basic. It involves rest, stretching, and over the counter pain medicine. It can also involve heat or ice to relieve pain, as well as physical therapy. However, sometimes symptoms do not improve. When this happens, the issue may be more severe. In those cases, providers may begin to consider other diagnoses. The process can involve additional diagnostic studies. It can also include more invasive treatment options such as injections or surgery.

 

In my experience, symptoms in certain areas of the body can be more diagnostically challenging than others. For example, I’ve seen diagnostic challenges happen when a work injury or occupational disease involves the neck or upper extremity nerves. Another area is the low back and hips. It seems that these areas are challenging because the symptoms could come from various sources.

 

Work injury involving neck and upper extremities

Some common upper extremity work injury or workplace disease symptoms involve numbness and tingling. They can also involve pain in the neck or arms with certain work activity or movement. It seems these kinds of symptoms come from some sort of nerve impingement. However, finding the nerves in question can be difficult. It can also be challenging to determine the level of impingement. For example, some swelling or inflammation could be temporarily causing the impingement symptoms.

 

Importantly, nerve impingement can be more permanent or severe if it’s coming from a workplace injury or work disease in the carpal tunnel or cubital tunnel. The same is true for a work injury in the middle or thoracic region of the back, or cervical region of the spine. In fact, the cause for the symptoms can sometimes be impingement in multiple areas. Of course, providers can perform a variety of clinical and diagnostic tests to help determine the origin. Yet, the diagnostic and treatment process can be long and frustrating for work injury claimants.

 

Low back and hips in L&I claim

Another region that can have diagnostic challenges is the low back and hip region. Pain in the low back radiating into a hip or down the leg can come from nerve impingement in the low back (i.e., sciatica). Other reasons can be dysfunction in the sacro-iliac (SI) joint or dysfunction in the hip joint. Additional examples include a tear in a supporting tendon or ligament (such as the labrum).

 

A traumatic work injury or occupational disease might injure or impact both the low back and the hip. In fact, I’ve seen situations where a work injury claimant doesn’t realize their hip is hurting until their back treatment completes successfully (and vice versa). Sadly, it can be very frustrating to undergo treatment to resolve your symptoms, only to have it reveal other symptoms that were not apparent before.

Negligence isn’t typically an issue in a workers’ compensation claim. When a work injury happens, or work illness develops over time, it doesn’t matter who’s at fault. In general, except in very rare circumstances, work injury claimants cannot sue their employer. Similarly, if a worker is injured at work or suffers an occupational disease, the worker is covered even if it’s their own fault.

 

Negligence in a workers’ compensation claim

However, sometimes negligence does matter. It matters when a negligent third party causes the workplace injury or disease . Here, a third party is someone other than the employer. It also cannot be an employee of the employer, or the work injury claimant. When a third party causes the injury at work or the industrial disease, they may still be liable for negligence. When this issue arises in an L&I claim or self-insured employer claim, then we call it a “third party claim”.

 

In my experience, most frequent third-party claims involve a motor vehicle accident (or MVA). Workers that drive often in their job are more likely to experience a work-related motor vehicle accident. For example, delivery drivers, truck drivers, bus drivers, and shuttle drivers. I’ve also seen third party claims involving flaggers or construction workers injured by a negligent driver. Third party claims also arise when a defective product causes an injury or disease. For instance, a manufacturer may be liable if a faulty piece of equipment causes the injury or illness. Examples include defective saw blade guards, defective respirators, or defective steel toe boots.

 

Costs in third-party L&I claim

When a negligent third party causes the injury at work, the work injury claimant can take legal action against the negligent party. This may shift some of the workers compensation claim costs onto the responsible third party. This kind of cost shifting helps reduce (or even eliminate) the cost burden on the L&I industrial accident fund. Therefore, the Department of Labor and Industries (L&I) has a financial interest in the legal action against the third party.

 

Sometimes, work injury claimants are reluctant to pursue the legal action against the third party. Mostly, it’s because of the time and energy spent on additional legal battles in civil court, outside the L&I setting. When this happens, L&I may pursue the action in the worker’s name, because L&I has its own financial interest. However, there are many cases where the work injury claimant takes on the legal fight. In that case, L&I becomes a lien holder in the legal action against the third party. Depending on the severity of the injury and the strength of the negligence case, it’s often a good idea to pursue the additional legal action.

 

Dividing the payout among all parties

Since L&I has financial interest, the parties to the legal action cannot reach a settlement without consulting L&I. Eventually, if the case settles or resolves through litigation, the monetary award divides between several entities. First, litigation costs and attorney fees are paid proportionately by the work injury claimant and L&I. Second, the work injury claimant receives twenty-five percent of the remaining balance (unless they agree to a smaller percentage). Then, the remainder goes to L&I but only to the extent they need to reimburse for payout of benefits.

 

In summary, when a negligent third party causes an injury or disease, they may be liable. Furthermore, the injured worker may bring legal action against the third party. If they do not, L&I can still pursue the legal action (if they choose to do so). Any monetary proceeds of the legal action are divided between attorneys, the injured worker, and L&I. Work injury claimants should get twenty-five percent. Finally, L&I is entitled to reimbursement for the benefits they pay under the workers’ compensation claim.

The Department of Labor and Industries (L&I) performs research and maintains data about every workers’ compensation claim in Washington State. In fact, its database of L&I claim information contains data from 2007 through 2020. The data captures each workplace accident type, body parts, and the nature of the injury. In addition, they store information about the source of the workplace injury, occupation, frequency, and risk classes. Interestingly, many work accidents involve trauma to the spine and surrounding muscles, bones, ligaments, joints, and tissues. Surprisingly, finger and hand work injuries are even more common than spinal injuries.

 

Hand work injury numbers and statistics

The US Bureau of Labor and Statistics published a fascinating study from 2017. In conclusion, finger and hand work accidents cause roughly 43% of all non-fatal work injuries whereby workers miss workdays. These incidents are most common in construction, woodworking, lumber and logging jobs. They are also very common among medical professionals and workers in mining, manufacturing, caregiving, janitorial jobs, and transportation jobs. However, in my experience, hand and finger injuries can occur in any profession. Even in some of the most sedentary jobs.

 

Workers’ compensation claim for hand or finger workplace injury

Sometimes, finger and hand accidents are simple. For example, small cuts or wounds that heal fast. They can also be far more severe and disabling. For instance, I’ve seen people lose a finger, multiple fingers, or their entire hand. Crushing injuries are also common. A severe crushing work injury can require surgical amputation of the finger or hand. They can also cause conditions like complex regional pain syndrome (CRPS), which is extremely painful with unusual symptoms like hair loss and skin changes.

 

Hand and finger workplace injury in certain industries also carries risk of contracting secondary infections. Such infections include Methicillin-resistant Staphylococcus aureus (MRSA) or staph infection. The risk is particularly high in the medical and caregiving setting. In fact, the risk exists for any job with exposure to unsanitary conditions. Consider janitorial work or working with animals, for example. Needle stick work injury is common in these settings. Needle pricks or needle sticks work accidents carry increased risk of transmitting serious diseases like HIV, Hepatitis and Syphilis.

 

Hand injury in the L&I claim setting

These examples illustrate why there are so many finger and hand injuries at work. When the injury is simple and resolves easily, the L&I claim costs are low. Yet, for more severe accidents with potential secondary conditions or industrial diseases, the costs are much higher. According to L&I, workers under twenty-four years old have the highest risk for finger and hand injury at work.

 

Many workers use their hands and fingers in regular work activities all the time. Consequently, a severe hand injury or hand disease can cause total disability. For younger workers, the inability to use a hand or a finger can permanently damage the future of their work. Therefore, I applaud L&I for continuing its efforts to educate employers and workers about the danger and risk of finger and hand injury on the job.