YOUNGER WORKERS AND WORK INJURIES:  YOUTHFUL WORKERS, SPECIAL CONCERNS FOR YOUNGER WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

“When I was young, it seemed that life was so wonderful”

Supertramp

Does Age matter?  Yes.  Younger Workers get injured at different rates than Older Workers.  A recent study brought light onto the issue of Age as a factor with respect to Work Injuries.

Younger Workers make up a significant number of the workforce.  Adolescents and Young Adults represent approximately 13% of the U.S. workforce. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

As a result of this, like all workers, they sustain work-related injuries. Per a study, it was estimated that “3.2 million nonfatal injuries to young workers were treated in hospital emergency departments, with the highest rates among workers aged 18–19 years. Data from 2018 indicate that the leisure and hospitality industry [i.e. food service such as McDonalds hotels, and amusement parks] contributed the highest percentage of injuries to workers aged 15–17 years requiring at least 1 day away from work.” Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

This article will discuss the rates of injury for Younger Workers, the implications for Younger Workers who sustain work injuries, the special concerns a Workers’ Compensation Attorney has with respect to these claims, and how the Workers’ Compensation Systems addresses Younger Workers’ Permanent Disability.

What Was the Study?

The study  that was done looked into nonfatal occupational injuries of Younger Workers within the United States during the years 2012 to 2018.  Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Does Age Make a Difference?

Yes. It was found that Younger Workers, aged 15-24, experienced a higher rate of job-related injury versus Adult Workers, aged 25-44.  Supra.

Are There Any Interesting Facts Concerning the Injury Rates?

AGE RANGE WITH HIGHEST RATE OF INJURY: The highest injury rate (404 per 10,000 FTE) occurred among workers aged 18–19 years.

MALE VERSUS FEMALE: Within each of the four age categories, the rate of injury was 1.4 to 1.5 times higher among males than among females.

YOUNGER VERSUS MIDDLE AGED WORKERS:  Annual rates of injuries among young workers aged 15–24 years were 1.2–2.3 times higher than those for workers aged 25–44 years. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Do Young People Get Hurt?

Younger Workers can get injured in a variety of ways.  One of the reasons why Younger Workers get injured is that they are often learning on the job. This makes them more susceptible to injuries.

For example,

“Contact with objects and equipment was the leading cause of occupational ED-treated injuries among all age groups examined, with rates of injuries ranging from 64 per 10,000 FTE among workers aged 25–44 years to 182 per 10,000 FTE among workers aged 18–19 years.” Supra.

“Lacerations and punctures were the most common type of ED-treated injuries reported among workers aged <25 years, with injury rates ranging from 66 to 99 per 10,000 FTE, “ Supra.

To the contrary, it should be noted that

“strains and sprains were most common among workers aged 25–44 years (injury rate of 47 per 10,000 FTE).” Supra.

Why are Work Injuries to Younger Workers a Concern?

One of the big concerns with respect to Younger Workers in California is the issue of lifetime medical care.   Young Workers, to some extent, are more able to recover from injuries versus Older Workers.

Some injuries that have long term implications.   There are injuries which can cause arthritis.   Arthritis can take decades to become a problem for the worker. Therefore, Younger Worker may need medical care decades after the injury happened.  Many Young Workers do not understand or appreciate this fact.   This is an issue of discussion concerning settlement of their case.

How Does the California Workers’ Compensation System View Younger Workers’ Permanent Disability?

Younger Workers’ Permanent Disability is not viewed as significant as older workers’ permanent disability.  For the same injury, a Younger Worker will receive less money than an Older Worker.

How is a Younger Worker’s Age Factored into Permanent Disability?

In the SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005) , there is a provision for adjusting with respect to the Injured Worker’s age.

One of the steps in the permanent disability rating formula is to make an age adjustment.  Using a Table, a Younger Worker’s Permanent Disability is lowered via the rating adjustment.   See Schedule at P. 1-9.

In sum, the Schedule has a specific table that is used in a permanent disability rating formula to lower the disability rating. The disability rating being lowered translates into less money for the Injured Worker.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 28 years. Contact us today for more information.

 

OPERATING ROOM PERSONNEL AND ORTHOPEDIC WORK INJURIES: MEDICAL PROFESSIONALS SUFFERING MUSCULOSKELETAL DISORDERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

There is some irony to the fact that Operating Room Personnel, who help repair and treat patients with workers’ compensation injuries, are at risk of work injuries in doing so.  Operating Room Personnel perform vital services in our society’s medical delivery system.  Their hard work is appreciated by all.  The Operating Room, however, is a difficult place to work.

This article will discuss Operating Room Personnel, the mechanisms of injury that occur as a result of the Operating Room, and the various musculoskeletal injuries that Operating Room Personnel are at risk for sustaining.

Who Are Operating Room Personnel?

Operating Room Personnel include Surgeons, Nurses, Scrub Nurses and Surgical Technicians.

What are the Mechanisms of Injury for Operating Room Personnel?

There are a variety of mechanisms of injury for Operating Room Personnel. These mechanisms include manipulation, standing and static stress.

What is Manipulation?

“Manual activities are another risk factor for work-related physical activity among operating room personnel. Manual activities mean the manual movement and transfer of surgical instruments and devices that require special attention. Pulling, pushing or lifting surgical instruments, heavy and specialized surgical equipment and patient displacement are the most common manual activities of operating room personnel.” J Multidiscip Healthc. 2020; 13: 735–741. Published online 2020 Jul 31. doi: 10.2147/JMDH.S259245 PMCID: PMC7402850 PMID: 32801736 A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel Reza Tavakkol, Ashkan Karimi, Soheil Hassanipour,  Ali Gharahzadeh, and Reza Fayzi.

Some of the problems with respect to manipulation is that some of these activities may not be performed in an ergonomic fashion. Supra.

One study found the abnormal posture with respect to nurses.  The study noted that “in most cases nurses were at high risk level and needed urgent and prompt change in their working posture.” Health Promot Perspect. 2016; 6(1): 17–22. Published online 2016 Mar 31. doi: 10.15171/hpp.2016.03 PMCID: PMC4847110 PMID: 27123432 Working posture and its predictors in hospital operating room nurses Farahnaz Abdollahzade, Fariba Mohammadi, Iman Dianat,  Elnaz Asghari, Mohammad Asghari-Jafarabadi,  and Zahra Sokhanvar. 

What is “Standing?”

“[T]the team members are in a standing position throughout the surgery.25,26 Standing up for a long time is one of the most important risk factors for musculoskeletal disorders.27 Andersen et al found that prolonged standing may increase back pain and leg pain J Multidiscip Healthc. 2020; 13: 735–741. Published online 2020 Jul 31. doi: 10.2147/JMDH.S259245 PMCID: PMC7402850 PMID: 32801736 A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel Reza Tavakkol, Ashkan Karimi, Soheil Hassanipour,  Ali Gharahzadeh, and Reza Fayzi.

What Is “Static Stress?”

“Static stress is one of the risk factors that cause musculoskeletal disorders in operating room personnel. Static stress includes activities such as prolonged standing and constant physical posture during surgery and holding equipment such as retractors during surgery.” J Multidiscip Healthc. 2020; 13: 735–741. Published online 2020 Jul 31. doi: 10.2147/JMDH.S259245 PMCID: PMC7402850 PMID: 32801736 A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel Reza Tavakkol, Ashkan Karimi, Soheil Hassanipour,  Ali Gharahzadeh, and Reza Fayzi.

What Body Parts that Can Be Injured by Operating Room Work?

Practically every orthopedic body part is susceptible for injury in the Operating Room. “Operating room personnel are most affected by musculoskeletal pain (58–90%) due to difficult working conditions.20 Musculoskeletal disorders can occur in different parts of the body. The most common areas of involvement include the neck, shoulder, elbows, wrists, and hands, upper and lower back, hip and thighs, knees, ankles, and feet. Among the musculoskeletal disorders, low back pain has the highest prevalence.” Supra.  

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 28 years. Contact us today for more information.

THE OWESTRY DISABILITY INDEX(ODI) AND WORKERS’ COMPENSATION: BACK INJURIES, EVALUATIONS, TREATMENT AND INDEXES: WHAT YOU NEED TO KNOW

Injured Workers are frequently given questionnaires and indexes to fill out as part of their workers’ compensation treatment and evaluations.   These questionnaires and indexes can play an important role with respect to workers’ compensation benefits.

One of the indexes that an Injured Worker may encounter is the Owestry Disability Index. This article will discuss the Owestry Disability Index (ODI), what it is used for, how is it scored, problems with scoring, and how it is used for in the workers’ compensation setting.

Why Are Indexes Used?

Indexes are a quick way of address one’s disability state.  Sometimes,  simple questions can provide an accurate picture as to an Individual’s physical state and their capabilities. In Workers’ Compensation, due to the employment of the American Medical Association Guide to the Evaluation of Permanent Impairment, 5th Edition, there is a focus on an Individual’s “Activities of Daily Living.” For an article on Activities of Daily Living, click here.

What is the Oswestry Disability Index?

“The Oswestry Disability Index (ODI) is one of the most commonly used outcome measures for individuals with low back pain (LBP)”Psychometric properties and clinical usefulness of the Oswestry Disability Index, Michael Vianin J Chiropr Med. 2008 Dec; 7(4): 161–163.

doi: 10.1016/j.jcm.2008.07.001 PMCID: PMC2697602 PMID: 19646379

“The ODI is a self-administered questionnaire that requires 5 minutes to complete and 1 minute to score. Scores are associated with degree of disability ranging from minimal to bedbound. The ease of administering, scoring, and interpreting renders the ODI a potentially meaningful tool in clinical practice.” Supra.

What is the Owestry Disability Index Used For?

As noted above, the Owestry Disability Index is used to make assessments for Low Back Injuries. Essentially, it is the self-reporting of the Patient.

For workers’ compensation purposes, functional status is important in assessing a variety of workers’ compensation issues. These issues can include disability status- temporary total, permanent and stationary, permanent total disability, and credibility.  Credibility can speak towards the truthfulness of the Injured Worker’s complaints versus possible malingering. A physician encountering malingering may use that finding as a basis to cut-off temporary disability benefits or assign a low level of impairment/permament disability.

“The ODI is a valid, reliable, and responsive condition-specific assessment tool that has withstood the test of time and scrutiny.3 So far, it has been used mostly in chronic and severely disabled populations, but shows good indicators for the assessments of less severe complaints.” Supra.  

How Does Owestry Approach Back Injuries?

The Owestry Disability Index looks at the Injured Worker’s ability to perform Activities of Daily Living.   The Index focuses on 10 sections designed to make such an assessment.  Each section is scored with a 0-5 number.   0 being the least disability and 5 being the greatest.

What Are The Questions Asked in the Owestry Disability Index?

  1. PAIN INTENSITY

I can tolerate the pain I have without having to use pain killers

The pain is bad but I manage without taking pain killers

Pain killers give complete relief from pain

Pain killers give moderate relief from pain

Pain killers give very little relief from pain … Pain killers have no effect on the pain and I do not use them

  1. PERSONAL CARE (e.g. Washing, Dressing)

I can look after myself normally without causing extra pain

I can look after myself normally but it causes extra pain

It is painful to look after myself and I am slow and careful

I need some help but manage most of my personal care

I need help every day in most aspects of self care

I don’t get dressed, I was with difficulty and stay in bed

  1. LIFTING

I can lift heavy weights without extra pain

I can lift heavy weights but it gives extra pain

Pain prevents me from lifting heavy weights off the floor, but I can manage if they are conveniently positioned, i.e. on a table

Pain prevents me from lifting heavy weights, but I can manage light to medium weights if they are conveniently positioned

I can lift very light weights

I cannot lift or carry anything at all

  1. WALKING

Pain does not prevent me walking any distance

Pain prevents me walking more than one mile

Pain prevents me walking more than ½ mile

Pain prevents me walking more than ¼ mile

I can only walk using a stick or crutches

I am in bed most of the time and have to crawl to the toilet

  1. SITTING

I can sit in any chair as long as I like

I can only sit in my favorite chair as long as I like

Pain prevents me from sitting more than one hour

Pain prevents me from sitting more than ½ hour

Pain prevents me from sitting more than 10 minutes

Pain prevents me from sitting at all

  1. STANDING

I can stand as long as I want without extra pain

I can stand as long as I want but it gives me extra pain

Pain prevents me from standing for more than one hour

Pain prevents me from standing for more than 30 minutes

Pain prevents me from standing for more than 10 minutes

Pain prevents me from standing at all

  1. SLEEPING

Pain does not prevent me from sleeping well

I can sleep well only by using medication

Even when I take medication, I have less than 6 hrs sleep

Even when I take medication, I have less than 4 hrs sleep

Even when I take medication, I have less than 2 hrs sleep

Pain prevents me from sleeping at all

  1. SOCIAL LIFE

My social life is normal and gives me no extra pain

My social life is normal but increases the degree of pain

Pain has no significant effect on my social life apart from limiting my more energetic interests, i.e. dancing, etc.

Pain has restricted my social life and I do not go out as often

Pain has restricted my social life to my home

I have no social life because of pain

  1. TRAVELLING

I can travel anywhere without extra pain

I can travel anywhere but it gives me extra pain

Pain is bad, but I manage journeys over 2 hours

Pain restricts me to journeys of less than 1 hour

Pain restricts me to short necessary journeys under 30 minutes

Pain prevents me from traveling except to the doctor or hospital

  1. EMPLOYMENT/ HOMEMAKING

My normal homemaking/ job activities do not cause pain.

My normal homemaking/ job activities increase my pain, but I can still perform all that is required of me.

I can perform most of my homemaking/ job duties, but pain prevents me from performing more physically stressful activities (e.g. lifting, vacuuming)

Pain prevents me from doing anything but light duties.

Pain prevents me from doing even light duties.

Pain prevents me from performing any job or homemaking chores.

See Fairbank JC, Pynsent PB. “The Oswestry Disability Index.” Spine 2000: 25(22):2940-2952;  Fairbank JCT, Couper J, Davies JB. “The Oswestry Low Back Pain Questionnaire.” Physiotherapy 1980; 66:271-273

How It is Scored? Is There a Problem With Scoring?

 “The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage. Thus, for every question not answered, the denominator is reduced by 5. If a patient marks more than one statement in a question, the highest scoring statement is recorded as a true indication of disability.” Oswestry Disability Index Scoring Made Easy A MehraD BakerS Disney, and PB Pynsent Ann R Coll Surg Engl. 2008 Sep; 90(6): 497–499. doi: 10.1308/003588408X300984

Scoring of the test can be problematic.  First, the individual may not understand the questions asked and answer them incorrectly. There can be language or literacy issues that can come into play.  Second, the individuals scoring the test may not use the highest score or may calculate the result appropriately. See Oswestry Disability Index Scoring Made Easy A MehraD BakerS Disney, and PB Pynsent Ann R Coll Surg Engl. 2008 Sep; 90(6): 497–499. doi: 10.1308/003588408X300984  (re: Issues concerning staff scoring tests accurately and their training)

What Does the Score Mean?

 The scores of ODI are as follow:

0 – 4                 No disability

5 – 14               Mild disability

15 – 24             Moderate disability

25 – 34             Severe disability

35 – 50             Completely disabled

See Fairbank JC, Pynsent PB. “The Oswestry Disability Index.” Spine 2000: 25(22):2940-2952  Fairbank JCT, Couper J, Davies JB. “The Oswestry Low Back Pain Questionnaire.” Physiotherapy 1980; 66:271-273

What Do These Disability Terms Mean?

No disability The patient can cope with most living activities. Usually no treatment is indicated apart from advice on lifting, sitting and exercise.

Mild disability The patient experiences more pain and difficulty with sitting, lifting and standing. Travel and social life are more difficult and they may be disabled from work. Personal care, sexual activity and sleeping are not grossly affected and the patient can usually be managed by conservative means.

Moderate disability Pain remains the main problem in this group but activities of daily living are affected. These patients require a detailed investigation.

Severe disability Back pain impinges on all aspects of the patient’s life. Positive intervention is required.

Completely disabled These patients are either bed-bound or are exaggerating their symptoms.

Supra.

What Does This Mean In Workers’ Compensation?

The Index can help address the credibility of the Injured Worker. Is the scoring commensurate with the pathology? For example, if someone scores “Completely Disabled” but has a minor back sprain, malingering comes into question.  If someone post-back surgery scores as “Moderate”, they would most likely be viewed as credible. In sum, an ODI score can either raise a “red flag” concerning an Injured Work or be a confirmatory basis for assigning impairment, disability status or permanent disability.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 28 years. Contact us today for more information. Click Here.

 

Workers’ Compensation Back Injuries: What You Need to Know

How can Industrial Back Injuries occur?

In California, Workers’ Compensation Back Injuries can occur in many ways. Injuries can be the result of a specific incident, a cumulative trauma, a presumptive injury, or a compensable consequence arising out of an injury to other body parts or systems. A Back Injury can also be an aggravation of a pre-existing back condition. This article discusses the types of industrial back injuries, the testings that are available, an the treatments that are available.

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