There are many ways for workers to suffer nerve damage in a work injury or work-related disease. For example, when nerve trauma or nerve compression occurs in a workplace injury, it can lead to nerve pain and damage. Another example is a work injury that pinches spinal nerves at the root. Such an injury can cause radiculopathy, which is a type of neuropathy. Furthermore, a workplace injury that crushes the nerve endings may cause peripheral nerve damage. Peripheral nerve damage can also come from diseases such as carpal tunnel syndrome (CTS) and autoimmune disorders.
Radiculopathy in L&I Claim
Radiculopathy is a common type of nerve damage in work injury and industrial disease workers’ compensation claims. The symptoms occur when a nerve root in the spine is pinched. Many times, radiculopathy can occur in the upper part (or neck part) of the spine, called the cervical region. It can also happen in the middle back, which we refer to as the thoracic region. On top, it can occur in the low back, also known as the lumbar and sacral regions.
Symptoms of radiculopathy include weakness, numbness or tingling. However, different individuals might feel the symptoms in different parts of their body. It all depends on the spinal region and location of the pinch. One well know form of radiculopathy is Sciatica. People often describe sciatica as shooting pains, numbness or tingling down one leg or both legs. Workers experience this type of radiculopathy when the nerves are pinched in the low back.
Peripheral neuropathy in workers’ compensation claim settings
Peripheral neuropathy is a different kind of nerve pain and damage. It doesn’t originate from the spinal nerve root. Peripheral nerves transmit information between the brain and other parts of the body. Moreover, our senses depend on peripheral nerves. For example, they help us feel when something is cold, hot, or sharp. Peripheral nerves are made of fibers. Interestingly, they are insulated by body tissue. They are fragile and they can experience damage easily.
When damage occurs, it impacts the communication between the brain and other body parts. For instance, if the damage is to motor nerves, it can cause difficulty controlling movements or uncontrollable muscle spasm. On top, if the damage is to sensory nerves, it can make it difficult to sense pain or to walk. In addition, it can be difficult to maintain balance or perceive temperature changes. Finally, when the damage is to autonomic nerves, it might impact subconscious functions like blood pressure, breathing, body temperature regulation, and digestion.
In particular, Carpal Tunnel Syndrome is a common work disease that involves peripheral nerve damage. Here, when the peripheral nerves in the wrist and forearm suffer inflammation, then people feel numbness, tingling or burning in their hands and fingers.
Work injury as cause for nerve damage and pain
You’d expect that it’ll be easy to figure out if a workplace injury or industrial disease causes nerve damage or pain. However, there are many non-occupational factors and conditions that can cause nerve problems. For one, diabetes and alcohol abuse are common causes of peripheral neuropathy. Many non-occupational autoimmune disorders also cause neuropathy. Consequently, it can be very difficult to determine the cause of nerve pain or damage. To complicate matters, people might have a preexisting disease like diabetes before their work injury or workplace illness.
Neuropathy in IME exams
Recently, I noticed a new trend. Independent Medical Examiners (IMEs) say that neuropathy is from non-work or non-occupational causes. Also, they say the other causes are genetic factors like gender, or diabetes and alcohol use. I don’t dispute these other factors cause neuropathy. Yet, I think they are taking the easy way out. More explicitly, they are using other conditions too often as convenient excuse for L&I or self-insured employers to avoid covering neuropathy in L&I claims.
When this happens, you must get a clear picture of the work injury claimant’s preexisting health. For that, you must order records from primary care providers or specialists that treated preexisting conditions. In fact, little time and effort collecting this data can go a long way. It can help medical providers formulate a more accurate opinion regarding causation. Sometimes, prior health records show neuropathy before the work injury or workplace disease. However, in many cases there are no previous records or symptoms.
The opinion of a workers’ compensation attorney
Very often, there are no documents or medical history that show prior symptoms. In such cases, it helps us show that symptoms stem, on a more-probably-than-not basis, from the work injury. Furthermore, when there’s objective medical evidence showing that symptoms relate to the work injury or disease, then it’s even more likely that a causal connection exists.
Neuropathy is a serious condition. It requires knowledgeable treatment to help eliminate long term issues. When the Department of Labor and Industries (L&I) or self-insured employers deny coverage, it can be a major setback for work injury claimants. It can seriously hinder their recovery. Therefore, it’s important to make sure that the causal connection to the work injury or work-related illness is well-documented, to try and prevent treatment delays.