UPPER EXTREMITY SURGERY, POST-OPERATIVE VISITS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Workers’ Compensation Studies will often provide Injured Workers insight as to Insurance Companies’ and Medical Providers’ tactics.   Injured Workers often feel like there is an agenda working against them.  A recent study about post-operative visits for Upper Extremity Surgery raises concerns.

This article will discuss Upper Extremity Surgery, the Study’s results and the Study’s implications for Injured Workers.

What Are Upper Extremity Surgeries?

In the workers’ compensation system, upper extremities can fit into two categories.

First, there are traumatic injuries which require surgeries.  A skill saw accident involving amputation is one which may require extensive and specific procedures.

Second, there are surgeries that are due to Occupational Illness.  These surgeries are most likely related to repetitive trauma.

One common occupational illness surgery is carpal tunnel.

What Are Typical Workers’ Compensation Upper Extremity Surgeries?

Typical workers’ compensation surgeries, which were also the subject to the Study, are Carpal Tunnel Release, Trigger Finger Release, Cubital Tunnel Release, and De Quervains.

With respect to these surgeries, sometimes two or more of these procedures can be done at the same time.

What Did the Study Find?

The study found that workers’ compensation patients have more post-operative visits after surgery than non-industrial surgeries.  Henry TW, Townsend CB, Beredjiklian PK. Workers’ Compensation Status Confers a Greater Number of Postoperative Visits After Common Upper Extremity Surgeries. Cureus. 2021;13(4):e14629. Published 2021 Apr 22. doi:10.7759/cureus.14629

The study viewed these additional visits as being an additional cost which could be targeted for saving.   Telehealth appointments were suggested as a means of lowering costs. Also, there is the concern overburdening the providers with additional appointments.

Comment: Workers’ compensation claims have reporting obligations. Therefore, there is a greater need for appointments.   Likewise, there are return to work issues which may also cause the need for additional post-operative appointments.

Further, non-industrial patients, if they are satisfied with their result, may be inclined to cancel or not follow through with post-operative appointments.   Thus, there are a number of drivers in the workers’ compensation system which cause more appointments than non-industrial patients.  The notion of telehealth evaluations, however, may be of value.   In matters where there is excellent post-surgery healing, an actual appointment with the provider may not be so important. A telehealth evaluation may suffice.

Besides Costs, What Are Other Concerns in the Workers’ Compensation System Claims involving Upper Extremities?

Risk Management concerns on post-operative cases include the Injured Worker’s compliance with treatment, their functional outcome, their symptom relief, their return to work and their satisfaction. Henry TW, Townsend CB, Beredjiklian PK. Workers’ Compensation Status Confers a Greater Number of Postoperative Visits After Common Upper Extremity Surgeries. Cureus. 2021;13(4):e14629. Published 2021 Apr 22. doi:10.7759/cureus.14629

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.

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