Overuse Syndrome After-A-Job-Injury is Reportable, Treatable, and Compensable.

Workers' Compensation

1/20/2012
Charles L. Powell
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Overuse Syndrome After-A-Job-Injury is Reportable, Treatable, and Compensable.

Every healthy person knows what happens when we overdo it. What happens if you double your exercise, if you double the grocery shopping, if you work an 80 hour week?

Sometimes the result is more than temporary soreness and temporary fatigue. Sometimes the result is overuse syndrome.

“Overuse syndrome” is exactly what it sounds like. It is a “syndrome” -- a collection of symptoms -- pain and restriction in ligaments, tendons, muscles or affected nerves involving an entire joint or region, as a result of “overusing” beyond biological design, over the intended physiological body limits.

OVERUSE ON THE JOB

In the case of Robin Brown-Williams vs. General Electric Transportation, Opinion No. 02-10WC (January 20, 2010), the employee had a “benching” job that required her to engage in sustained posturing so that while there was no direct trauma, there was repetitive overuse injury to the neck, right arm, elbow and wrist. The Department of Labor stated:

“… Claimant’s job involved not just repetitive motion, but also sustained posturing, force in vibration. In that context, I am convinced that the neck pain claimant noted…was not an isolated event. To the contrary, it comprised a symptom of work-related overuse involving her entire right upper extremity.”

OVERUSE AFTER-A- JOB-INJURY, WHICH CAUSES NEW INJURY

Overuse syndrome after-a-job-injury is an imbalance of load on one side of the body.

Instead of unloading the groceries using two hands, all the groceries are loaded and unloaded and brought into the residence with just one hand and one arm. Instead of writing notes in a class for vocational rehabilitation with the injured dominant hand, all writing is done with the non-injured non-dominant hand which has never been use to do any writing before. The “overused” limb or joint begins to feel sore, painful, achy. As “overuse” continues, the non-injured limb begins to bother the patient, and things get very difficult day by day.

There’s just one problem: The limb that is “overused” and painful wasn’t the one originally injured. Is it also reportable? Most employees mistakenly believe it will not be covered under workers’ compensation.

Armed with the mistaken belief that his overused joint can’t be claimed, the injured employee talks to the doctor about the injured limb. But the injured employee does not see any sense in bringing up the overuse syndrome in the non-injured limb. Though not unreal, the overuse syndrome is untold, unreported and unknown.

In most cases, the employee brings up an overuse after-a-job-injury problem only when it becomes practically impossible to use the overused joint or limb anymore, or when the overused limb or joint is so inflamed or is so painful that the employee can hardly stand it, and then asks about what the physician can do. Insurance companies are tempted to exploit the absence of discussion up until that point, the absence of examination up until that point, the absence of documentation in the medical records.

Overuse syndrome after-a-job-injury is compensable. That’s because Vermont workers’ compensation claim law requires the workers’ compensation insurer to pay for the reasonable medical expense of overuse syndrome as long as the doctor confirms that it is “related to” the work injury.

Physicians are familiar with overuse syndrome, and quickly understand when injured employees decide to mention that “this other arm” or “this other shoulder” is “really sore now.” They quite convincingly establish that the non-injured limb or joint would never have developed tendonitis, inflammation, nerve damage, etc., if the original work injury had never occurred. Put another way, if the reason why the limb is being “overused” is due to the fact that it is trying to make up all of the work that the injured arm can no longer do, then it is related to the work injury and it is compensable.

In a case of overuse syndrome after-a-job-injury called J.D. vs. Putney Paper Co., Opinion No. 1308WC (April 8, 2008), the primary injury was to the left arm, which led to overuse of the right:

“…following a referral by Dr. Beehler, Claimant was examined by Edward J. Orrechio, MD, a neurologist. Dr. Orrechio reported that Claimant had several medical issues with his right upper extremity, all related to overuse of the right arm, which is related to the original injury to the left upper extremity. Dr. Orrechio diagnosed and reported that Claimant had (1) a primary shoulder issue, (2) epicondylitis, and (3) carpal tunnel syndrome. … At Defendant’s request, Claimant was examined by Donald M. Kinley, MD, an orthopedic surgeon (Kinley IME). Dr. Kinley concluded that Claimant was suffering from overuse syndrome of the right upper extremity and required carpal tunnel surgery.”

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