Construction Laborers and Work Injuries

Performing heavy labor at a construction site can lead to work injuries. Construction laborers commonly sustain injuries to their back, fingers and hands, and knees, as the result of repetitive, strenuous job activities.

Some types of job activities, that when performed repetitively for prolonged periods of time, can lead to injuries, include:

• Exerting significant force to perform tasks or use tools 
• Remaining in a static position for extended periods of time 
• Pressure against a body part from a hard surface or edge 
• Using awkward back, hand, wrist, elbow, or shoulder positions 
• Working in positions such as bending, stooping, kneeling, twisting, or overhead reaching, repetitively, or for prolonged periods 
• Sitting on, standing on, or holding vibrating equipment or tools 
• Working in very hot or very cold temperatures 

Symptoms of a construction injury can include:

• Pain 
• Stiffness 
• Aching 
• Fatigue 
• Temperature changes in the hands or feet 
• Swelling 
• Numbness 
• Tingling 
• Changes in skin color 
• Weakness 
• Loss of sensation 

If you sustain an injury on the job as a construction laborer, it’s important to get medical attention. It is also important that you report your injury to your employer as soon as possible. If you sustain an on-the-job construction labor injury in Minnesota, you may be entitled to workers’ compensation benefits, including medical expense benefits, wage loss benefits, permanent partial disability benefits, and/or rehabilitation benefits.

Construction workers often run into unique issues on their workers' compensation cases, including insurance coverage issues, and third party liability issues. An experienced Minnesota workers' compensation lawyer can help you navigate the system. To learn more about your Minnesota workers’ compensation rights, contact Meuser & Associate at 877-746-5680 or click here to send us an email for a FREE, NO-OBLIGATION case evaluation.

Causes of Carpal Tunnel Syndrome and MN Workers' Comp.

Carpal tunnel syndrome is one of the most common work-related injuries we see in our Minnesota workers’ compensation law practice. Carpal tunnel syndrome is not only painful, but it can interfere with your ability to do your job. 

If your work activities substantially contributed to your development of carpal tunnel syndrome, you may be eligible for Minnesota workers’ compensation benefits, including medical expense benefits, wage loss benefits, permanent partial disability benefits, and rehabilitation benefits.

In Minnesota, when carpal tunnel syndrome is caused by a worker’s day-to-day activities, or where it develops over time as a result of an employee’s work, it is known as a repetitive motion injury, or a Gillette-type injury.

Unfortunately, workers’ compensation cases involving carpal tunnel syndrome are also very commonly disputed by workers’ compensation insurance companies. Rather than acknowledging that your work activities contributed to the development of your condition, the workers’ compensation insurance company will usually try to point to some other cause, such as obesity, diabetes, or no cause at all.

In fact I’ve seen a number of independent medical examiners simply conclude that females over the age of 40 are more likely to develop carpal tunnel syndrome, and that therefore, the workers’ job activities are not a substantial contributing factor to her carpal tunnel syndrome.

Carpal tunnel syndrome occurs when there is pressure on the median nerve as it passes through the carpal tunnel in your wrist. This pressure causes sensations of tingling, numbness, pain, and/or weakness in parts of your hand.

Things that can contribute to the development of carpal tunnel syndrome include:

• Repetitive or forceful hand and wrist movements that cause the membranes surrounding the tendons to swell putting pressure on the median nerve. 
• Work that requires awkward positioning of the hands or wrists for long periods can also put pressure on the median nerve or cause swelling of the tendons. 
• Work activities that cause hand-arm vibration for long periods can contribute to carpal tunnel syndrome. 
•  Broken wrist bones, dislocated bones, new bone growth or bone spurs can put pressure on the median nerve.
• Conditions or illnesses that cause swelling in the joints and soft tissues, or restricted blood flow to the hands, such as obesity, rheumatoid arthritis, gout, diabetes, lupus, or hypothyroidism can result in pressure on the median nerve. 
• Buildup of fluid, or edema, in the carpal tunnel, caused by pregnancy or conditions such as rheumatoid arthritis or diabetes, can put extra pressure on the median nerve. 
• Smoking may contribute to carpal tunnel syndrome by affecting blood flow to the median nerve. 

If you’ve developed carpal tunnel syndrome as a result of your work activities, a Minnesota workers’ compensation lawyer can help protect your rights. For a free no-obligation case consultation call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Degenerative Disc Disease and MN Workers’ Comp: Exercise and Physical Therapy for Pain Management

Degenerative disc disease is one of the most common causes of low back and neck pain, and it can significantly impact your ability to do your normal day to day activities, and your ability to work.

Degenerative disc disease refers to changes to the spinal discs from chronic wear and tear or injury. There are a variety of treatment options for degenerative disc disease, including exercise and physical therapy. For individuals suffering from degenerative disc disease, a regular routine of back or neck exercises can prevent neck or back pain and/or reduce the frequency, severity, and duration of flare-ups. Stretching exercises can improve range of motion, which in turn, can reduce neck or back pain. Strengthening exercises can help stabilize the spinal segments, and stronger muscles can help compensate for degenerated discs. Before beginning an exercise or therapy program, consult with your spinal specialist.

In the context of workers’ compensation, in many cases, degenerative disc disease is a condition that is covered for work comp benefits. The condition itself may be caused by an employee’s work activities, or an employee’s work activities may have substantially contributed to the condition.
Alternatively, an employee may suffer an aggravation of underlying degenerative disc disease, which is covered by workers’ compensation.

While the term “degenerative disc disease” refers to a medical condition, for workers’ compensation insurance adjusters, the term is also a legal defense to a claim for benefits. In plain language, what that means is that if you are injured at work, and you are diagnosed with degenerative disc disease, or there’s even a reference to degenerative disc disease in your medical records, be prepared for the work comp. adjuster to deny your claim on the basis that your condition is pre-existing.

Just because the workers’ compensation insurance company says your condition is pre-existing, doesn’t mean they’re right! 

In many cases, an individual’s work activities caused, or substantially contributed to, wear and tear on the spine over time, resulting in degenerative disc disease. That is a condition that IS covered by workers’ compensation, and is often referred to as a repetitive motion injury, or a Gillette-type injury.

In other cases, an individual’s work activities or an injury substantially aggravated or accelerated pre-existing degenerative disc disease. Again, in that instance, the injury IS covered by workers’ compensation.

If you are suffering from degenerative disc disease as a result of your work activities, you can expect that the workers’ compensation carrier will dispute your claim. It is important to speak with a Minnesota workers’ compensation lawyer to protect your rights. For a free, no-obligation consultation, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Is My Injury Work-Related? -- Minnesota Workers’ Compensation

If you’re sustained a work-related injury in Minnesota, you may be eligible for workers’ compensation benefits, including medical expense benefits, wage loss benefits, permanent partial disability benefits, and/or rehabilitation benefits.

In order to qualify for workers’ compensation benefits, you must be able to establish that your injury arose “out of and in the course and scope of employment.” The work activities must also be a substantial contributing factor to the injury.

Arising Out of the Employment 

The “arising out of” requirement is a legal causation standard. It basically means that there must be a causal connection between the employment and the injury. Generally, what this means is that you must show that a condition or incident of employment increased your exposure to potential harm beyond that of the general public or beyond your exposure to potential harm outside of work. In plain language, what this means is that the circumstances of your employment must have had something to do with the work injury.

Most on-the-job injuries satisfy this rule. There, are a few exceptions, however, where an on-the-job injury may not necessarily “arise out of’ the employment, including:

Injuries caused by “Acts of God.” Acts of God can include anything from injuries caused by disease or severe weather. There are many “exceptions” to this “exception,” however. If an employee’s work circumstances placed them at increased risk to exposure to the “Act of God,” or if an employee’s injuries sustained as a result of an “Act of God,” were worsened due to their work activities or circumstances, those injuries are generally compensable.

Injuries while “Coming or Going.” Generally speaking, if you sustain injury while on your way to work, or on your way from work, your injury is not covered for purposes of workers’ compensation. This is known as the “Coming and Going Rule.” Again, there are several exceptions to this exclusion. For example, employers are obligated to provide safe ingress to or egress from the employment premises. In plain language, that means injuries sustained on your way into or out of the workplace, such as walking to an employee parking lot, are generally covered.

Injuries due to the intentional acts of third parties. On the-job injuries that are the result of a violent act of a third party, totally unconnected with the employment, are not compensable. In most cases, however, there is at least some connection between the circumstances of the employment and the violent act, so these types of injuries are usually covered.

Idiopathic injuries. “Idiopathic” basically means spontaneous, or peculiar to the individual. Personal conditions that cause an injury at the workplace are not compensable. That being said, if the employment premises or activities aggravate or increase the risk of injury, these types of injuries can be compensable.

In the Course and Scope of Employment 

To meet the second part of the legal causation test, you must also show that the injury occurred within the period of the employment, and at a place where you could reasonable expected to be, and while you were performing your duties or something incident thereto. In plain language, this means that typically your injury must have occurred on the employer’s premises, during working hours, while performing your job duties.

There are, however, a number of exceptions to these requirements, including:

Traveling employees. Employment that requires travel involves a special set of rules. Each case is very fact specific, and involves an analysis of where the employee was at the time of the injury, what the employee was doing, and if the employee was required to be traveling as part of his or her duties.

Acts to assist others outside the employment. Generally, an act outside an employee’s regular duties, which is performed to advance the interests of the employer, is considered to be within the course of employment.

Acts of “personal comfort.” Under what is known as the “Personal Comfort Doctrine,” injuries that are sustained while an employee is attending to personal needs or comforts are generally held to be within the course of employment. This can include getting a drink of water, smoking, and using the restroom.

Horseplay. “Goofing around” or “horseplay” is generally considered to be incidental, or related to employment, and injuries that occur during such activities are generally compensable.

Violation of employer rules. Even violating an employer’s rules which results in an injury, is usually not grounds to deny benefits, unless the employee is engaged in a prohibited act at the time of the injury, and there must be a direct link between the performance of the prohibited act and the injury.

Recreational activities and employer sponsored events. Most social and recreational activities are no longer considered to be within the course of employment, unless the employee is able to show that the employer ordered or assigned the employee to participate in the program.

Injuries during lunches or breaks. Injuries that occur during a lunch break that is unpaid and off the employer’s premises are usually not covered, although there are some exceptions.

Work from home and home offices. This is becoming more and more common. Injuries sustained by employees during the actual performance of work activities while at home are generally compensable.

Substantial Contributing Factor

In addition to meeting the legal causation requirements set forth above, an employee must also show that his or her work activities were a substantial contributing factor to the development of his or her injury. There are a variety of different types of injuries that satisfy this definition, including specific injuries, Gillette-type or cumulative trauma injuries, aggravations or accelerations of a pre-existing condition, and occupational diseases. An employees work activities need not be the only cause of the condition—they need only be a substantial contributing factor.

Specific injuries. Specific injuries occur as a result of a specific incident or an accident. These are usually pretty clear. For example, falling off a ladder, sustaining a lifting injury, or being involved in a work-related motor vehicle collision are all specific incidents or events.

Cumulative trauma or Gillette-type injuries. Compensation is allowed for injuries that occur as a result of repetitive, minute trauma brought about by the performance of ordinary job duties. These types of injuries can occur over a long period of time. So long as an employee’s work activities are a substantial contributing factor to the development of the injury or condition, they are covered. Some common examples of these types of injuries include carpal tunnel syndrome or degenerative disc disease of the spine.

Aggravations or accelerations of a pre-existing condition. If an employee’s work activities substantially contribute to an aggravation or acceleration of a pre-existing condition, those conditions or injuries are compensable as well. A work-related aggravation can be temporary, or an aggravation can be permanent.

Occupational diseases. In very general terms, a disease that arises out of and in the course of employment, and which is peculiar to the occupation in which the employee is engaged, and which is not an ordinary disease of life to which the general public is equally exposed, is covered under Minnesota workers’ compensation. Occupational diseases have very specific definitions, causation requirements, and procedural rules.

Consequential injuries. Injuries that occur as a direct and natural consequence of a previous compensable injury are also, themselves, compensable. This can include conditions that develop as a medical consequence of an injury, and it can include injuries that are sustained as a legal consequence of a prior, work-related injury. For example, an injury that is sustained while doing physical therapy for a prior injury is a consequential injury. Injuries sustained as a result of a car accident on the way to a workers' compensation doctor's appointment are consequential injuries.

Psychological injuries.  Physical injuries which are occasioned by mental stimulus, and psychological injuries which are caused by a physical injury, may be covered for purposes of workers’ compensation. Psychological injuries which are occasioned by mental stimulus are not generally covered by workers’ compensation.

Some on-the-job injuries are obvious – if you fall off a ladder while performing your job duties and you sustain injuries, that’s clearly a work-related injury. If you sustain a lifting injury and hurt your back while performing your job duties, that’s clearly a work-related injury. Some work-related injuries, however, are not quite so obvious. If your injury falls into one of these "gray" areas, chances are, the workers' compensation insurer will deny your claim. Don't rely on the workers' compensation insurance company to make a "fair" determination as to whether your claim is compensable or not.

We frequently talk to individuals who sustain injuries or conditions that clearly meet the requirements of a work-related injury, but they didn't realize they had a compensable claim. If you believe you've sustained an injury that may be a result of your work activities, contact Meuser & Associate for a free, no-obligation case evaluation at 877-746-5680, or click here to send us an email. 

 

Common Minnesota Construction Injuries and Work Comp

As the weather starts to warm up here in Minnesota, construction season is going to get into full swing. Unfortunately, with more construction comes more construction worker injuries.

Some of the most common and most severe construction worker injuries we see in our Minnesota workers’ compensation practice include:

Head injuries. Construction-related head injuries can be caused by slip and falls, trip and falls, motor vehicle accidents, falling equipment or materials, blunt force trauma and many other things, and can result in closed-head injury, traumatic brain injury, concussion, coma, or even death.

Repetitive motion injuries. Repetitive motion injuries are also known as cumulative trauma injuries, or Gillette-type injuries in Minnesota workers’ compensation. They can include carpal tunnel syndrome, tendinitis, rotator cuff tears, trigger finger, epicondylitis, degenerative disc disease, cervical or lumbar herniations, meniscus tears, and many other conditions. These types of injuries occur over time and are usually the result of a combination of muscle tension, repetitive motions, over use, and incorrect posture.

Spinal cord injuries. The spinal cord controls every function of the human body. A spinal cord injury can be devastating. Spinal cord injuries can cause a variety of disabilities, including loss of sensation or function, A severe spinal cord injury can cause devastating disability, paralysis, quadriplegia, paraplegia, or even death.

Crush and amputation injuries. Equipment used in the construction trades is meant to cut and shape wood, metal, concrete, and other materials. When the human body comes into contact with these types of tools and machines, the results can be devastating, including traumatic or surgical amputation, loss of function, and disfigurement.

Burn injuries. Construction workers are surrounded by burn risks on a job site, including hot water, steam, chemicals, explosions, and electricity. Burn injuries are terribly painful, and can result in loss of function and disfigurement.

Broken bones and dislocated joints. Fractures can occur as a result of trip and falls, slip and falls, dropped equipment or materials, motor vehicle collisions, or a variety of other accidents. Dislocations usually occur when a joint is suddenly moved beyond its normal range of motion. These types of injuries can cause severe disability and loss of range of motion.

Eye injuries. Construction sites are eye injury hazards, ranging from chemicals, to wood and metal chips, to tools like nail guns or staplers. Eye injuries that cause blindness or impair a workers’ vision can be devastating.

Herniated discs. Herniated discs in the low back or neck are probably the most common construction worker injury we see in our workers’ compensation practice. They can be caused by almost any kind of trauma – overuse, lifting, twisting, falls, contact with objects, and motor vehicle collisions. They can also be severely disabling.

Construction worker injuries also raise a number of unique issues in workers’ compensation law, including determining whether the injured worker is an independent contractor, which contractor is responsible for workers’ compensation insurance coverage, and whether there is a third party liability claim.

Unfortunately, construction worker injuries can be some of the most contentious types of workers’ compensation claims. If you’ve sustained an injury as a result of a construction accident in Minnesota, you may be entitled to workers’ compensation benefits. Make sure you get all the workers’ compensation benefits you are entitled to. Don’t let a construction injury ruin your life. Contact us at 877-746-5680 or click here to send us an email for a free, no-obligation consultation with one of our workers’ compensation lawyers.

Visit us at MeuserLaw.com to learn more about Minnesota workers' compensation.

Pronator Teres Syndrome and Minnesota Workers' Compensation

Repetitive motion injuries, or cumulative trauma injuries, are commonly known as Gillette injuries under Minnesota workers’ compensation law.

Because the symptoms of carpal tunnel syndrome and pronator teres syndrome are similar, it is often difficult to determine which nerve has been injured when a person experiences symptoms in his or her fingers, hands, wrists, forearms, and elbows.

Pronator teres syndrome (also referred to as Pronator syndrome) is an upper extremity nerve entrapment syndrome involving the median nerve.

PTS develops from compression of the median nerve by the pronator teres muscle, and is sometimes referred to as pronator syndrome. The term pronator syndrome also can include median nerve compression by other structures in the elbow, such as the ligament of Struthers or the bicipital aponeurosis (lacertus fibrosus). Compression can be due to muscle hypertonicity or fibrous bands within the muscle pressing on the nerve. In some cases, pressure is placed on the nerve by anatomical anomalies, such as the nerve traveling deep to both heads of the pronator teres. In this situation, the nerve might be compressed against the ulna by the pronator teres muscle itself.

Symptoms of pronator syndrome include a diffuse forearm ache, usually resulting from prolonged muscular effort. Paresthesia may also be noted in the median field of the hand. There may also be tenderness over the area of entrapment, which can lead to pain in the forearm. Pressure on the area of nerve entrapment may cause abnormal sensations down the path of the median nerve. This is known as Tinel’s sign. People suffering from pronator syndrome may also experience decreased strength to muscles in the forearm. Specifically, victims of pronator teres syndrome may result in a decreased ability to pronate the wrist, a loss of wrist flexion, partial loss of finger flexion, and a loss of thumb opposition. In contrast, people with carpal tunnel syndrome will not demonstrate weakness in wrist flexion, wrist pronation, or finger flexion.

People with carpal tunnel syndrome and pronator teres syndrome both experience sensory loss, however the patterns of sensory loss differ. Pronator syndrome causes sensory loss in the entire median nerve field of the hand. In contrast, carpal tunnel syndrome causes sensory loss primarily in the thumb and fingers. Additionally, pronator teres syndrome pain is exacerbated by repetitive elbow flexion, and symptoms arise in the forearm as well as the hand. Carpal tunnel syndrome, on the other hand, is aggravated by wrist movements, and forearm pain is not as common or as severe.

People with carpal tunnel syndrome frequently report night pain, while individuals with pronator syndrome generally do not. This is because prolonged wrist flexion during sleep aggravates carpal tunnel syndrome, whereas wrist flexion does not affect the pronator teres muscle.

Treatment for pronator teres syndrome may include conservative therapies such as massage and physical therapy, ultrasound, anti-inflammatory medications, pain medications, or corticosteroid injections. If conservative therapies fail, decompressive surgery may be necessary.

People suffering from pronator teres syndrome as the result of repetitive motions at work are entitled to workers’ compensation benefits under Minnesota law, including medical benefits, wage loss benefits, permanency benefits, and/or rehabilitation benefits. Unfortunately, workers who suffer from pronator teres syndrome may ultimately be medically required to avoid the types of repetitive motions required by their jobs.

If you’ve been diagnosed with pronator teres syndrome as the result of your work related activities, you should report the injury to your employer, and consider retaining an experienced workers’ compensation lawyer to make sure you get the benefits you are entitled to. To schedule a free, no-obligation consultation with one of our attorneys, contact Meuser & Associates at 877-746-5680, or click here to send us an email.

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Gillette-Type Repetitive Motion Injuries in Minnesota

When people think of on-the-job injuries, they often think of sudden, unexpected accidents, such as falling off a ladder, being involved in a car accident, slipping and falling, or injuries due to lifting heavy objects. These types of work injuries are known as “specific injuries” under Minnesota workers’ compensation law. These types of injuries are caused by an ascertainable event, at a specific time.

But what about injuries that occur over a long period of time, that weren’t necessarily caused by a specific event, and didn’t occur at one specific time? Under Minnesota work comp law, these types of injuries are known as Gillette-type injuries. They are also commonly referred to as cumulative trauma injuries or repetitive motion injuries.

Repetitive motion injuries or cumulative trauma injuries are referred to as Gillette-type based on the name of the case where the Minnesota Supreme Court recognized the compensability of these types of injuries. In Gillette, the court stated:

It is well established by the authorities that when the inevitable effects of an underlying condition are hastened by an injury that is sudden and violent or the result of unusual strain or exertion, the injury and its disabling consequences are compensable. It should further be conceded, however, that injuries may arise out of and in the course of the employment which do not occur suddenly or violently. In the course of one’s ordinary duties injuries may occur daily which cause minimal damage, the cumulative effect of which in the course of time may be as injurious as a single traumatic occurrence which is completely disabling. We have been presented with no good reason why compensation should be paid in one instance and not in the other.

Gillette v. Harold, Inc., 101 N.W.2d 200, 206 (1960).

People in occupations where their job duties require repetitive motions tend to be at greater risk for Gillette-type work injuries; however, almost any type of work activity can cause a cumulative trauma or repetitive motion injury. Repetitive motion injuries are frequently seen in the following types of occupations:

• Assemblers
• Machine operators
• Textile sewing machine operators
• Secretaries
• Cashiers
• Packaging operators
• Electronic assemblers
• Data entry workers
• Truck drivers
• Welders
• Butchers and meat cutters
• Bookkeepers
• Auditors
• Accountants
• Freight, stock and material handlers
• Carpenters
• Hairstylists
• Mechanics
• Dental hygienists
• Construction laborers

There are many factors that affect the development of repetitive motion, cumulative trauma, or Gillette-type injuries:

• Repetitive motion: when a task is repeated frequently it can cause strains and fatigue in muscles, joints and tendons.
• Forceful exertion: tasks that require force place a higher load or stress on muscles, tendons and joints.
• Awkward posture/position: poor posture while performing a task, especially a repetitive task, puts strain on joints and muscles.
• Duration: tasks that require the use of the same muscles for long periods of time can cause fatigue in those muscles and make them susceptible to injury.
• Compression: pressing body parts on hard or sharp surfaces causes a decrease in blood flow to the muscles, tendons and nerves in that area. This can cause symptoms of tingling, numbness and change in sensation, and lead to tissue damage in that area.
• Vibration: activities involving vibration put stress on individual parts or the whole body.
• Poor physical health: conditions such as diabetes, cardiovascular disease, Raynaud's, arthritis, smoking, alcoholism, gout, hypertension, poor nutrition, lack of exercise, stress and job dissatisfaction can increase the chance of developing a repetitive motion injury.

Common types of Gillette-type, repetitive motion, cumulative trauma injuries include:

• Tendinitis
• Bursitis
• Carpal tunnel syndrome
• Rotator cuff tears
• Lumbar or cervical disc degeneration
• Lumbar or cervical disc herniations or bulges
• Epicondylitis
• Trigger finger
• Tenosynovitis
• Ganglion cyst
• Hand-arm vibration syndrome
• Radial tunnel syndrome
• Cubital tunnel syndrome
• Thoracic outlet syndrome
• Plica syndrome
• Patellofemoral pain syndrome
• Medial collateral tears
• Meniscus tears

Gillette-type injuries are very frequently contested by employers and their workers’ compensation insurance company. If you have sustained a repetitive motion, cumulative trauma, or Gillette-type injury at work, call Meuser & Associates at 877-746-5680 or click here to send us an email to schedule a free consultation.

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Carpal Tunnel Syndrome and Minnesota Workers' Compensation

Carpal tunnel syndrome is one of the most common work-related injuries we see in our practice.

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes compressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers. The carpal “tunnel” is a narrow, rigid passageway of ligaments and bones at the wrist, and it houses the median nerve and tendons. Thickening of the tendons due to irritation or other swelling can cause the tunnel to narrow and cause compression on the median nerve. Compression of the median nerve can cause pain, weakness, and numbness into the hand and wrist, which can radiate up into the arm.

Symptoms of carpal tunnel syndrome can include:

• A burning sensation in the palm and fingers.
• Tingling or numbness in the palm and fingers.
• An itching sensation in the palm and fingers.
• A sensation of swelling, with or without actual visible swelling.
• Waking at night due to pain, burning, or numbness in the hands.
• Decreased grip strength.
• Difficulty grasping small objects.
• Loss of the ability to feel hot or cold.
• Sensation that the hands are “falling asleep.”
  

Usually, work-related carpal tunnel syndrome is the result of long-term repetitive motions. Carpal tunnel syndrome is commonly referred to as a repetitive motion injury or a Gillette-type injury under Minnesota workers’ compensation law.

Contrary to popular belief, carpal tunnel syndrome is not an injury that occurs only to office workers, nor is it an injury that only women experience. We frequently see injured workers, both men and women, with carpal tunnel syndrome as the result of repetitive motions in the following lines of employment:

• Assemblers
• Manufacturers
• Heavy Equipment Operators
• Press Operators
• Machine Operators
• Factory Workers
• Dental Hygienists
• Hairstylists
• Secretaries
• Administrative Assistants
• Data Entry Personnel
• Food Processors
• Packaging Workers
• Finishers
  

In order to diagnose carpal tunnel syndrome, frequently a doctor will examine the affected wrist for tenderness, swelling, warmth, and discoloration. The fingers will also be tested for sensation, and muscles at the base of the hand will be tested for strength and signs of atrophy. The doctor may order laboratory tests and X-rays to rule out other conditions. If carpal tunnel syndrome is suspected, a doctor may order a nerve conduction study to diagnose damage to the median nerve. Ultrasound imaging may also be used to confirm a diagnosis of carpal tunnel syndrome.

Conservative treatment for carpal tunnel syndrome often involves avoiding repetitive motions, icing, splints or braces, anti-inflammatory medication, pain medication, corticosteriodal medications or injections, and/or physical therapy and exercise.

If conservative treatments are not effective at relieving symptoms, surgical treatment may be indicated. Carpal tunnel release is one of the most common surgical procedures in the United States. Surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve. It can be an open release surgery or an endoscopic surgery. It is often an outpatient procedure, performed under local anesthesia. Following surgery, patients usually require physical therapy to restore wrist strength, and they may need to adjust their job duties or even change jobs to avoid recurrence of the injury.

Carpal tunnel syndrome is a serious injury, and it can cause an employee to lose a lot of time from work. If the employee’s job duties require repetitive motions, and the employer cannot (or will not) accommodate an employee’s need to avoid repetitive motions, that employee may also lose his or her job. Work-related carpal tunnel syndrome is covered by Minnesota workers’ compensation. If you suffer from work-related carpal tunnel syndrome, you may be entitled to medical benefits, wage loss benefits, permanency benefits, and rehabilitation benefits.

In addition to work-related repetitive motions, it is also thought that carpal tunnel syndrome may be a genetic condition, or that it is related to diabetes, arthritis, and obesity. Workers’ compensation insurance companies frequently argue that an employee’s carpal tunnel syndrome was caused by something other than his or her work activities. Moreover, it is often very difficult for an employee to go back to work in his or her original position if the job duties include repetitive motions. Some employers cannot or will not accommodate an employee’s need to avoid repetitive work, and suddenly that employee finds his or herself looking for a new line of work. If you suffer from work-related carpal tunnel syndrome, it is wise to consult with an experienced workers’ compensation lawyer.

In our experience, workers’ compensation insurance companies frequently dispute that the employee’s carpal tunnel syndrome was caused by the employee’s work. To schedule a free, no obligation consultation, call Meuser & Associates at 877-746-5680 or click here to send us an email.

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Occupational Hearing Loss and Minnesota Workers' Compensation

Hearing loss that is caused by work or occupational activities is covered by workers’ compensation. Hearing loss can be caused by a blow to the head which causes injury to the brain or the structure of the ear. It can also be caused by exposure to certain kinds of chemicals, such as Ototoxic medicines (including certain antibiotics) and other substances (such as arsenic, mercury, tin, lead, and manganese). More commonly, occupational hearing loss is caused by exposure to noise or vibration that causes damage to the inner ear. This is also known as acoustic trauma.

Symptoms of hearing loss include:

• Decreased hearing
• Muffled hearing
• Difficulty understanding speech
• Ringing, roaring, hissing, or buzzing in the ear (tinnitus)
• Ear pain, itching, or irritation
• Pus or fluid leaking from the ear. This may result from an injury or infection that is causing hearing loss
• Vertigo, which can occur with hearing loss caused by Ménière's disease, acoustic neuroma, or labyrinthitis.
  

Sounds above 90 decibels (dB, a measurement of the loudness or strength of vibration of a sound), particularly if the sound is prolonged, may cause such intense vibration that the inner ear is damaged.

• 90 dB is about the loudness of a large truck about 5 yards away. Motorcycles, snowmobiles, and similar engines range around 85 to 90 dB.
• 100 dB is reached by some rock concerts.
• 120 dB is a jackhammer from 3 feet away.
• 130 dB is a jet engine from 100 feet away.
  

People who work in certain types of jobs are more susceptible to hearing loss, including:

• Airport workers
• Landscapers
• People who work in the music industry
• Bartenders
  
• Police officers
• Firefighters
• Cab, truck, and bus drivers
• Hairstylists
• Mechanics
• Factory workers
• Farmers and agricultural workers
• Manufacturers
• Metal workers
• Construction workers
  

Construction workers are particularly at risk for hearing loss. The decibel (dB) measurement for some common construction tools are very high:

• Pneumatic chip hammer 103-113 dB
• Jackhammer 102-111 dB
• Stud welder 101 dB
• Concrete joint cutter 99-102 dB
• Bulldozer 93-96 dB
• Crane 90-96 dB
• Earth Tamper 90-96 dB
  
• Skilsaw 88-102 dB
• Hammer 87-95 dB
• Gradeall 87-94 dB
• Front-end loader 86-94 dB
• Backhoe 84-93 dB
• Garbage disposal (at 3 ft.) 80 dB
  
• Vacuum cleaner 70 dB
  

Hearing loss may be permanent. Treatment for hearing loss is to try to improve any remaining hearing, and to develop coping skills, such as lip reading. A hearing aid may also be prescribed to improve communication. Methods for protecting the ears from further damage may be recommended.

Steps can be taken to prevent or reduce the risks of hearing loss. You should protect your ears when you are exposed to loud noises by wearing protective ear plugs or earmuffs. You should also educate yourself about the hearing loss risks of activities such as attending loud concerts, snowmobiling, or firing guns.

Under Minnesota workers’ compensation, if your occupational activities are substantial contributing factors to your hearing loss, your condition is covered under workers’ compensation. Medical care and treatment for your hearing loss is covered by workers’ compensation insurance. If you are unable to work due to your hearing loss, you may be entitled to wage loss benefits. If you are unable to go back to your former employment due to your hearing loss, you may be eligible for rehabilitation or retraining benefits. Finally, depending on the extent of your hearing loss, you may be entitled to permanent partial disability compensation. If you or someone you know suffers from work-related hearing loss, contact Meuser & Associates for a free consultation. Make sure you get the benefits you are entitled to. Call us at 877-746-5680 or click here to send us an email. An ASL translator is available on request.

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Nerve Conduction Studies and Workers’ Compensation Injuries

Many types of work injuries, such as disc herniations that impinge on nerves, carpal tunnel syndrome, or ulnar neuropathy can cause nerve damage or insufficiencies.

A nerve conduction study is often done to evaluate paresthesias (numbness, tingling, burning) and or/weakness of the arms and legs. Some common disorders which can be diagnosed by nerve conduction studies are peripheral neuropathy, carpal tunnel syndrome, ulnar neuropathy, Guillain-Barré syndrome, Facioscapulohumeral muscular dystrophy, and spinal disc herniation.

During a nerve conduction study, specific nerves are stimulated and the study records their ability to send the impulse to the muscle. The study can show where there is damage to or a blockage of the nerve pathway. This can help isolate the location of abnormal sensations, such as numbness, tingling, or pain.

In the study, several flat metal disc electrodes are taped or pasted to your skin. A shock-emitting electrode is placed directly over the nerve to be studied. A recording electrode is placed over the muscles supplied by that nerve. Several, brief electrical pulses are sent to the nerve. You will feel a brief, burning pain, a tingling sensation and a twitching of the muscle when the electrical pulse is applied. It feels like the tingling you feel when you rub your feet on the carpet then touch a metal object. Each pulse is very brief (less than a millisecond).

The time it takes the muscle to contract in response to the electrical pulse is recorded. The speed of the response is called the conduction velocity. Nerve conduction studies show whether the nerves transmit electrical impulses to the muscles or up the sensory nerves at normal speeds (conduction velocities). Sensory nerves allow the brain to respond to pain, touch, temperature and vibration. Different nerves have different normal conduction velocities.

The results of a nerve conduction study can help diagnose a work-related injury. If the workers’ compensation insurer is denying payment for a nerve conduction study, if they are denying pre-approval for an appointment, or if you have sustained carpal tunnel syndrome, a disc herniation, ulnar neuropathy, or any other work related nerve injury, give us a call at 877-746-5680 or click here to send us an email to schedule a free consultation.

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Work-Related Rotator Cuff Tears

Rotator cuff tears are very common workplace injuries. They can be the result of a single, traumatic incident, or they can be caused by repetitive use. People who are especially at risk for repetitive use rotator cuff tears are those who engage in repetitive overhead motions.

The rotator cuff is made up of four muscles and a number of tendons that form a cover over the top of the upper arm bone. The rotator cuff holds the upper arm bone in place in the shoulder joint and allows the arm to rotate. The four muscles of the rotator cuff, the supraspinatus, infraspinatus, subacpularis, and teres minor muscles, are attached to the scapula on the back, and to the greater tuberosity of the humerus on the side and front of the shoulder.

Most rotator cuff tears occur in the supraspinatus muscle, but tears can occur in other parts of the cuff as well. Rotator cuff tears are generally classified into three types:

• Partial thickness tears are tears that do not go all the way through the tendon. They often appear as fraying of an intact tendon.

• Full thickness tears are tears that go all the way through the tendon. They can range in size from the size of a pin-point, to tears that involve the majority of the tendon. When there is a full thickness tear, the tendon is still substantially attached to the humeral head.

• Full thickness tears can also involve a complete detachment of the tendon from the humeral head which can cause serious impairment in shoulder motion and function.

Some symptoms of a rotator cuff tear include:

• Atrophy or thinning of the muscles about the shoulder
• Pain when lifting the arm
• Pain when lowering the arm from a fully raised position
• Weakness when lifting or rotating the arm
• Crepitus or crackling sensation when moving the shoulder in certain positions
  

Diagnosis of a rotator cuff tear is usually based on symptoms, examination, X-rays, MRI’s, or ultrasounds.

Often, conservative, or nonsurgical treatment can provide pain relief and improve the function of the shoulder. Conservative treatment options can include rest and limited overhead activity, use of a sling, anti-inflammatory medication, steroid injection, and physical therapy.

If conservative treatment does not relieve symptoms, if the tear causes severe pain, and if the strength and motion of the shoulder is significantly impaired, surgery may be considered as a treatment option.

The type of surgery performed depends on the type, size, shape, and location of the tear. A partial tear may require only a trimming procedure called a “debridement.” A complete tear is usually repaired by suturing the two sides of the tendon back together. If the tendon is torn away from the bone, it is usually repaired by reattaching it to the bone.

In general, there are three types of surgical procedures to repair a torn rotator cuff. An arthroscopic repair involves insertion of a fiber-optic scope and small, fine instruments through a small incision. A mini-open repair involves a open surgery through a relatively small incision. Open surgical repair is often required if the tear is large or complex, or if additional reconstruction of the rotator cuff and shoulder joint must be performed. In some cases, where there is severe arthritis, total shoulder joint replacement may be an option.

Rehabilitation after surgery usually involves immobilization of the arm and physical therapy.

While rotator cuff tears can occur as the result of a specific trauma, more often, they occur over a long period of time. Under Minnesota workers’ compensation law, injuries that occur over a long period of time are known as Gillette-type injuries. Employees frequently have difficulty dealing with the workers’ compensation insurance company when the injury occurred as the result of repetitive use rather than as the result of a specific injury.

If you’ve sustained a rotator cuff tear as the result of your work activities, whether it was caused by a specific injury, or whether it was caused by years of overuse, and you’re having difficulties dealing with your employer or the workers’ compensation insurance company, call Meuser & Associates at 877-746-5680 or click here to email us to schedule a free consultation.

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