Shoulder and Elbow Injuries

Workers' compensation laws require that an employee who has suffered a work-related injury get medical coverage, disability insurance, and vocational rehabilitation. In extreme scenarios where fatalities occur, the departed employee's family is entitled to death benefits and other compensations. The California Labor Codes 4663 is a directive for employers to cover injuries suffered by staff in the line of duty, but they are only liable for the percentage of permanent disability their employees suffer. Labor Code 4663 has the following provisions:

• The apportionment of enduring disability shall be based on causation.
• Any doctor who drafts a report addressing a permanent disability due to a claimed workplace injury shall explain the causation of the said permanent disability.
• For a doctor's report to be considered complete on the matter of permanent disability, it must have an apportionment determination of what approximate percentage of the permanent disability was caused as a direct result of workplace injury and what other factors caused were at play. These factors could have played a role prior to and after the industrial injury, and they include previous cases of industrial injuries suffered by the employee.
• If the attending physician is unable to include an apportionment determination in their report, they are required to state the specific reasons for not adding the effect of a pre-existing condition on the permanent disability under investigation.
• The physician will then consult with other doctors or refer the employee to another doctor from whom the employee is allowed to seek treatment or evaluation as per these Labor Codes so they can make the final evaluation.
• An employee who is pursuing a claim of industrial injury shall, upon request, divulge all previous enduring disabilities or impairments on their body even if not precisely the presently injured parts.

Minor shoulder and elbow problems like aches and pains and sore muscles are relatively common. These problems can arise from everyday wear and tear, overuse, or an injury that goes undetected over time. The natural process of aging also plays a role in how our bodies function and with time, wear and tear of joints are inevitable. In general, workplace shoulder and elbow injuries happen when too much stress is placed on the joint or other tissue and when an activity is done repeatedly or when overdoing an exercise.

Shoulder injuries can either be minor or severe enough to warrant medical intervention. Common symptoms of these problems may include excruciating or mild pain, swelling, numbness, tingling, or general weakness of the shoulder or elbow. Changes in temperature, color or range of motion are also frequent. Acute injuries or overuse injuries are also responsible for shoulder problems.

You need your elbow to throw, lift, swing, and hug your loved ones. Thus, an elbow injury poses a significant inconvenience and it must be dealt with as soon as possible to get you back to your normal life. There are two broad categories of elbow injuries that you could incur in the workplace:

1. One-time Injuries

These are injuries that occur instantaneously and cause immediate harm as explained below:

• Dislocated elbow – this happens when one of the bones that form the elbow is moved out of place, perhaps when bracing against a fall with your hand.
• Strains and sprains – this injury happens when muscles get stretched or torn after suffering excessive strain such as pushing a load that is disproportionate to your weight. If the ligaments are affected, then the injury is called a sprain.
• Fractured elbow – this happens when one of your arm bones breaks at the elbow joint after an unexpected blow during an accident. Moving your elbow afterward does not mean all is well and the pain could get worse if you postpone getting medical attention.

2. Wear and Tear Injuries

These are elbow injuries that occur over time after repeating certain activities that create wear and tear on the elbow.

• Bursitis – bursa are small fluid-filled sacs found inside joints to help cushion your bones, tendons, and muscles. They can become swollen after repeating the same motion over time or from an accident or infection thus causing you pain. A physician will prescribe pain medicine to manage the discomfort.
• Stress fractures – this is a tiny crack in one of your arm bones that occurs after overuse of the elbow such as reaching for items that are too far. The pain gets worse each time you exert pressure on the affected elbow.
• Trapped nerves – this condition happens when a nerve that passes through your wrist is squeezed thus triggering wrist, arm, and elbow problems that can impede the functionality of your hand. Other associated conditions include radial tunnel syndrome and cubital tunnel syndrome which can create a burning sensation and numbness in your arm.

There are two broad classifications of shoulder injuries, in this case, depending on what triggered them.

1. Sudden (Acute) Injury

Acute injuries are the most common causes of shoulder-related problems. An unexpected injury may arise from a fall landing on an outstretched arm, an abnormal twisting or bending of the shoulder or a direct blow to the shoulder. The person will experience sudden and severe pain followed by bruising and swelling right after depending on the force exerted on the shoulder. If nerves or blood vessels were hurt, your shoulder might feel numb, tingly, or cold for a while. You may also notice paleness or blue discoloration at the point of impact.

Acute injuries on the shoulder include the following:

• Bruises or contusions which ensue when small blood vessels under the skin tear or rupture after a fall perhaps from a scaffold, twisting when handling heavy machinery, or a direct force on the shoulder. Blood leaks into tissues beneath the skin, and this is what causes discoloration on the surface as the bruise heals.
• Separation of the shoulder after the outer end of the collarbone (clavicle) separates from the end (acromion) of the shoulder blade due to torn fibers.
• Shoulder dislocation, when the bones that make up the shoulder joint are pulled or pushed out of their normal functioning relationship.
• An injury that damages the strong ligaments that connect bones and steady shoulder joints. A muscle strain can from carrying weighty items at work.
• Injuries to the sturdy and ropy fiber ligaments that connect muscles to tendons.
• Damage to one of the four tendons that cover the shoulder joint and this can arise from an overstretched ligament.
• Fracture on the shoulder after a bone is twisted used to brace against an imminent fall, or it is struck directly with force.
• Damage to nerves on the shoulders

2. Overuse Injuries

Overuse injuries are difficult to notice as the symptoms often develop over time as you carry out daily activities, and you may not have a specific injury calling your attention. When excessive stress is exerted on a joint or other tissue through repeated movement or overdoing a task at work, the result is an overuse injury.

Overuse injuries on the shoulder include the following scenarios:

• Inflammation of the sac of fluid that pads and lubricates the joint area between bones, a tendon, or the skin.
• Muscle strain or pulled muscle after overstretching or tearing of flesh and this is attributed to overuse, fatigue, or improper use of tissues. Stresses can occur anywhere, but they are most common on shoulders, hamstrings, or lower back.
• A frozen shoulder (adhesive capsulitis) is a limited range of motion on the shoulder and commonly occurs after an injury. Health conditions such as diabetes or a stroke can also contribute to this injury.
• Overhead arm movements may lead tendons to rub against the acromion which is part of the shoulder blade. This rubbing may trigger abrasion of the rotator cuff tendons, a condition otherwise known as impingement syndrome.
• Tendinitis, an inflammation of the firm and ropy ligaments that connect muscles to bones, can also cause overuse injuries.

3. Other Causes of Shoulder Injuries

Apart from acute and overuse shoulder injuries, there are other less common causes of shoulder injuries as listed below:

• Excess buildup of calcium in the tendons of the shoulder
• Shoulder injuries, particularly a dislocated shoulder, that cannot be explained, or there are dubious explanations, and it occurs routinely could be due to abuse
• A herniated disc in the neck that transfers pain to the shoulder joints
• Joint infections (infectious arthritis) and other kinds of medical issues like septic bursitis or osteomyelitis
• The tension in the muscles or poor posture
• Referred shoulder pain from other parts of the body
• Osteoarthritis where the cartilage that shields and pads shoulder joints collapse
• Invasive cancer that has spread to the bones of the shoulder

The worker can be oblivious of these injuries developing over time until they are overwhelmed by intense pain and possibly unable to work. Whether the injury occurs instantaneously or over time, it is imperative that you report any damage that happens in the line of duty to your supervisor or employer immediately. Follow this up with an injury report. Request medical treatment soon after so you can have a doctor examine the extent of your injuries and launch a recovery plan. Note that failure to promptly report injuries could lead to erroneous diagnosis by the insurance company physicians, who could attribute the damage to a non-work related activity. For instance, if you are an avid sports fan, the doctor could claim that you were injured during a baseball game at the local park.

Regrettably, many workers accept the flawed diagnosis and do not pursue alternatives like getting a second opinion from a doctor who is not attached to the insurance company. The second doctor is more likely to advocate for you as opposed to minding the welfare of your employer's insurance companies. Consulting with a workers comp attorney at this unfortunate time when you are experiencing pain may be the last thing on your mind, but it is an essential thing to do. If you are not in a position to speak, have your spouse or other trusted person act on your behalf.

Occupational Safety & Health Administration (OSHA) derives that repetitive stress injuries – also known as repetitive motion injuries or repetitive strain injuries – are the most common occupational injuries. In a 2013 report, the Bureau of Labor Statistics (BLS) derived that 33% of all absenteeism was linked to musculoskeletal disorders (MSD) like RSIs. Jobs that require you to perform the same manual tasks or stand in the same position for hours on end effectively heighten the risk of suffering from repetitive stress injuries. Unfortunately, RSIs develop over time, so most workers only seek medical intervention when the discomfort is unbearable. If RSIs are not attended to within a reasonable timeframe, these conditions can become debilitating so much that the worker is unable to perform normal tasks like grooming with ease.

Many factors pave the way for RSIs to befall a worker such as being assigned a task that is mismatched for your physical body; this will exert excessive wear and tear on the muscles and tendons of the shoulder, elbow, or another area. For instance, overstretching across a conveyor belt on the assembly line is bound to cause stress and strain on your back, neck, and shoulders. The human body is not made for stretching or bending in awkward positions for a long duration as this creates micro damages to the affected areas and eventually, an RSI or other condition develops.

Apart from these repetitive motions and excessive muscle strain, RSIs can be caused by:

• Operating vibrating equipment
• Remaining in a static position for excessive durations
• Working at very high speeds to increase production
• Routinely lifting heavy or awkwardly shaped objects
• Using equipment with a faulty design
• Working in a setting that is not ergonomically sound, especially when your work involves much sitting
• Not taking enough breaks to give muscles a rest

Generally, any worker who encounters the above causative factors is prone to getting RSIs, but there are occupations where workers sustain these injuries more often. For instance, construction workers, manufacturing and assembly line workers, truck and bus drivers, butchers and meat packers, farm, dairy, and field workers, restaurant workers, telephone operators, mechanics, cleaning industry workers, etc.

After seeing the kind of elbow and shoulder injuries that workers are susceptible to in the line of duty, employers must take stringent measures to protect the workers. The desired level of safety can be achieved by identifying ergonomic problems where workers could be mismatched with their jobs. More so, encouraging workers to participate in developing solutions creates awareness on the employees. They should then implement solutions to remove the hazard and evaluate these solutions periodically. Employers also need to encourage workers to report warning signs of MSD symptoms to control the progression of symptoms and promote job assessment and make continuous improvements. Overall, there must be a strong commitment by a company to make the ergonomic process a success, thereby keeping the workplaces safe for employees.

OSHA's mission is to promote and to guarantee workplace safety and health to reduce workplace fatalities, injuries, and ailments. To fulfill this mandate, OSHA continues to address new challenges from emerging technologies and an evolving workforce by implementing strategic mechanisms like Enhanced Enforcement Program (EEP), National Emphasis Programs (NEPs), and Site-Specific Targeting (SST). These strategies are continuously being revised to match the prevailing circumstances and more so, to narrow the focus on employers who have a history of gross, willful and recurring violations with OSHA.

As part of ongoing efforts to ensure safe workplaces, OSHA focuses on the following industries:

• Oil and gas field services
• Residential building construction
• Commercial and institution building construction
• Highway, street, and bridge construction

Workers are called upon to familiarize themselves with OSHA law that safeguards their rights that are in line with the federal law requiring employers to provide safe workplaces that are free of health and safety hazards. Your line of work notwithstanding, you have the following rights under OSHA law:

• Receive training in a language you comprehend
• Operate safe machines
• Be given required safety gear (gloves, harness, lifeline, etc.)
• Be protected from poisonous substances
• Request an OSHA inspection, and speak to the inspector
• Report damages or illness, and get copies of your medical records
• Access copies of workplace injury and illness logs
• Review records of work-related injuries and illnesses
• Get copies of test results done to find hazards in the workplace

Even when your employer adheres to the above requirements, you are still prone to sustaining workplace injuries, and in this case, you are entitled to compensation. OSHA laws allow employees to lodge confidential complaints against their employers if they deem their workplace conditions as unsafe or unhealthful, or upon incurring an injury. Workers are not required to know the particular OSHA standards that are being violated before lodging a complaint or requesting an inspection. Nonetheless, this complaint should be filed soon after recognizing a lack of compliance because OSHA citations are only issued for contraventions that exist now or were present in the past six months.

There are three options for workers to use when filing complaints: online; fax or mail; and through telephone through a toll-free line 1-800-321-6742 (OSHA) or finding their offices near you. OSHA takes every charge seriously, and they keep whistleblower's information confidential. Moreover, it is unlawful for an employer to retaliate against workers who raise these issues by firing, demoting, transferring them for exercising their rights under the law. Should this happen, the affected employee is required to file a complaint within 30 days of the supposed retaliation action.

Workplace injuries involving the shoulders and elbows can make it difficult or impossible to work or at least necessitate long absences to allow for recovery. Shoulder and elbow injuries typically require physical therapy and sometimes surgery to control the pain and eradicate it in the long run.

In extreme cases, the worker is unable to return to the same line of work if their injuries emanated from constant strain and they may not be qualified to do other kinds of jobs. This downtime amounts to lost income which subsequently affects their ability to support themselves and their dependents. As you can see, these injuries come with a great deal of physical and psychological suffering that could go on for months or years. Bear in mind that your employer has a team of lawyers fighting for their welfare and that is why you need an aggressive and ethical attorney to examine your case. They will help you file a worker's compensation claim that addresses your immediate and anticipated needs concerning your shoulder or elbow injury.

If you are or think that you're suffering from a workplace injury, see a physician immediately as putting off this checkup will only worsen the situation. Shoulder and elbow injuries will impede your ability to work at full capacity and, thus, jeopardizing your job not to mention the adverse effects on your health. Hold your employer accountable for subjecting you to less than the stipulated working conditions. If you are pursuing a shoulder and elbow injury compensation claim, the Workers Compensation Attorney Group in Long Beach, California, is experienced in handling these cases. Call our Long Beach workers compensation attorney at 714-716-5933 for a consultation with our team of legal experts.