Diagnostic Tests for Cervical Herniated Discs

If your doctor suspects that you have a herniated disc in your cervical spine (neck) as the result of a work-related injury, you may be referred to undergo diagnostic tests to confirm a diagnosis. 

MRI 

An MRI (Magnetic Resonance Imaging) scan is the most common test used to diagnose a herniated disc. An MRI scan can image disc bulges, herniations, and nerve root impingement.

CT Scan

A CT (computerized tomography) scan combines x-ray views from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. A CT scan may also performed using injected contrast dye, called a CT myleogram, to better visualize nerve root compression.

Discography 

Discography involves the insertion of a small needle into the discs to inject contrast dye. If the injection reproduces your pain, it confirms that the injected disc is the source of your pain.

EMG 

An EMG (Electromyography) is an electrical test involving stimulating specific nerves and inserting needles into various muscles in the arms and legs that may be affected by a pinched nerve. An EMG can help confirm the presence of nerve impingement, and help pin-point which nerve is causing you trouble.

In Minnesota, if you’ve sustained a work-related injury, and your doctor directs you to undergo an MRI, a CT scan, a discography, or an EMG to help diagnose your injury, these tests are often covered by Minnesota workers’ compensation insurance. Referrals for diagnostic studies such as MRIs, CT scans, discograhpies, or EMGs, are commonly the source of disputes in Minnesota workers’ compensation cases.

If the workers’ compensation insurance company is refusing to authorize the diagnostic procedure your doctor has recommended, a Minnesota workers’ compensation lawyer can help you get the medical care you need. Call Meuser & Associate at 877-746-5680 or click here to send us an email for a free, no-obligation Minnesota workers’ compensation legal consultation. 

Alternative Treatments for Neck Pain

If you’ve got constant, severe neck pain that just won’t go away, it can be difficult to perform your activities of daily living, such as self-cares, cooking or cleaning, it can cause you to be depressed or irritable, leading to friction in your family relationships, and it can make it difficult, if not impossible, to be remain gainfully employed.

If you’re suffering from neck pain, and you’ve tried a variety of traditional treatment options, such as physical therapy, cortisone injections, narcotic pain medications, or surgical intervention, and you’re looking for other options, you may wish to ask your treating physician about alternative forms of treatment.

You might want to ask your doctor about:

Acupuncture: Many patients experience neck pain relief after a course of acupuncture treatments. Practitioners believe that acupuncture can help restore the healthy flow of energy in the body, which in turn can lead to pain relief. Acupuncture involves the insertion of fine needles into your body at specific points.

Herbal remedies: Ask your doctor before trying any herbal remedies. Some herbal remedies have side effects, and some can interfere with other prescribed medications. Some herbal remedies that may help with neck pain relief include capsaicin cream, devil’s claw, or white willow bark.

Massage: Stress can cause neck pain, and it can make neck pain worse. Massage helps release tension, and can help reduce muscle inflammation and pain.

Yoga or Pilates: Yoga and Pilates help increase your core strength, help improve your balance and posture, and help reduce stress. Increased strength, better balance and posture, and reduced stress can all help decrease neck pain.

Minnesota workers’ compensation covers almost any type of medical treatment, so long as it is reasonable and necessary, and causally related to your work injury. Several of our Minnesota workers’ compensation clients who are suffering neck injuries have had success in reducing their pain with acupuncture and massage. Unfortunately, workers’ compensation insurance companies sometimes tend to be somewhat wary about approving or paying for so-called “alternative” therapies.

For a free, no-obligation evaluation of your Minnesota workers’ compensation case, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

When Pain Interferes with Your Sleep

When pain interrupts your sleep, it can literally add insult to injury. If you’re dealing with a workers’ compensation injury, pain that interferes with your sleep can take an additional toll on your physical health, your mental well-being, your ability to work and engage in recreational activities, and your personal relationships. 


Unfortunately, one of the most common things we hear from our injured worker clients is that their pain is interrupting their sleep, which can negatively impact all other areas of a person’s life.

According to the National Sleep Foundation, the types of pain most commonly associated with insomnia include back pain, headaches, and temporomandibbular joint (TMJ) syndrome. Musculoskeletal pain, including arthritis and fibromyalgia, can also cause sleep problems.

Pain Interferes With Sleep

Pain disrupts sleep cycles. If pain wakes you up, it can cause you to miss out on deep sleep, and REM (rapid eye movement) sleep. Losing out on this more restful sleep can not only make you feel run down and fatigued, but it can also increase your sensitivity to pain, creating a vicious cycle.

Pain can affect sleep position. Arthritic pain and orthopedic pain can make it difficult to get comfortable at night. Joint and muscle pain can make it difficult to stay asleep at night. Lack of sleep makes you more sensitive to pain. Some research indicates that sleep deprivation causes increased production of chemicals that cause inflammation in the body, which can in turn, cause pain.

Some narcotic pain medications interrupt sleep. Some pain medications, such as codeine and morphine, can cause insomnia. They can also cause apnea, or brief pauses in breathing, during sleep.

Chronic pain may make it difficult to be active. Decreased activity level and lack of exercise can cause weight gain. Added weight can lead to sleep apnea, which can prevent restful sleep.

Getting the Sleep You Need 

• Meditate or try other relaxation techniques. Guided meditation, tai chi, yoga and other forms of meditation can help train your mind to ignore pain.  
• Get a massage. Research indicates that people that had massages twice a week experienced better sleep and less low back pain. 
• Get active. Regular exercise can help with both pain and insomnia. Moderate, low-impact exercises, such as walking, yoga, or swimming, done early in the day, can help with both pain control and can improve your sleep.
• Avoid long naps late in the day. 
• Take a warm bath or shower before bed. 
• Play relaxation CD’s with soothing sounds to fall asleep. 
• Remove all light-producing appliances from your bedroom, including the TV. 
• Abstain from alcohol in the evening. Alcohol disrupts sleep cycles. 
• Run a fan or other white noise machine. White noise can drown out outside noises.
• Avoid caffeine after noon. 
• Don’t exercise or eat within three hours of going to bed. 

If you are having difficulty sleeping due to pain from a work-related injury, talk to your doctor. There are a variety of treatments available, including medication, physical therapy, and other treatments.

In Minnesota, if your work-related injury is causing you to have sleep problems, you may be eligible for medical care for your sleep problem that is covered by the workers’ compensation insurance company. Don’t let insomnia make your work injury worse. 

Call Meuser & Associate at 877-746-5680 or click here to send us an email for a free, no-obligation workers’ compensation case consultation.

 

Epidural Steroid Injections of the Neck and Back: Minnesota Workers’ Compensation

Epidural injections deliver steroids into the epidural space around the spinal nerve roots to relive pain caused by irritated spinal nerves. The steroid reduces inflammation of the nerves, which are often the source of pain. About 50% of patients receive significant pain relief following an injection. The purpose of epidural steroid injections is to help patients get enough pain relief in order to be able to undergo rehabilitation program. Unfortunately, epidural steroid injections don’t actually cure the underlying problem.

Spinal nerves can become inflamed due to irritation from a damaged disc or contact with bone spurs. Symptoms of nerve inflammation can cause pain and/or numbness and tingling in parts of the body associated with the nerve.

Nerve irritation in the cervical spine can cause:

• Neck pain, tingling, or numbness. 
• Shoulder pain, tingling, or numbness. 
• Arm pain, tingling, or numbness. 

Nerve irritation in the thoracic spine can cause:

• Upper back pain. 
• Pain along the ribs to the chest wall. 
• Pain in the abdomen. 

Nerve irritation in the lumbar spine can cause:

• Low back pain. 
• Hip pain. 
• Buttock pain. 
• Leg pain, tingling, or numbness. 

Before the injection is administered, the patient is given a local anesthetic to the area that is to be injected. The injection is performed using a guided x-ray procedure called fluoroscopy. Contrast dye and a combination of numbing medicine and an anti-inflammatory medicine are injected into the epidural space. The procedure generally takes about 30 minutes, followed by approximately 45 minutes of recovery time. Some patients may experience partial numbness from the anesthetic in the arms or legs, which usually subsides after a few hours. Pain levels after an epidural steroid injection should be documented in a “pain diary” so the treating physician can evaluate the effectiveness of the injection. Improvements in pain will generally occur within 10 days after the injection, and may begin as soon as one day after the injection.

For more information about spinal epidural injections check out Spine-Health.com.

Workers with neck and back injuries frequently undergo one or more epidural steroid injections, with varying degrees of success. If you’ve sustained an on-the-job injury, contact Meuser & Associate for a free, no obligation consultation to learn more about your Minnesota workers’ compensation rights. Call us at 877-746-5680 or click here to send us an email. 

Work-Related Herniated Disc: Non-Surgical Treatment Options

Low back herniated disc injuries are the most common work-related injury we see in our Minnesota workers’ compensation practice. 

While a good portion of our clients do ultimately require some sort of surgery to address their herniated discs, many of our clients experience improvements in their condition, or they are able to manage their symptoms through other, non-surgical medical treatments.

During the initial time period following a lumbar herniated disc injury, many patients will try a variety of “conservative” treatments to alleviate pain from the herniated disc, and to give the disc herniation time to heal. If an injured worker experiences symptom relief with non-surgical options within the first several weeks following the disc herniated injury, continued non-surgical treatment may be appropriate.

Some types of non-surgical disc herniation treatment options include:

Chiropractic treatment and physical therapy. If symptoms persist for several weeks, a trial of chiropractic or osteopathic manipulation and/or physical therapy may be warranted. The goals of chiropractic/osteopathic manipulation and physical therapy are to reduce pain and to help the patient return to his or her normal level of function.

Medications. Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain caused by a disc herniation. Oral steroids may also be utilized to try to reduce inflammation promote healing of a herniated disc. Narcotic pain medications may be prescribed to reduce acute pain. Muscle relaxers may be prescribed to reduce muscle spasm, and to encourage healing in the affected area.

Epidural steroid injections. Injections of steroids directly into the area of the disc herniation can help reduce inflammation and promote healing. Patients may experience pain relief that can last from one week up to a year. Up to three injections may be done within a year.

In Minnesota, if you sustain a work-related herniated disc, the workers’ compensation insurance company is required to pay for reasonable and necessary medical expenses, which may include chiropractic treatments and physical therapy, medications, and injections, and a variety of other medical treatments.

Lumbar herniated discs can be extremely painful and can seriously interfere with your ability to work. Herniated discs are the most common work-related injury we see in our workers’ compensation practice. To learn more about your Minnesota workers’ compensation rights, call Meuser & Associate at 877-746-5680, or click here to send us an email to schedule a free, no-obligation case consultation. 

Work Comp. is Denying My Surgery, What Do I Do?: MN Workers' Compensation

We often get calls from folks who have Minnesota work-related injuries who find themselves in a difficult spot when the workers’ compensation insurance company refuses to authorize a proposed surgery or other recommended treatment. 

 A workers’ compensation insurance company frequently refuses to authorize surgeries and other medical treatment either on the basis that the proposed surgery or treatment is not reasonable or necessary, that the proposed treatment or surgery is outside the Minnesota permanent treatment parameters, or that the underlying injury is not a substantial contributing factor to your need for surgery or other medical treatment. Often times, the workers’ compensation insurer will base its denial on the findings of an Independent Medical Exam. Unless the proposed surgery is done on an emergency basis, the workers’ compensation insurer does have the right to require you to attend an Independent Medical Examination before agreeing to the proposed treatment.

No matter what the reason for the denial, don't have to simply accept it if the workers' compensation insurance company disputes your entitlement to medical care!

The rules and hoop-jumping that can go along with getting pre-approval for surgical treatment in a Minnesota workers’ compensation case can, unfortunately, substantially delay your medical care.

Where medical care is disputed in a Minnesota workers’ compensation case, particularly in disputes over pre-authorization for surgery or other treatment, there are procedures that allow many of these disputes to be heard on an expedited, or “fast-track” basis. In some cases, the injured worker can file a Request for Certification of Dispute, and a Medical Request, and the issue will be heard at the Department of Labor and Industry at an Administrative Conference. Other cases are initiated by filing a Claim Petition, and the issue is heard by a judge at the Office of Administrative Hearings.

Unfortunately, disputes over medical care are very common in Minnesota workers’ compensation cases. In fact, it’s not unusual to have multiple disputes over medical care during the course of an injured worker’s claim. When an insurance company starts disputing medical care on a workers’ compensation case, it’s usually only a matter of time before they start disputing other benefits, if they haven’t already been denied.

For a free, no-obligation case evaluation to learn more about your options when the workers’ compensation insurance company is disputing your medical care, call Meuser & Associate at 877-746-5680 or click here to send us an email. 

Back Pain Mistakes: MN Workers' Compensation

Back injuries are the most common type of work-related injury we see in our Minnesota workers’ compensation law practice. 

Dealing with severe or chronic back pain due to a work injury can be incredibly difficult. According to Spine-Health.com, avoiding some common mistakes can help keep you from making your back pain worse.

1. Ignoring your pain for too long. Often, an acute attack of low back pain will get better within a few weeks, but that doesn’t mean you should ignore it. For chronic or severe back pain, a spine specialist may be able to give you a diagnosis and treatment plan to help you manage or reduce your pain.
2. Relying on your general practitioner for too long. If your back pain is severe and/or lasts for more than a few weeks, you may need to see someone with more specialized training in back pain, such as a chiropractor or spine specialist. A spine specialist may be able to give you a better diagnosis and treatment plan than a general practitioner. 
3. Jumping to surgery too quickly. Surgery is not necessarily a “quick fix.” In most cases, it is typically recommended that back pain patients try non-surgical, or conservative treatment, such as chiropractic care or physical therapy, for several weeks or months before seeing a spine surgeon. While surgery can correct a structural problem in the spine, such as a disc pressing a nerve, a sustained exercise and rehabilitation program can often promote long-term recovery.
4. Postponing back surgery for too long. For some types of back conditions, such as those involving nerve root compression, patients often tend to do better if they have surgery sooner, rather than later. 
5. Focusing on MRI results. While an MRI scan can show areas of your spine that might be responsible for causing your pain, you need a full clinical diagnosis to determine an appropriate treatment plan. Often patients with severe back pain have a normal MRI scan, and individuals with significant structural abnormalities on an MRI have no back pain. 
6. Being inactive. Often people with back pain try to avoid aggravating their back pain or triggering pain flare-ups by limiting their physical activity. Over time, however, lack of activity often leads to more pain. Keeping your back flexible and strong improves your core support, hastens the healing process, and reduces the chances of future injury or aggravations. 

In addition to the pain you have to deal with as a result of a work-related back injury, you may suddenly be looking at significant medical expense, an extended time off work, or even a permanent disability.

In Minnesota, if you sustain an on-the-job back injury, you may be eligible for workers’ compensation benefits, including medical expense benefits, wage loss benefits, vocational rehabilitation benefits, and/or permanent partial disability benefits. For a free, no-obligation case consultation, call Meuser & Associate at 877-746-5680 or click here to send us an email to speak with one of our Minnesota workers’ compensation attorneys.

Medical Mileage Reimbursement for MN Workers’ Compensation Injuries

One of the workers’ compensation benefits provided to injured workers in Minnesota is reimbursement for medical mileage. 

This is also one of the most frequently overlooked benefits. If you don’t submit your medical mileage to the insurer for reimbursement, they aren’t going to pay it.

The current medical mileage reimbursement rate for travel for medical care or treatment for a work-related injury, on or after July 1, 2011 is 55 ½ cents per mile.  If you’re traveling back and forth to multiple doctor appointments, chiropractor visits, or physical therapy, your claim for medical mileage reimbursement, your mileage reimbursement claim can really add up.

The most challenging aspect to making a claim for medical mileage reimbursement is remembering to keep track of your round trip mileage to and from your appointments, and remembering to periodically submit your mileage to the workers’ compensation insurer for reimbursement.

For a free, no-obligation consultation to learn more about your Minnesota workers’ compensation rights, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Treatment for Burn Injuries

Severe burn injuries caused by car accidents or workplace accidents, often require hospitalization. Burn injuries are treated with a variety of types of treatment. For example, treatment may include: 

• Topical treatments with antibiotics. Patients with severe burn injuries are susceptible to viral and bacterial infections. Topical antibiotic medications may be applied to the skin to speed the healing process, to minimize scarring, and to prevent infection. 
• Bandages. Serious burns typically need to be bandaged to prevent infection, and to allow the wound to remain clear of fluids and pus. Bandages also help reduce pain and keep the skin and body part immobilized during healing.
• Pressure garments. Pressure garments are often worn on a burned area during the healing process to help prevent excessive scarring. 
• Elevating burned areas. Elevation helps minimize swelling of the affected limb. In severe burns, fluid often accumulates in the wounded area, causing swelling. Swelling can complicate a burn injury because the affected area can develop high levels of pressure and blood flow problems. 
• Surgical cuts or escharectomies. This procedure helps reduce excess pressure under the skin in a burned limb. 
• Skin grafts. This procedure involves transplanting a piece of skin from one area of the body to another. 
• Synthetic skin grafts. If a large portion of a victim’s skin is burned, synthetic skin may be used instead of the victim’s own skin. 
• Physical therapy. During healing, scar tissue is formed. To help keep the newly formed skin flexible for normal movement, burn victims may participate in rehabilitation and physical therapy. If the burn extends through the skin into the muscle tissue, more intensive physical therapy may assist in a patient’s recovery. 
• Dermabrasion. This is a surgical procedure to improve or minimize the appearance of scars, restore function and correct disfigurements as a result of a burn. 

If you’ve suffered burns as a result of a motor vehicle accident, in Minnesota, your auto insurance company is obligated to pay for up to $20,000.00 for your medical expenses. These are known as personal injury protection benefits. In addition to claims for your past and future medical expenses, you may be able to make a claim for past and future wage loss and past and future pain and suffering as part of a civil liability claim against the at-fault driver.

If you suffered burn injuries as the result of a workplace accident, you may be eligible for Minnesota workers’ compensation benefits, including medical expense benefits, wage loss benefits, permanent partial disability benefits, and rehabilitation benefits.

If you’ve suffered a burn injury as the result of a car accident or workplace injury, a Minnesota personal injury lawyer or workers’ compensation lawyer can help you through the process of making sure you get the benefits you’re entitled to. For a free, no-obligation consultation, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Facet Joint Disorders and Back Pain: MN Workers’ Compensation

One common source of neck and back pain among our Minnesota workers’ compensation clients is facet joint disorders. Facet joints are small stabilizing joints located between and behind the vertebra of the spine. Facet joints prevent excessive motion, over-twisting, and slipping of the vertebrae. They slide on each other and are normally coated by a very low friction, moist cartilage. A small sack or capsule provides lubricant for the facet joint.

The facet joints are in almost constant motion with the spine, and they often become degenerated, or wear out, due to overuse. When facet joints become worn or the cartilage is torn, bone spurs can develop in adjacent areas. This can cause considerable pain with movement and is known as “facet joint disease” or “facet joint syndrome.”

Diagnosing facet joint problems can be difficult because the symptoms can be similar to other types of conditions, such as a herniated disc, a vertebral fracture, or a torn muscle. Symptoms of facet joint problems can include:

• Acute episodes of neck or back pain a few times a month or year. 
• Persistent point tenderness overlying the inflamed facet joints. 
• Loss of spinal muscle flexibility, also known as guarding. 
• More discomfort with backward leaning than forward leaning. 
• Radiating pain down the buttock and the back of the upper leg. 
• Locally radiating pain, or pain into the shoulders or upper back. 

Diagnosing facet joint problems often involves x-rays or a CT scan. Facet joint injections can also be used to diagnose a facet joint problem if a patient experiences pain relief following the injections.

There are a number of treatment options for facet joint disorders that can help with reducing the severity, persistence, and frequency of flare-ups. Conservative measure can include physical therapy and exercise, heat or cold therapy, avoiding static position, use of anti-inflammatory medications, chiropractic or osteopathic manipulation, and traction. More invasive options can include facet joint injections, facet rhizotomy, or fusion surgery.

Diagnosing facet joint problems often involves eliminating other possible causes of neck or back pain. This can be a frustrating process. It can also lead to disputes in workers’ compensation cases due to the difficulty in diagnosing the condition. As a rule, the more difficulty a condition is to diagnose, the more difficulty a patient will have securing the medical care they need from their workers’ compensation insurer.

Visit Spine-Health.com for more information about facet joint problems. 

If you’ve suffering from facet joint problems, or any other back problem, due to a work injury or your work activities, we can help make sure you get the medical care you need. We can also make sure you get the Minnesota workers’ compensation benefits you’re entitled to if you’re having difficulty doing your job because of your symptoms. For a free, no obligation consultation, contact Meuser & Associate at 877-746-5680 or click here to send us an email. 

New Study Shows Meditation Helps Reduce Pain

I ran across an interesting article in Medical News Today reporting on a recent study out of Wake Forest studying the effects of meditation on reducing pain.

Healthy individuals were subjected pain stimulation while their brain activity was monitored on an MRI.

After these individuals were trained in meditation techniques, MRI imaging showed a reduction in the areas of the brain that were activated in response to pain without using meditation techniques.

In addition to the differences evident in the MRI scans, Dr. Fadel Zeidan noted that meditation also produced a significant reduction in pain intensity and in pain unpleasantness. Specifically, meditation resulted in about a 40 percent reduction in pain intensity and a 57 percent reduction in pain unpleasantness.

The type of meditation used during this study was Shamatha, which focuses on learning how to observe what’s going on in one’s mind and body without judging, and while maintaining focus on one’s breathing or a chanted mantra.

Interesting stuff. Obviously, not all pain can be relieved or cured by meditating, but this study seems to show that meditation may be an option for people who have run out of other medical treatment options to control their pain. Certainly, if an pain can be reduced, it can improve his or her functioning and quality of life.

I haven’t run across a Minnesota case yet in my practice where an individual has specifically sought payment from a workers’ compensation insurer for a course of training in meditation techniques. However, many chronic pain programs designed to help seriously injured individuals learn cope with pain do utilize meditation as a pain control technique.

Under Minnesota workers’ compensation law, most types of medical treatment are covered. So-called alternative or holistic treatments are also generally covered, although they are often disputed by the workers’ compensation insurance companies. In my opinion, if an injured worker’s doctor has recommended a course of training in meditation techniques to help control pain, and if meditation does indeed help an individual control his or her pain levels, certainly that would be preferable to taking daily doses of narcotic medication, both for the injured worker, and for the insurance company who foots the bill.

There are a wide variety of medical benefits available to injured workers under Minnesota workers’ compensation, in addition to other benefits. To learn more about your Minnesota workers’ compensation rights, contact us at 877-746-5680 or click here to send us an email to schedule a free, no-obligation consultation with Jen Yackley or Ron Meuser.

Medical Bills Leading Cause of Bankruptcy: Don’t Let Work Comp. or Personal Injury Bills Send You Into Financial Ruin

I ran across an interesting article in the Hutchinson Leader about the rates of bankruptcy filings related to medical bills. Dr. David Himmelstein, a professor of public health at City University in New York and an associate professor of medicine at Harvard Medical School noted that medical-related bankruptcies went up substantially between 2002 and 2007, even before the economic recession began.

Interestingly, the vast majority of people filing for bankruptcy due to medical bills actually had some form of insurance. Dr. Himmelstein noted that “[m]ost people who are driven into bankruptcy by illness and medical bills actually have coverage, but it’s such inadequate coverage that it doesn’t keep them from financial ruin…they’re facing huge premiums and copayments and deductibles – and things that aren’t covered by their insurance.”

Dr. Himmelstein cautions against targeting public-sector health benefits and benefits through health and human services for budget cuts. Leaving people with worse coverage will lead to more people incurring greater medical expenses.

If you’ve sustained a personal injury as a result of a motor vehicle accident due to someone else’s fault, or if you’ve sustained a work-related injury and the insurance company is denying your claim, outstanding medical bills can pile up quickly. We can help get these bills paid. Don’t let an injury force you into financial ruin.

We understand how frustrating and stressful it can be when you're injured and your medical bills are piling up. If you're off work, and you've lost your insurance, paying for your bills out of pocket probably isn't an option. We can help get those bills paid.

If you’ve sustained a Minnesota work injury or personal injury, and need help with your medical expenses, contact us for a free, no-obligation consultation. Call us at 877-746-5680 or click here to send us an email to speak with one of our lawyers.

Visit us at MeuserLaw.com!

Do I Need an MRI?

The MRI (Magnetic Resonance Imaging) was developed in the 1980’s and has been used since that time to diagnose and treat back pain. The MRI is considered to be the single best imaging technique to determine the cause of back pain and to develop a treatment plan. MRI’s provide a detailed image of the spinal anatomy, including the anatomy of discs, nerve roots, and bony structures.

MRI scans are useful for:

• Assessing the health of the intervertebral discs
• Revealing fractures not seen on x-rays or CT scans
• Diagnosing tumors or infection in the spine
• Diagnosing disc herniations and nerve impingement
• Assessing the success of a surgical intervention

An MRI works by rotating a magnet around the patient which causes a reaction in the hydrogen atoms in the body. The hydrogen atoms emit a small amount of radiation that is recorded in the form of an image.

While an MRI can be useful in diagnosing a cause for back pain and developing a treatment plan, results of an MRI should not be read in isolation, but should be viewed as part of the patient’s entire medical situation. For instance, an “abnormality” that is revealed on an MRI does not always pinpoint the problem. Studies have shown that approximately 30% of the general population have an MRI-indicated disc abnormality, but no back pain.

MRI results should be correlated with a patient’s symptoms, including duration, location, and severity of pain, and any neurological deficits on physical examination.

An MRI of the spine is usually indicated in the following situations, although you and your doctor should make all treatment decisions:

• After 4 to 6 weeks of leg pain, if the pain is severe.
• After 3 to 6 months of the low back pain, if the pain is severe.
• If the back pain is accompanied by constitutional symptoms (such as loss of appetite, weight loss, fever, chills, shakes, or severe pain) which may indicate a spinal tumor or infection.
• For patients who are considering an epidural injection.
• For patients who do not experience expected improvement following spinal surgery.

If an individual is experiencing bowel or bladder incontinence or progressive weakness in the legs due to nerve damage, usually an MRI should be ordered immediately.

Workers’ compensation insurance companies very commonly refuse to approve an MRI that’s been ordered for an injured worker, whether it is to diagnose a suspected herniation, or to assess a patient’s improvement after a course of conservative care, or in anticipation of surgery. Don’t ignore disputes with the workers’ compensation insurance company!

If you’re having difficulty getting the medical treatment you need for your work injury, or to learn more about your Minnesota workers’ compensation rights, contact Meuser & Associates at 877-746-5680, or click here to send us an email.

MN Workers’ Compensation Benefits: Types of Benefits Available for Injured Workers in Minnesota

There are four main types of workers’ compensation benefits available to injured workers under the Minnesota Workers’ Compensation Act.

Medical Expense Benefits

If you’ve sustained a work-related injury in Minnesota, the employer and insurer are responsible for payment of “reasonable and necessary” medical care and treatment to cure and/or relieve the effects of the work injury. Covered treatments include, but are not limited to: hospitalization, prescriptions, medical mileage reimbursement, nursing services, chiropractic care, physical therapy, assistive devices, MRI’s, CT scans, EMG’s, counseling, injections, chronic pain management, psychological care, and occupational therapy.

Wage Loss Benefits

Temporary total disability benefits (TTD): Temporary total disability benefits are wage loss benefits available to injured workers who are completely unable to work, or who are released to return to work with restrictions, but are unable to find work within those restrictions. TTD is calculated at 2/3 of an injured worker’s average weekly wage (AWW) at the time of the injury. This benefit is current capped at a maximum of $850 per week, for a maximum of up to 130 weeks. An injured workers’ entitlement to temporary total disability (TTD) also ends 90 days after reaching maximum medical improvement (MMI), if the employee fails to conduct a diligent job search, if the employee is released to work without restrictions, or if the employee is terminated for misconduct.

Temporary partial disability benefits (TPD): Temporary partial disability benefits are wage loss benefits available to an injured worker who is back at work but is earning less than they were at the date of injury due to his or her work restrictions. TPD benefits are calculated by subtracting a worker’s post-injury earnings from their average weekly wage (AWW) at the time of the injury. The difference is then multiplied by 2/3 to determine the amount of temporary partial disability benefits. This benefit is limited to 225 weeks and is not payable more than 450 weeks after the date of the injury.

Permanent total disability benefits (PTD): Permanent total disability benefits are available for injured workers who are permanently prevented from performing any substantial gainful employment. This wage loss benefits is payable as 2/3 of the worker’s average weekly wage (AWW) through age 67. As of October 1, 1995, in order to qualify for permanent total disability (PTD) benefits, an injured worker must meet certain thresholds in addition to showing he or she is physically incapable of substantial gainful employment.

Permanent Partial Disability Benefits

Permanent partial disability (PPD) or permanency benefits is a payment for the loss of use of a body function. PPD benefits are paid in accordance with the permanent partial disability schedules set forth by the Department of Labor and Industry. These benefits are payable weekly or as a lump sum.

Rehabilitation Benefits

Rehabilitation benefits are available to injured workers that are having difficulty returning to their former job due to their work injury. Vocational rehabilitation services are provided by a Qualified Rehabilitation Consultant (QRC). You have the right to choose your own QRC. A QRC will provide you with an initial consultation to determine whether you're entitled to rehabilitation services. Rehabilitation services can include medical management, return to work services, job search and placement services, or formal retraining.

For a free, no-obligation consultation regarding your Minnesota workers’ compensation rights, contact Meuser & Associates at 877-746-5680, or click here to send us an email.

What is a Pinched Nerve?

Nerves extent from the brain through the spinal cord into the arms and legs and transmit messages in the form of electrical impulses to and from the brain and throughout the body. Nerves that extent from the spine into the arms or legs are called peripheral nerves.

If the nerve is pinched, the flow of messages is reduced or blocked. If the nerve is pinched or blocked long enough, the nerve may lose its ability to transmit electrical charges, and the muscles controlled by those nerves may not function properly, or the skin linked to that nerve may feel numb.

A nerve may become “pinched” as it leaves the spine by a herniated disc or bone spurs.

The symptoms of a pinched nerve depend on which nerve is being affected. A pinched nerve in the low back often includes radiating pain or numbness down the leg. A pinched nerve in the neck can cause pain or numbness in the arm and hand.

Muscle spasms and strains can also put pressure on a nerve, causing temporary pinched-nerve like symptoms. If your pinched nerve symptoms are caused by muscle spasm or sprain, you may be able to relieve those symptoms by:

• Alternating between heat and ice on the painful area
• Taking a hot shower
• Laying down with a rolled up towel under your neck
• Using a handheld massager
• Getting a massage
• Do range of motion stretches
• Take a light walk
• Take an over-the-counter anti-inflammatory

If you’ve suffered a pinched nerve as the result of a Minnesota work injury, you may be entitled to workers’ compensation benefits. For a free, no-obligation consultation to learn about your legal rights, call Meuser & Associates at 877-746-5680 or click here to send us an email.

Medical Expense Benefits – MN Workers’ Compensation

One of the benefits available to injured workers under Minnesota workers’ compensation law is coverage for reasonable and necessary medical expenses. Reasonable and necessary medical expenses are fully covered under Minnesota Workers’ Compensation, meaning that you do not pay a premium, you do not have a deductible, and you do not pay co-pays for these benefits.

Minnesota Statute §176.135 provides coverage for a wide variety of medical benefits, including, but not limited to:

• Medical treatment in an emergency room
• Appointments with a medical doctor
• Chiropractic treatment
• Prescription medications
• Over-the-counter medications
• Podiatric treatment
• Surgical treatment, hospitalization, and nursing services
• Home nursing services
• Crutches, walkers, and wheelchairs
• Diagnostic tests, such as X-rays, MRI’s, and CT scans
• Physical therapy and rehabilitation
• Preventative rabies treatment
• Dental treatment
• ….and pretty much anything else necessary to cure and/or relieve the effects of your injury.

That being said, there are treatment parameters that apply to certain types of medical treatment. For example, chiropractic treatment is generally limited for neck, upper back, low back and upper extremity injuries for a period of up to 12 weeks, plus an additional 12 visits over the next 12 months if certain requirements are met, although there are several exceptions to this rule.

The chiropractic treatment parameters are one of the most contentious issues in Minnesota workers’ compensation medical dispute cases. We regularly represent injured workers who receive substantial benefit from chiropractic treatment, but then, once they’ve reached twelve weeks of treatment, the workers’ compensation insurer stops paying.

We often speak with injured workers who are hesitant to retain an attorney when their case involves a relatively small dispute over medical treatment. Maybe the insurer hasn’t reimbursed them for some prescriptions. Or maybe the insurer won’t pre-approve a follow up MRI. Or maybe the insurer is refusing to pay for additional chiropractic treatment or physical therapy.

DON’T IGNORE MEDICAL DISPUTES WITH THE WORKERS’ COMPENSATION INSURANCE COMPANY!

Injured workers often wonder whether a Minnesota workers’ compensation lawyer will take their case if they just have a medical dispute. YES! Under Minnesota workers’ compensation law, if your case is limited to a dispute primarily involving medical issues, your workers’ compensation lawyer can petition the Office of Administrative Hearings to order the workers’ compensation insurer to pay your lawyer fees called Roraff fees, which are normally separate and above and beyond benefits payable directly to you.

We regularly represent injured Minnesota workers for claims involving primarily disputes over medical care. For example:

• We tried and won a case where a workers’ compensation insurer refused to pay a $90.00 bill for a follow up visit with the employee’s spine surgeon. The employee had previously undergone two back surgeries, and had settled her case, closing out monetary benefits. The insurer refused to pay the bill because the employee was pregnant when she had her appointment, and they argued that it was her pregnancy, not her two prior back surgeries for herniated discs, that was causing her back pain.
•  We represent an employee who settled his monetary benefits over 15 years ago. He has severe degenerative disc disease in his spine, and when he moved to Michigan, he couldn’t find a doctor who was willing to take on his challenging case. Each year, he returns to Minnesota for a follow up appointment with his surgeon, and each year, the insurer refuses to pay for his mileage and lodging, and each year, we file a claim on his behalf, and ultimately get the insurer to reimburse him.
• We represented a woman who sustained a severe shoulder injury in the early 1990’s. Over the last several years, she began developing severe low back pain, which we believed was related to the bone graft which was harvested from her pelvis on two separate occasions. We ultimately procured a monetary settlement on her behalf, and recently secured pre-approval from the insurer to return for a consultation for her shoulder injury with the surgeon who performed her sixth and final shoulder surgery almost 15 years ago.

For a free, no-obligation consultation with one of our workers’ compensation lawyers, call Meuser & Associates at 877-746-5680 or click here to send us an email.

What is a Minnesota Workers’ Compensation Functional Capacity Evaluation?

A Functional Capacity Evaluation (FCE) is a course of objective testing to determine your functional limitations following a work related injury. This testing typically involves an interview to determine what types of conditions you have, both work-related and non-work related, what types of treatment you’ve undergone, the type and intensity of symptoms you are experiencing, and how your symptoms impact your activities of daily living. The testing itself usually takes at least several hours, and may be conducted over the course of a couple days. The testing involves having you perform simulated work tasks such as lifting, pushing and pulling, squatting, overhead activities, and other activities relevant to your conditions.

The goal of this testing is to objectively measure your physical work limitations. Often times, this testing is done after you’ve reached Maximum Medical Improvement (MMI), to determine your permanent limitations. An FCE report will often list weight lifting limitations, limitations on bending, twisting, pushing, pulling, kneeling, overhead work, or limitations on sitting or standing for prolonged periods.

During the testing, you are not expected to continue to perform activities that cause you pain. However, the goal of the testing is to determine the maximum abilities you are able to perform. It is important to inform the tester when the activities you are performing cause you pain or discomfort. It is also critical that you don’t try to exaggerate your symptoms during the course of the testing. The testers are experts and will absolutely be able to tell if you are exaggerating. If you exaggerate, this will be put in writing in your FCE report. Almost nothing sinks an otherwise legitimate workers’ compensation case than an FCE report which indicates that the injured worker was exaggerating some of his or symptoms.

Your QRC will often use the results of your FCE to help define what types of work are appropriate for you, and to develop a plan to try to get you back to work within those restrictions.

For a free, no-obligation consultation regarding your Minnesota workers’ compensation case, contact Meuser & Associates at 877-746-5680 or click here to send us an email.

Increased Costs for Neck and Back Injuries Equals Increased Denials on Minnesota Workers' Compensation Claims

Apparently, there’s a new study that suggests that more U.S. health care dollars are spent on back pain and neck pain than almost any other medical condition. After adjusting for inflation, medical costs associated with back and neck pain increased by 65% between 1997 and 2005, to about $86 billion a year.

Back injuries are the most common work-related injury we see in our Minnesota workers’ compensation law practice. In one survey, one in four adults reported low back pain within the previous year.

According to a study published in the Feb. 13 issue of The Journal of the American Medical Association, the estimated annual individual expenditures among adults with back and neck problems were $4,695 in 1997 and $6,096 in 2005.

Some of the largest increases in costs related to neck and back treatment relates to prescription drugs. Pharmaceutical expenses related to back and neck pain increased by 188% between 1997 and 2005, and the cost of prescription narcotics increased 423%.

So what does this mean for Minnesota workers who have neck and back injuries? From what we have been seeing over the past couple years, it appears that workers’ compensation insurance adjusters are more aggressive in claim denials to reduce their per-claim expenditures, whether it be in their denials of primary liability, or in denying various treatments, including MRI’s, prescriptions, cortisone injections, or surgery for back and neck injuries.

Don’t ignore disputes over medical expenses with your workers’ compensation insurer!

If you are having difficulty procuring the medical treatment you need for your Minnesota workers’ compensation injury, contact Meuser & Associates, P.A., at 877-746-5680 or click here to send us an email for a free, no-obligation consultation with one of our Minnesota workers’ compensation lawyers.

Spinal Disc Herniation Injuries

One of the most common injuries we see in our workers’ compensation and personal injury practice is disc herniation. If you’ve suffered a disc herniation as the result of your work activities, or as the result of a motor vehicle collision, you may be entitled to compensation.

A disc herniation, also commonly referred to as a prolapsed disc, ruptured disc or “slipped disc,” is a medical condition affecting the spine, where a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus) of the disc to bulge out. A tear in the outer disc ring may cause the release of inflammatory chemicals into your body, causing severe pain. If the bulge or prolapse compresses on a nerve root, it can cause pain and symptoms extending from the neck or back into the arms or legs. A disc herniation may begin as a disc protrusion, or disc bulge, where the outer layers of the disc are intact, but protrude outward when the disc is under pressure.

Disc herniations can occur at any level of the spine, but most commonly, they occur in the cervical spine (neck) or in the lumbar spine (low back). Lumbar disc herniations occur 15 times more often than cervical spine disc herniations. Cervical disc herniations occur in 8% of cases, and herniations occur only 1-2% of the time in the thoracic spine (mid-to-upper-back). Lumbar disc herniations often cause leg pain, which is commonly referred to as sciatica.

Lumbar herniations occur most commonly between the fourth and fifth vertebrae (L4-L5), and between the fifth vertebrae and the sacrum (L5-S1). Symptoms from a herniation in the lumbar spine can affect the low back, buttocks, hips, thigh, calf, foot, and toes. The sciatic nerve can be affected, causing symptoms of sciatica. The femoral nerve can also be affected, causing a numb, tingling feeling throughout one or both legs, or a burning feeling in the hips and legs.

Cervical herniations occur most often between the sixth and seventh vertebrae (C6-C7). Symptoms from a herniation in the cervical spine can affect the back of the skull, the neck, shoulder girdle, scapula, arm, and hand. The nerves of the cervical plexus and brachial plexus can also be affected.

Interestingly, most disc herniations occur to persons in their thirties or forties. After age 50 or 60, intervetebral discs tend to “dry out” and are less likely to herniated. Low back pain after the age of 50 or 60 is more frequently caused by spinal degeneration or spinal stenosis.

Disc herniations can be caused by repetitive motions, overuse, general wear and tear, blunt force trauma, lifting injuries, sharp impacts, or a variety of other strains.

Symptoms of a herniated disc depend largely on the location of the herniation. Herniations can cause little or no pain, isolated to the neck or back, or they can cause severe and disabling pain throughout virtually the entire body. Other than pain symptoms, herniated discs can cause sensory changes, such as numbness, tingling, muscular weakness, paralysis, paresthesia, decreased sensation and decreased reflexes. Generally, symptoms are experienced on one side of the body or other, in correlation whith the side of the spine where the herniation has occurred. If the herniation is large and presses on the spinal cord or cauda equina in the lumbar spine, both sides of the body may be affected.

A herniated disc is diagnosed by a doctor based on the patient’s history, symptoms, and physical examination. If a disc herniation is suspected, X-rays, a CT-Scan, an MRI, or a Myelogram may be performed to confirm a suspected herniation and to pinpoint its location.

Many herniated discs will heal after several weeks or months without surgical intervention. Often, conservative therapies including chiropractic treatment, physical therapy, bed rest, support belts, prescription anti-inflammatory medications, yoga therapy, prescription pain killers, spinal decompression, prescription muscle relaxers, oral steroid medications, and cortisone and steroid injections, are used to treat the symptoms of a herniated disc.

Surgery is generally considered as a last resort after conservative treatments fail to relieve pain or heal the disc herniation. Surgery is generally required if a patient has a significant neurological deficit, such as paralysis or cauda equina syndrome (in which there is incontinence, weakness and genital numbness). This condition is considered a medical emergency.

Surgical options include:

• Microdiscectomy 
• IDET 
• Laminectomy 
• Hemilaminectomy 
• Lumbar/Cervical fusion
• Anterior cervical discectomy and fusion
• Disc arthroplasty 
• Dynamic stabilization
• Artificial disc replacement 
• Nucleoplasty

If you have sustained a herniated disc as the result of a work injury or car accident, a workers’ compensation lawyer or personal injury can help you get the compensation you deserve. To schedule a free, no-obligation consultation with one of our attorneys, call Meuser & Associate at 877-746-5680 or click here to send us an email.

Visit Minnesota Workers' Compensation and Personal Injury Law Firm, Meuser & Associates, P.A., at MeuserLaw.com

Physical Therapy is an Effective Treatment for Work-Related Low Back Injuries

A new review article published in the Journal of the American Academy of Orthopaedic Surgeons by the American Physical Therapy notes that physical therapy, in combination with anti-inflammatory medication, is the most effective treatment for low back pain caused by degenerative disc disease. The review concludes that most patients with symptoms due to degenerative disc disease receive relief from their symptoms without the need for surgical intervention.

Degenerative disc disease can be caused by an old acute injury to the spine, or it can be caused by long-term overuse. Symptomatic lumbar degenerative disc disease develops when a disc weakens, is injured, or deteriorates from aging. As a result, the disc causes the vertebrae to become unstable, which in turn can cause back pain. Approximately 75-85 percent of adults will be affected by low back pain at some point in time.

Exercise and manual therapy, including spinal manipulation was shown to benefit many patients. Additionally, patient education on exercises and appropriate body mechanics is helpful for patients with low back pain.

If conservative treatments fail to reduce a patient’s symptoms, surgery may become an option. However, Dr. Luke Madigan of Knoxville Orthopaedic Clinic in Knoxville, Tennessee, concluded that “[s]urgery should be the last option, but too often patients think of surgery as a cure all and are eager to embark on it.”

For many people with chronic or acute low back pain, whether it is caused by degenerative disc disease, or other spinal disorders, physical therapy may help improve pain symptoms, range of motion, vocational capacity, and quality of life.

If you have suffered a work-related back injury, physical therapy may be of benefit to you. Often, however, workers’ compensation insurance companies are hesitant to authorize or pay for physical therapy programs. If you want help with your Minnesota workers’ compensation case, or have questions about obtaining the medical treatment you need, contact Meuser & Associates for a free consultation. Call us at 877-746-5680 or click here to send us an email to schedule a free, no-obligation consultation.

Visit Minnesota Workers' Compensation and Personal Injury Law Firm, Meuser & Associates, P.A., at MeuserLaw.com