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EVEN TREATERS GET INJURED AT WORK: OCCUPATIONAL AND PHYSICAL THERAPISTS SUSTAINING INDUSTRIAL INJURIES: MEDICAL PROVIDERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on December 2, 2020 by Edward Singer

Occupational and Physical Therapists play a large role in helping Injured Workers recover from their industrial injuries. In doing so, however, Occupational and Physical Therapists may be placing themselves at risk for sustaining a work injury. More specifically, both Occupational and Physical Therapist’s work activities can place them at risk for sustaining musculoskeletal disorders. These musculoskeletal disorders can include back problems, shoulder problems, and wrist problems.

The article will discuss Occupational and Physical Therapists, what activities they perform on the job that may be injurious to them, and the rates of injuries that occur for Occupational and Physical Therapists.

What is an Occupational Therapist (OT)?

Per the American Occupational Therapy Association, “occupational therapists …help people… participate in the things they want and need to do through the therapeutic use of everyday activities (occupations.)”

OT Programs can include “an individualized evaluation, during which the client/family and occupational therapist determine the person’s goals, [a] customized intervention to improve the person’s ability to perform daily activities and reach the goals, and an outcomes evaluation to ensure that the goals are being met and/or make changes to the intervention plan.”

What is a Physical Therapist (PT)?

Per the American Physical Therapy Association, “[p]hysical therapists are movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education.”

“Physical therapists examine each person and then develops a treatment plan to improve their ability to move, reduce or manage pain, restore function, and prevent disability.”

What is the Difference Between an Occupational and Physical Therapists?

The Occupational Therapist focuses on the patient’s ability to perform work-related functions. The Physical Therapist focuses on physical activities in general.

What Are The Work Activities That Are Injurious to OTs and PTs?

Transfers/Lifts and manual therapy have been found to be associated with musculoskeletal disorders. “Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-84. doi: 10.3233/WOR-2012-1430. PMID: 22523031; PMCID: PMC3839086. These activities have been found to impact the lumbar spine. Supra.

Patient handling activities include (transfers, repositioning and patient lifting. Supra.

Manual therapy includes soft tissue work, joint mobilization, and orthopedic techniques. Supra.

Manual Therapy was found also found as a risk factor consistent risk factor for both injuries as well as gradual onset of WSMDs. Supra. In workers’ compensation terms, this would be considered as a cumulative trauma injury.

With Respect to Musculoskeletal Disorders? Is There Any Difference Between OTs and PTs?

No. “Occupational (OTs) and physical therapists (PTs) have substantial and similar rates of work-related injury (WRI), musculoskeletal pain and musculoskeletal disorders (WMSD)” Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-84. doi: 10.3233/WOR-2012-1430. PMID: 22523031; PMCID: PMC3839086.

“Darragh et al. reported an annual WRI incidence rate among OTs and PTs of 16.5 and 16.9 per 100 full-time workers, respectively.” Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-84. doi: 10.3233/WOR-2012-1430. PMID: 22523031; PMCID: PMC3839086.

What Are Injury Rates for Activities? What Do Therapists Think Are the Causes of Their Injuries?

“Manual therapy and transfers/lifts accounted for more than half of all injuries (54.0%), across all practice areas.” Supra. “Manual therapy was the greatest proportion of injuries to the wrist and hand (69.1%).” Supra. “Transfer and lifting activities were associated with 26.6% of injuries Over half of these injuries were to the low back (53.0%), followed by the shoulder (19.7%) and the head/neck (18.2%).” Supra. “Other activities associated with injury included environmental and equipment interactions (10.9%), multiple activities (6.5%) and patient falls (5.7%)”

What Do Therapists Think of How They Get Hurt?

Therapists opine that force, awkward posture, repetitive motion, sustained posture, and fatigue were factors contributing to those type of injuries. Supra.

For wrist and hand injuries, therapists opine that repetitive motion (experienced during joint mobilizations and range of motion activities), force (experienced during range of motion, soft tissue work, and joint mobilizations), awkward posture and sustained posture were factors contributing to those type of injuries. Supra.

For transfer and lifting activities, opined that “these injuries occurred both gradually because of repeated performance of transfers over time and more suddenly when a patient behaved in an unexpected way (grabbed the therapist, stumbled, or moved in an unexpected direction.) The majority of therapist identified force (72.7%;48/66), including overexertion and lifting, and awkward posture (54.5%; 36/66) as the primary contributing factors to their transfer injuries.” Supra.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

AGE, PHYSICAL DEMANDING JOBS AND MUSCULOSKELETAL DISORDERS: OLDER WORKERS AT RISK FOR WORK INJURIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on October 19, 2020 by Edward Singer

The Labor Market in the United States is aging. As a result, Older Workers are performing a large variety of task within the Open Labor Market. Older Workers performing more tasks that make them at risk for work injuries. This is the case with respect to musculoskeletal injuries. Musculoskeletal injuries are commonly known as orthopedics injuries which include medical conditions with respect to the spine, the upper and the lower extremities. A study was done with respect and there were some findings made.

This article will discuss Older Workers, injury rates for Older Workers, and laws which impact Older Workers’ Workers’ Compensation Claims.

Does Age Matter When Looking at the Risk of Work Injuries?

Age alone is not the issue. The type of labor is what is of import. In the labor market, there are jobs with minimal physical demands. There are other jobs which involve greater physical demands. Thus, some Older Workers perform light duty jobs such as receptionists or greeters. Other Older Workers perform more arduous jobs such as warehouse worker or construction worker.

The study, of interest, focused on jobs with physical demands.

Old Age combined with greater physical demands were relevant with respect to work injuries. See P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

It was found when the occupational [physical] demands were greater there was an increase of risk of injury. Further, “[t]he relationship between age and claim-risk was strongest when occupational demands were highest.” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Is the Increase Risk Associated only with Musculoskeletal Injuries?

It was found that “Older age was associated with a higher risk of work injury claims for both musculoskeletal and non-musculoskeletal conditions,” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Is there a Difference Between Musculoskeletal vs. Non-Musculoskeletal Disorders?

Yes. “with a slightly stronger relationship observed for occupational physical demands and risk of musculoskeletal, compared with non-musculoskeletal, conditions.” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Are There any Laws or Rules in Workers’ Compensation that Assist Older Workers?

Yes. Age is factored as part of the Permanent Disability Rating Formula.
Per the Schedule for Rating Permanent Disabilities, California Workers’ Compensation Law provides for an age adjustment which provides for an increase in permanent disability for ages 42 and older. It also scales up with age and tops out at age 62. The age used in this assessment is the age on the date of injury. There is a table upon which you obtain the figures. It is on Pages 6-1-6-5. See SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005)

Are There Any Rules that Do Not Assist Injured Workers?

Yes. There is a legal issue of apportionment. Apportionment is a tool allowed to reduce an Injured Workers’ Award.

Labor Code Section 4663, provides that “[a] physician shall make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries. See Escobedo v. Marshalls, CNA Ins. Co., 70 Cal. Comp. Cases 604, 2005 Cal. Wrk. Comp. LEXIS 71 (W.C.A.B. April 19, 2005). In Escobedo, the board indicated that apportionment of permanent disability can be made based on the preexisting arthritis in applicant’s knees was found acceptable. Note: Older Employees are more likely to have pre-existing arthritic processes which could allow for apportionment to be found.

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CAR WASH WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on October 9, 2020 by Edward Singer

Car Wash Workers have many unique issues with respect to workers’ compensation. Car Wash Workers perform varied tasks which place them at risk for injury. Car Wash Workers are exposed to chemicals and liquids which may place them at risk for injury.

This article will discuss Car Wash Workers and the job tasks that place them at risk for industrial injury.

What Makes Car Wash Workers at Risk for Injury?

“The car wash industry, however, has salient features that predispose to important occupational health risks, namely, the use of hazardous chemicals (ie, hydrofluoric acid), the requirement of repetitive use of extremities, [and] close contact with moving machinery,” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What are the Common Job Tasks Do Workers Perform at Car Washes?

In the study, most participants rotated among the few major tasks at the car wash, including drying cars (63%), brushing and soaping cars (56%), and vacuuming and cleaning cars (50%).
Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Complaints Can Car Wash Workers Have?

In the study, “Car wash workers reported a high prevalence of health symptoms during the 12 months prior to the survey, including at least one site of musculoskeletal pain (80%); upper airway, eye, or skin irritation (71%); and at least one lower respiratory symptom (47%) (Table 2). Approximately one-half of all workers reported eye and throat irritation, back pain, neck or shoulder pain, hand pain, headaches, or nausea/stomach discomfort. The majority of workers reported multiple symptoms across the different symptoms groups. Thirty-eight (54%) participants reported two or more musculoskeletal symptoms in the past 12 months, and 37 (53%) reported two or more types of irritation (nose bleeds, throat irritation, eye irritation/burning, skin rash, or skin burn). Two workers had suffered fractures at work in the past 12 months, and one-quarter of the work force reported a laceration or abrasion of the skin. Three workers reported an episode of asthma or an asthma attack in the past 12 months.” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, Dr PH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Hand Movements Can Be a Source of Injury?

There are numerous tasks at Car Washes that can be a source of injury. These tasks involve Manual Handling, Awkward Hand Positions, Applying Pressure, and the use of Vibrating Tools.

Manual Handling includes “lifting, pulling, pushing, carrying and holding. Tasks that require these actions can include moving and transporting heavy equipment; everyday machines, such as vacuums; and loads, such as laundry.”

Awkward Hand Position includes “contorting hand posture to abnormal positions to clean hard-to-reach areas or slanted surfaces, such as windows. This would also include risks associated with using older or cheap spray bottles or equipment handles.”

Applying Pressure includes “pressing down or applying extra pressure to remove dirt or soil. Consider more powerful cleaning products or equipment if workers are using too much elbow grease to get the job done.”

The Use of Vibrating Equipment which includes “losing control and constant shaking. Machines that vibrate too much can cause hand fatigue, increasing the chances of workers losing control of the equipment.” . The importance of hand care in the car care industry Rich DiPaolo (2016)

Are There Chemical Exposures That Are Injurious to Car Wash Workers?

Yes. Chemicals used at Car Washes have been implicated in causing occupational illness.

“Exposure to hydrofluoric acid (HF) causes corrosive chemical burns and potentially fatal systemic toxicity. Car and truck wash cleaning products, rust removers, and aluminum brighteners often contain HF because it is efficient in breaking down roadway matter.” Reeb-Whitaker CK, Eckert CM, Anderson NJ, Bonauto DK. Occupational Hydrofluoric Acid Injury from Car and Truck Washing–Washington State, 2001-2013. MMWR Morb Mortal Wkly Rep. 2015;64(32):874-877. doi:10.15585/mmwr.mm6432a4

“Occupational exposure to HF-based wash solutions can result in chemical burns, disability, and death. HF’s potential to cause severe injury.” Supra.

Are Car Wash Employees At Risk for Skin Disorders?

Yes. Cash Wash Employees suffer skin-related due to working with liquids. This type of work is called “wet work.” Zani MLC, Lazzarini R, Silva-Junior JS. W arm-water immersion foot among car wash workers. Rev Bras Med Trab. 2017;15(3):217-221. Published 2017 Sep 1. doi:10.5327/Z1679443520170021

“Wet work is characterized by activities involving frequent immersion of the hands in water, frequent or intensive hand washing or frequent use of impermeable gloves. Workers exposed to wet work might develop hand eczema and contact dermatitis”

Car Washes provide for the risk of both hand skin disorders as well as foot skin disorders. Supra.

“Prolonged contact with water causes different forms of dermatitis, including hand eczema among workers exposed to wet work3. In turn, superficial mycoses are the conditions that most commonly affect the lower limbs. However, continuous and excessive contact with water might also cause a disorder known as immersion foot or trench foot. The latter is a dermatosis that results from prolonged exposure to physical agents such as dampness and cold, and was first described among soldiers in World War I (1914-1918). ”
Supra.

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