DENTAL HYGIENISTS, MUSCULOSKELETAL DISORDERS, AND WORKERS’ COMPENSATION: MEDICAL PROFESSIONALS AT RISK OF INDUSTRIAL ORTHOPEDIC INJURIES: WHAT YOU NEED TO KNOW

Many occupations are susceptible to work injuries.  One of these occupations is that of a Dental Hygienist.  More specifically, Dental Hygienists are at risk for musculoskeletal disorders (MSDs.)  This has been recognized by the California Department of Public Health (CDPH.)

This article will discuss the occupation of Dental Hygienist, how Dental Hygienists are at risk for musculoskeletal disorders, and caselaw of interest.

What is a Dental Hygienist?

Per the American Dental Association(ADA), a Dental Hygienist is a licensed position which varies from state to state.  Note: The practice of dental hygiene in California is regulated by the Dental Hygiene Board of California.

The tasks of Dental Hygienists can include “patient screening procedures; such as assessment of oral health conditions, review of the health history, oral cancer screening, head and neck inspection, dental charting and taking blood pressure and pulse, taking and developing dental radiographs (x-rays), removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth, applying preventive materials to the teeth (e.g., sealants and fluorides), teaching patients appropriate oral hygiene strategies to maintain oral health; (e.g., tooth brushing, flossing and nutritional counseling), counseling patients about good nutrition and its impact on oral health, making impressions of patients’ teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs,)[and] performing documentation and office management activities.”

Dental Hygienists can work in a variety of locations.   This locations include Dental Offices.  This can include Dental Offices of General Practitioners as well a Specialty Practitioners’ Offices such as Periodontics and Pediatric Dentistry.

Dental Hygienists also may work at Public Health Agencies, Hospitals and Community Health Clinics. They can work for public school systems, dental schools and dental hygiene educational programs.  Dental hygiene services can be performed in hospitals, nursing homes, prisons and public health clinics.

Note: Activities of interest involve the activities in which the patient is in the dental chair and the Dental Hygienist is performing services upon them.

What Are Musculoskeletal Disorders (MSD)?

Per the Centers for Disease Control and Prevention (CDC), Musculoskeletal disorders (MSD) are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs.

What Types of Musculoskeletal Injuries Do Dental Hygienists Sustain?

Dental Hygienists are susceptible to a multitude of musculoskeletal disorders.  Upper Extremity problems are common.  These upper extremity diseases or conditions include tendonitis, tennis elbow, and carpal tunnel syndrome.

Has There Been Any Caselaw Concerning Dental Hygienists with Cumulative Trauma Musculoskeletal Injuries?

Yes. In Barnes vs. WCAB (2013) 78 C.C.C. 1137 (writ denied), the case involved a Dental Hygienist who suffered a cumulative trauma musculoskeletal injury to her neck and back.  In the matter, there was a dispute as to whether there was also an aggravation of an underlying fibromyalgia and chronic fatigue syndrome.  In the case, there was a finding of industrial causation for those body parts.

Are Musculoskeletal Disorders for Dental Hygienists a Concern for the State of California?

Yes.  The State of California is concerned over the risk of injury for Dental Hygienists. The State recommends ergonomics programs in order to promoted a safe and efficient workplace.

What Are Ergonomics?

Per OSHA,  “ [w]orkers in many different industries and occupations can be exposed to risk factors at work, such as lifting heavy items, bending, reaching overhead, pushing and pulling heavy loads, working in awkward body postures and performing the same or similar tasks repetitively. Exposure to these known risk factors for MSDs increases a worker’s risk of injury.

Work-related MSDs can be prevented. Ergonomics — fitting a job to a person — helps lessen muscle fatigue, increases productivity and reduces the number and severity of work-related MSDs.”.

Are There Ergonomic Tools for Dental Hygienists?

Yes. The State of California offer videos designed for Dental Hygienists.  Here is the link. https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/Pages/ErgonomicsDentalHygiene.aspx

There are videos which include topics such posturing and position, use and choice of instruments and body strengthening.

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.

CARPAL TUNNEL SYNDROME, OCCUPATIONS, AND WORKERS’ COMPENSATION: INJURED WORKERS, THEIR JOBS, CARPAL TUNNEL SYNDROME AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Carpal Tunnel Syndrome (CTS) is a common industrial injury.  Studies have been conducted to investigate which industries and occupations are impacted by Carpal Tunnel Syndrome Claims.  One such study analyzed Carpal Tunnel Syndrome Claims in the State of California.  The California Department of Public Health(CDPH) performed the analysis of the data.

This article will discuss Carpal Tunnel Syndrome and the findings made within the study. The study discussed in this article pertains to full-time employees.  The analysis defined full-time employees.  The study focused on individuals whom they considered to be full-time equivalent (FTE) employment.  This FTE was defined as a worker who worked 50 work weeks [in a year]and 40 hours a week.

What is the Background of This Data?

The data, which is the basis for these statistics referenced in this article, is based upon data for the years 2007-2014 for industry analysis and the year 2014 for the occupation analysis. Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

Note:  Since these statistics were generated, there may be changes in the numbers.   There are various industries which take measures to address the prevention of carpal tunnel syndrome injuries.   Such measures can include improved ergonomic workstations and procedures.  Therefore, it will be interesting to see if there are any statistically significant changes in the future with respect to the frequency of carpal tunnel syndrome within various industries and its rates within particular occupations.

What Is Carpal Tunnel Syndrome?

Per the American Academy of Orthopaedic Surgeons (AAOS), Carpal Tunnel “is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist.” The condition can be treated conservatively via the use of braces and the avoidance of certain activities.  Injections can be a form of treatment.  Surgery may be indicated to take the pressure off of the nerve.   This is commonly know as a “carpal tunnel release.”

Carpal Tunnel Syndrome can cause a variety of symptoms.  These symptoms can include “Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers, Pain or tingling that may travel up the forearm toward the shoulder, Weakness and clumsiness in the hand—this may make it difficult to perform fine movements such as buttoning your clothes, Dropping things—due to weakness, numbness, or a loss of proprioception (awareness of where your hand is in space).” Symptoms can also occur at night and can awaken an individual from their sleep.  Symptoms can occur during the day when an individual maintains their wrist or wrists in a prolonged period of time in a bent position.

What Is the Rate of Carpal Tunnel Syndrome Among Workers?

Per the research, the overall rate of CTS among workers was 6.3 cases per 10,000 FTE.  Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097

Note: Essentially, .063% of all full-time workers developed occupationally-related carpal tunnel syndrome. Note: this data does not take into consideration claims that were not filed.

Does Sex of the Worker Matter? Is There a Difference Between Male and Female Workers?

Yes. The rate for Carpal Tunnel Injuries among women  was 3.3 times higher than that among men.  Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

Is There a Particular Age Group that CTS is Most Common?

The rate of CTS was highest among persons aged 45–54 years. .  Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

Note: Carpal Tunnel Syndrome is generally considered as a cumulative trauma injury.   The fact that the highest incidence of CTS is during the period from 45-54 years of age means that these individuals likely have a significant history of work. Assuming individuals started employment at age 18, there is a possible  exposure to hand-related work activities for a period from 27-36 years prior to the injury.

What Industries Have the Highest Rate of Incidences of Carpal Tunnel Syndrome?

The Industries with the highest rates of CTS were textile, fabric finishing, coating mills. apparel accessories and other apparel manufacturing,  and animal slaughtering and processing. Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

Which Industries Have the Most Numbers of Claims of Carpal Tunnel Syndrome?

Industries with high rates of CTS include those that manufacture apparel, process food, and perform administrative work. Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

What Occupations Have the Highest Rate of Carpal Tunnel Syndrome?

“The occupation groups with the highest rates included production workers, material moving workers, and office and administrative support workers. Workers in these occupations are often required to perform forceful or repetitive tasks with their hands (e.g., sewing clothing, butchering meat, or repeatedly lifting heavy items), or maintain an awkward posture on the job (e.g., driving a motor vehicle, working on a production line, or computer work), all known risk factors for CTS.” Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

It is also noted in the report that Census Occupation Groups with “[t]he highest rates of CTS were …telephone operators; cafeteria, food concession, and coffee shop counter attendants; and electrical, electronics, and electromechanical assemblers.” Jackson, R. Beckman, J., Frederick M, Musolin K, Harrison R, Rates of Carpal Tunnel Syndrome in a State Workers Compensation Information System by Industry and Occupation, California, 2007-2014, MMWR Morb Motal Wkly Rep 2018:67:1094-1097.

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.

CLEANING PRODUCTS AND WORK-RELATED ASTHMA: HOUSEKEEPERS, PROFESSIONAL CLEANERS, JANITORS, AND HEALTHCARE WORKERS: WHAT YOU NEED TO KNOW

Cleaning Products can be a source of Industrial Asthma also known as Occupational Asthma.   There are certain occupations that account for a large percentage of these claims.  This article will discuss Industrial Asthma, the occupations that are at risk for Industrial Asthma.  It will also discuss caselaw on the issue as well.

What is Industrial Asthma?

Per the American Academy of Allergy, Asthma, and Immunology, “Occupational asthma has become the most common work-related lung disease in developed countries. However, the exact number of newly diagnosed cases of asthma in adults due to occupational exposure is unknown. Up to 15% of asthma cases in the United States may be job-related. Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while “on the job.”  Often, …symptoms are worse during the days or nights…work[ed], [and] improve[d] when…[there is]time off and start again when…[there is a return] to work.”

What Occupations Are Impacted by Industrial Asthma?

The highest percentages worked in healthcare (41.1%), and were building cleaners (20.3%), or registered nurses (14.1%.) Cleaning Products and Work-Related Asthma 10 Year Update DOR 10.1097 JOM.0000000000001771

It has been found that Cleaners are at risk of some asthma‐associated symptoms and reduced lung function. Respiratory health in professional cleaners: Symptoms, lung function, and risk factors https://doi.org/10.1111/cea.13597

A “study found that professional cleaners have an increased risk of current asthma and reduced lung function. Cleaners identified as having asthma were more likely to be non‐atopic, less likely to have a doctor diagnosis of asthma ever, and had airway obstruction that was less responsive to bronchodilator administration. Amongst cleaners, working in cafes/restaurants/kitchens and/or use of multi‐use cleaner and upholstery sprays was associated with a significantly increased asthma risk, whilst exposure to glass cleaning sprays was associated with reduced (pre‐bronchodilator) lung function.” Respiratory health in professional cleaners: Symptoms, lung function, and risk factors    https://doi.org/10.1111/cea.13597

Further, concerns of Industrial Asthma relate to domestic cleaners as well.  See Job hazards and respiratory symptoms in Hispanic female domestic cleaners Kristina W. Whitworth,Brenda Berumen-Flucker,George L. Delclos,Sonia Fragoso,Claudia Mata & David Gimeno Ruiz de Porras,Pages 70-74 | Published online: 29 Apr 2019 https://doi.org/10.1080/19338244.2019.1606774 (“In conclusion, this vulnerable population has high prevalence of physician-diagnosis asthma and BHR(bronchial hyperresponsiveness) symptoms and is potentially exposed to myriad occupational hazards.”)

What Types of Agents Do Cleaners Use that May be Involved with Industrial Asthma? 

“Cleaners are frequently exposed to a range of agents including chlorine/bleach, ammonia, ethanolamines, chloramine‐T, aldehydes, and quaternary ammonium compounds (QACs),7 which may contribute to both new‐onset asthma through sensitization (in a minority) or irritation, and exacerbation of pre‐existing asthma.8 Importantly, as many people worldwide, other than cleaners, are exposed to cleaning products, asthma due to, or exacerbated by cleaning products is a considerable public health concern.”  Respiratory health in professional cleaners: Symptoms, lung function, and risk factors,  https://doi.org/10.1111/cea.13597

Is There Any Caselaw Concerning Cleaners and Asthma? 

In LAUSD vs. WCAB (2007) 72 C.C.C. 1719 (writ denied), a Health Care Assistant was found to have sustained an injury to her lungs and in the form of asthma when Applicant was exposed to toxic fumes during daily cleaning duties from chlorine gas that evaporated from hypochlorite found in the cleanser, “Dispatch.”

Is there anything Important that an Injured Worker can do if They believe that They have Industrial Asthma?

There are three things that are recommended.   First, the Injured Worker should seek medical attention to diagnose and treat their condition.   Second, the Injured Worker should documents the chemicals and cleaning material that they use on the job.   Third, the Injured Worker should seek a consultation whether an industrial injury claim should be pursued.

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.

INSURANCE COMPANIES INVESTIGATING INJURED WORKERS: INJURED WORKERS, PRIVATE INVESTIGATORS, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

 

Private eyes They’re watching you They see your every move”

Hall & Oates

 

When Insurance Companies adjust an Injured Worker’s claim, there are times in which they may employ a Private Investigator (PI.)  The purpose of the PI is to investigate various issues relating to the claim.

This article will discuss the nature of Private Investigators with respect to workers’ compensation cases, the new technologies which have changed the nature and scope of their abilities to investigate, and caselaw which addresses the issue of the boundaries that exist with respect to Private Investigators within the Workers’ Compensation System.

What Are the Issues that an Insurance Company May Want a Private Investigator to Address?

There are many issues/questions that arise on workers’ compensation claims such as:

Whether the Injured Worker actually worked for the Company?

Whether they were in fact injured at work?

Whether they have had injuries or medical conditions in the past?

Whether they have had past or concurrent employment?

Whether they truly are impacted by their injury?

Whether they have a history of Personal Injury Claims, Lawsuits and Workers’ Compensation Claims?

What Has Changed with Respect to Private Investigation Services?

Private Investigators and their abilities to conduct investigations have improved as a result of ongoing advances in technology.  These advances have made certain investigations more cost effective to perform.  As a result, Insurance Companies may be more willing to employ them.  These new technologies have allowed Private Investigators to obtain greater knowledge and information about the Injured Worker.   Also, they have allowed for greater surveillance.

These new technologies include the improved quality and nature of the cameras, drones, and the employment of the internet for the purposes of obtaining data.

Who Are Private investigators (PI)?

Within the State of California, a Private Investigator is a licensed position.  Per the State of California, the PI duties are described as an individual that, among other things “ (1) investigates crimes, (2) investigates the identity, business, occupation, character, etc., of a person, (3) investigates the location of lost or stolen property, (4) investigates the cause of fires, losses, accidents, damage or injury, or (5) secures evidence for use in court. Private investigators may protect persons only if such services are incidental to an investigation; they may not protect property. An individual, partnership, or corporation licensed as a private investigator may employ a qualified manager to manage the business on a day-to-day basis. To be eligible to apply for licensure as a private investigator/qualified manager, you must meet the following requirements:”

PIs must be meet certain qualifications. This requires that they are 18 year or older, they have undergone a criminal history back background check through the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI.)  Further they must have “at least three years (2,000 hours each year, totaling 6,000 hours) of compensated experience in investigative work; or have a law degree or completed a four-year course in police science plus two years (4,000 hours) of experience; or have an associate degree in police science, criminal law, or justice and 2 ½ years (5,000 hours) of experience. Also, they must pass an examination covering laws and regulations, terminology, civil and criminal liability, evidence handling, undercover investigations and surveillance.

In sum, PIs are educated, experienced and intelligent individuals.  In fact, a number of them are former law enforcement personnel. Therefore, even before they were PIs, they had extensive experience in conducting investigations.

What Type of Investigations Do PIs Do on Workers’ Compensation Cases?

 PIs engage in surveillance, generating background reports, obtaining witnesses statements, conducting accident site investigation, conducting social media investigation, and canvassing medical history.

What is Surveillance?

Surveillance can involve the use of the camera to record an Injured Worker’s activity. Technology has improved surveillance activities by having “high definition” (HD) camera quality and the ability to use “unmanned” cameras.  In essence, they can leave a camera at a location without having to have an investigator present to operate it.  For example, they can leave a camera in an empty car across the street from the Injured Worker’s residence. This capability significantly reduces the investigation cost as well as allowing for a 24/7 ability to conduct surveillance.

What are Background Reports?

Background Reports can be a comprehensive report which provides the Injured Worker’s information and history by utilizing online bases, public records information, such as courthouse records and real property records, as well as other information.

What Are Witness Statements?

PIs can go to the workplace or other locations or import to the claim and take recorded statements of potential witnesses.   Also, they can reduce them to written statements and have them signed by the individuals.   Further, they can do interviews of witnesses telephonically.  Witness Statements can cover a variety of issues.   This can include facts concerning how the accident occurred and facts concerning other employment.

What Are Accident Site Investigations?

Accident Site investigations can include a variety of items.   It can include the investigator’s impressions concerning whether the accident happened as well as the credibility of the witnesses.   It can include pictures of the site. It can include statements from percipient witnesses.  Further, it is possible that video can be attached to such a report.

What Are Social Media Investigations?

Social Media Investigations can involve a report of the Injured Worker’s presence online. This can include past and present activity.   This investigation can involve various social networks such as Facebook, LinkedIn, and Instagram.

It should be noted that in the United States, there are over 200 million users of Social Media.   Many Injured Workers participate in Social Media.   This Social Media most likely documents the Injured Worker’s pre and post-injury activities and hobbies.

What is Medical Canvassing?

Medical Canvassing is an investigation which locates the Injured Worker’s widespread medical and treatment history.   This would include identifying the various medical facilities such as emergency rooms, health care clinics, hospitals, and pharmacies where the Injured Worker was a patient or customer.   

How Does the Court View the Private Investigation of Injured Workers?

There is a California Supreme Court decision which addressed the consequences of an investigation gone awry. Unruh vs. Truck Ins. Exch. (1972) 7 Cal. 3d 616.

In the matter, the Injured Worker had had four back surgeries and her condition deteriorated causing her extreme pain and requiring treatment. The Insurance Company in the case placed her under surveillance and  the investigator “befriended the plaintiff and did in the City of  Long Beach and elsewhere misrepresent his capacity [ and his intentions toward the plaintiff.” On specified dates, for the purpose of obtaining motion pictures of plaintiff, defendants “did entice and cause the plaintiff to conduct herself in a manner beyond her usual and normal physical capabilities . . . .”

In particular defendants enticed plaintiff to visit Disneyland with defendant Baker, in the unseen presence of defendant Marino, where Baker caused plaintiff to cross a rope bridge and a barrel bridge and “did wilfully and intentionally violently shake and disturb said bridges and the physical person of the plaintiff, and the defendants did at said place cause the plaintiff to engage in other activities so as to aggravate and injure the plaintiff.” These events were filmed by defendant Marino.”

With respect to it, the Injured Worker “did not know at any time that she was under surveillance, that defendant Baker had misrepresented his capacity, or that defendant Marino was photographing her activities. At the instance and invitation of Baker, plaintiff had been caused “to become emotionally interested” in him.”

The Court noted that “[a] negligent investigation of an employee’s claim may well be an aberration in the carrier’s normal activities, but when it does have a harmful effect on the employee, we see no reason why it cannot be treated by the Board as a compensable aggravation of the original injury, if the evidence so warrants.”

In sum, there is a line that a Private Investigator can cross into what is unacceptable conduct.    The question is “where is the line?”   With the present technology, is it a drone taking video while flying over the Injured Worker’s residence?   Is it leaving non-operator cameras viewing an Injured Worker’s residence on a 24/7 basis for an excessive period of time?

With respect to these issues, the boundaries will either be defined by the Courts or by the State of California by statute.  The Unruh case involved deception and misrepresentation. Excessive or unusual surveillance may not rise to that level of misconduct.  There needs to be some point defined as to when excessive surveillance becomes unreasonable and unacceptable.  The State of California has a constitutional provision for the “right to privacy.”   The spirit of that “right” should be considered.

It should also be noted that an injury arising out of a negligent investigation can be tacked onto the Injured Worker’s original claim of injury.  See Patrick vs. Marina City Club 2010 Cal. Wrk. Comp. P.D. Lexis 19 (Noteworthy Panel Decision.)  Adjuster misconduct was found to have caused a heart injury for which the Injured Worker received compensation.

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.

WHAT IS ZERO PERCENT WHOLE PERSON IMPAIRMENT?: INJURED WORKERS WITH MEDICAL REPORTING INDICATING ZERO PERCENT WHOLE PERSON IMPAIRMENT: WHAT YOU NEED TO KNOW

In California Workers’ Compensation Law, Medical Evaluators are asked to report and determine an Injured Workers’ Permanent Disability.   In California, Permanent Disability is generated by the Medical Evaluator’s reporting.   The Evaluator’s reporting assesses the Injured Worker’s Permanent Disability in the form of a Whole Person Impairment (WPI.)  Whole Person Impairment is generated by using the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th Edition (AMA Guides.)

 

Sometimes, Injured Workers are assigned a zero percent whole person impairment by an Evaluator for their permanent disability. A zero percent whole person impairment has significant implications for an Injured Worker.  This article will discuss (a) the meaning of “whole person impairment,” (b) what a “zero” whole person impairment means? and (c) what “zero” percent whole person impairment impacts other benefits?

What Is Whole Person Impairment (WPI)?

American Medical Association Guides to the Evaluation of Permanent Impairment, 5th Edition, on Page 603, defines “Whole Person Impairment” as the “percentages that estimate the impact of the impairment on the individual’s overall ability to perform activities of daily living, excluding work.”

How Does the AMA Guides Defines Zero Percent Disability?

In the AMA Guides, “[a] 0% whole person (WP) impairment rating is assigned to an individual with an impairment if the impairment has no significant organ or body system functional consequences and does not limit the performance of the common activities of daily living indicated in Table 1-2.” [emphasis added.]

What Are The Activities of Daily Living( ADLs) that are to be addressed?

Table 1-2 of the AMA Guides provides a list of Activities of Daily Living.

Table 1-2, defines “Activities of Daily Living Commonly Measured in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) Scales”  These ADLs include:

Self-care Urinating, defecating, brushing teeth,

personal hygiene combing hair, bathing, dressing, oneself, eating.” [emphasis added.]

Communication Writing, typing, seeing, hearing, speaking” [emphasis added.]

Physical activity Standing, sitting, reclining, walking, climbing stairs” [emphasis added.]

Sensory function Hearing, seeing, tactile feeling, tasting, smelling” [emphasis added.]

Nonspecialized Grasping, lifting, tactile hand activities discrimination” [emphasis added.]

Travel Riding, driving, flying” [emphasis added.]

Sexual function Orgasm, ejaculation, lubrication, erection”  [emphasis added.]

Sleep Restful, nocturnal sleep pattern” [emphasis added.]

What Should Happen in Your Evaluation to Address ADLs?

To properly assess the Industrial Injury’s impact on ADLs, the Evaluator should interview the Injured Worker about their ADLs, they should have the Injured Worker address them via filling out an inventory of their ADLs and their difficulties concerning them.   Also, the Evaluator should look to their examination, any testing done, and their review of records to further give them insight as to the injury’s impact on ADLs.

How Can a Zero WPI Be Wrong?

It is this author’s contention that if the Evaluation Reporting shows that there is “limited performance of the common activities of daily living” then, per the AMA Guides, by their definition, it cannot be a Zero Impairment.   Therefore, the report should be questioned.  This can be done by deposition of the Evaluator, interrogatory of the Evaluator, or the offering of another Evaluator with differing opinion.

How Does a Zero Percent WPI Impact the Eligibility to Obtain a Job Displacement Voucher?

Labor Code Section 4658.7, provides that for injuries on or after 1/1/13, a requirement for obtain a job displacement voucher is that the injury caused a permanent partial disability. A “zero” percent whole person impairment assessment will, in most circumstances, will yield a zero percent permanent disability.  A zero percent disability will bar the Injured Worker from obtaining a voucher.

As an Injured Worker With a Zero WPI Report, What Should I Do?

You need to reach out a Practitioner within Workers’ Compensation to evaluate the report to see what can be done.  Don’t be discouraged by the Medical Evaluators report.  Seek advice to see if there are problems with the report and if there is a strategy to correct the problem so that you can obtain a “fair and accurate” assessment of your impairment.   There is caselaw to support this. See Almaraz Guzman vs. Environmental Recovery Service (2009) 74 C.C.C. 1084.

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.

 

     

 

 

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