Hernias and Workers’ Compensation: Can a Hernia Be Work-Related? What You Need to Know

What is a Hernia?

Organs are held in place by either muscles or tissues. When an organ pushes through the muscle or tissue which is holding it in place, a Hernia has occurred. For example, the intestines may break through a weakened area in the abdominal wall. Hernias can occur in the abdomen, upper thigh, belly button or groin. Most Hernias don’t go away on their own and they require treatment. Hernias can become serious and life threatening. Surgery may be required.

Are there different kinds of Hernias?

Yes. There are a variety of hernias: inguinal, hiatal, umbilical and incisional.

  • Inguinal Hernias are generally located near the inguinal canal. They are located in the groin. They are different for men and women. They can occur when the intestines push through a weak spot or tear in the lower abdominal wall. These are some of the most common of hernias.
  • Hiatal Hernias are located near the chest cavity. These occur when part of the stomach protrudes up through the diaphragm into the check cavity.
  • Hiatal Hernias can cause gastroesophageal reflux or GERD.
  • Umbilical Hernias are located near the bellybutton. They occur when the intestines bulge through the abdominal wall.
  • Incisional Hernias can occur after an abdominal surgery. The intestines can push through the incision scar or the surrounding weakened tissue.

What causes a Hernia?

Hernias can be caused by a combination of muscle weakness and strain. They can occur quickly or develop over a long period of time. Common causes of muscle weakness include congenital defect, age, chronic coughing, or damage from a surgery or injury. Causes of physical strain which can was muscle weakness include pregnancy, constipation, lifting heavy weight, fluid in the abdomen, sudden weight gain, surgery in the area, persistent coughing or sneezing.

hernia pain in the stomach

How can a Hernia be work-related?

Hernias can be work-related in two ways:

Directly Related: First, hernias can be directly caused by work activities. This can relate to either a specific or cumulative trauma. Hernias can be caused by a specific lifting incident that causes a tear of the muscle of the abdominal wall. Hernias can also be caused by repetitive lifting over time. Over time, a slow tear can occur over time.

Compensable Consequence: Hernias can be work-related when they are a compensable consequence of an underlying injury. Examples of compensable consequences are as follows: Coughing and sneezing: An underlying injury such as dust exposure which can cause a pulmonary problem which includes persistent coughing and sneezing. This coughing and sneezing can thus cause a hernia. Constipation: A person can have an underlying orthopedic injury such as a back injury which eventually requires the taking of opiod medications . Those opiod medications in turn cause constipation which in turn can cause a hernia. Weight Gain: An person can have an underlying orthopedic injury such as a back injury which causes the person to be inactive. This inactivity can potentially cause sudden weight gain. This sudden weight gain can cause a hernia.

I have a Hernia and I believe it is work-related: What should I do?

The first step in having workers’ compensation the hernia condition is to report the injury to your employer. It is recommended that you report the injury to either your supervisor or to your Human Resources Department. Pursuant to Labor Code Section 5402, you are entitled to receive up to $10,000.00 of medical treatment during the pendency of determination of whether the claim is accepted as work-related by the claims administrator.

What happens after I report the injury?

If your employer reports the injury to the claims administrator, they will refer you to a treating physician. This physician’s recommendations will be in the form of Requests for Authorization (RFA) for treatment. These requests will be subject to Utilization Review(UR) and Independent Medical Review (IMR.)

What types of treatment are indicated for hernias?

One common treatment for hernias is surgery. Surgeries can be performed either under local anesthesia or general anesthesia. Some surgeons will repair the damaged wall with either a synthetic mesh or tissue. The surgery now can be done using a laparoscope. Otherwise, they can be done in an open fashion. Hernia surgeries can be done on an outpatient basis. Hernia surgeries are very common. Almost one million hernia surgeries are performed in the United States each year.

For some hernias, such as hiatal hernias, they can also be treated with medication, diet, lifestyle changes, and weight loss.

For certain hernias, trusses, corsets or binders can be used to hold hernias in place. These devices hold the hernias in place by applying pressure on the skin and abdominal wall.

Can Hernias re-occur?

Yes. There is a chance that hernias can re-occur. There is about a 10 percent change of that occurring. If the initial hernia was treated as an industrial injury, the re-occurrence should be considered industrial as well.

What Benefits can I get as a result of claiming an Industrial Hernia?

The full array of workers’ compensation benefits are available in hernia claims. Injured Workers on accepted workers’ compensation claims are entitled to medical treatment, medical mileage and reimbursements, payment of total temporary disability indemnity for time off, payment of permanent disability indemnity if there is not a complete recovery, entitlement to future medical care if indicated, the provision of a job voucher if indicated, and death benefits for dependents.

Am I entitled to a disability award as a result of a Hernia?

Depending on the result of the surgery, it is possible that one can receive a permanent disability award. The AMA Guides 5th Edition to the Evaluation of Permanent Impairment provides a Table that is the initial basis for evaluating impairment that is the result of a hernia.

If you would like a “free” consultation with a workers compensation attorney, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 25 years. Contact us today for more information.