- I already had degenerative disc disease or arthritis and then hurt my back at work; am I eligible for PA Workers' Compensation benefits?
- I have been diagnosed with Carpal Tunnel Syndrome; can that be related to my work duties?
- I had surgery for a work-related injury and now the doctors say I have Complex Regional Pain Syndrome; can that now be part of my work injury?
- My first doctor said I have a rotator cuff tear, but my new doctor says I have thoracic outlet syndrome; what is that?
- Can a meniscal tear in my knee be related to work?
- What if I suffer depression and anxiety from my work injury; will the workers' comp insurance carrier pay for treatment?
- I hurt my arm at work and the doctor won't give me an MRI; is that right?
An "aggravation" of a pre-existing condition, such as degenerative disc disease, is considered a "new injury" for the purposes of a workers' compensation claim in PA. We have many clients who have had neck or back problems over the years, before their work injury, who we helped obtain Pennsylvania workers' comp benefits. The key fact is that, before the work injury, you were able to perform your job, and after the work injury, you were not.
Carpal tunnel syndrome is the name for a condition where the median nerve is compressed at the level of the wrist. Symptoms are usually felt in the hand, frequently in the thumb, index and middle fingers. Carpal tunnel syndrome can be caused by many things, including repetitive use of the hands, trauma, pregnancy, some disease processes, among many other things. Whether the carpal tunnel syndrome in your case is related to your work duties depends on the type of work you do and the opinion of your treating doctors. To answer the question, though, yes, work duties can lead to carpal tunnel syndrome.
The short answer is yes. The longer answer is, any condition that happens "but for" the work injury, is related to the work injury. This can be a complication of surgery for the work injury, or something that happens as a result of treatment for the work injury (for example, injuring a different body part while in therapy for a work injury, or having a car accident while on the way to therapy for a work injury). The important consideration is this other thing would not have happened "but for" the work injury. Complex Regional Pain Syndrome (CRPS, formerly known as Reflex Sympathetic Dystrophy, or RSD) is a terrible condition, of which severe burning pain is a primary symptom. This condition has been known to develop after an injury (including, of course, a work injury), as well as after a surgical procedure.
Injuries to the shoulder can be difficult for doctors to diagnose. While a diagnostic study, such as an MRI, can identify the presence of a rotator cuff tear or an injury to another of the structures in the shoulder, such as the labrum, that may not absolutely identify the source of the symptoms. Sometimes, the damage is actually in the front of the chest area, toward the side, in a structure called the "brachial plexus." This is like a junction where the nerves come together. Thoracic outlet syndrome is the name for a condition where there is a compression of the nerves within the brachial plexus. This may also be referred to as a "brachial plexopathy." Whether the injury which disables you is actually in the structure of the shoulder, or in the brachial plexus, if you are disabled from work as a result of your injury, you should be eligible for workers' comp benefits. It is important to remember that a definitive diagnosis is not necessarily required to have a valid workers' comp claim in Pennsylvania.
While one can have a meniscal tear from many things, including just the wear and tear of the aging process, one can certainly tear the meniscus in the knee from an injury at work. This injury, as with any to ligaments in the knee, is best addressed by MRI. Once diagnosed, a torn meniscus can be treated operatively (often by arthroscopic surgery, entailing only a small incision) or conservatively with rest and/or therapy.
Representing injured workers in PA, we see anxiety and depression appear in workers' comp cases in two distinct ways. First, the anxiety or depression may be the work injury itself. In that case, known as a "mental/mental" claim (mental stimulus causing a mental injury), the workers' compensation insurance carrier will only be responsible if the injured worker was subjected to "abnormal working conditions." What constitutes an "abnormal working condition" under the Pennsylvania Workers' Compensation Act depends on the job a person performs (in other words, firemen, police officers and other emergency responders have a greater area of what would be considered "normal").
The other situation we see with anxiety and depression is when these conditions appear after a physical injury; perhaps due to the injured worker's inability to do his or her job or earn money for the family. In this situation, there is no requirement to prove "abnormal working conditions;" as long as a Workers' Compensation Judge finds the anxiety and/or depression are related to the accepted work injury; the workers' comp insurance carrier will be responsible.
There are reasons why doctors order various diagnostic studies for various conditions. Each type of study has advantages over others for various things. For example, a plain x-ray shows injury to bone very well, but is not very useful in evaluation of spinal discs, nerves, ligaments or tendons. An MRI shows soft tissue, such as cervical or lumbar discs, ligaments or tendons, but is not as good at showing bone or nerves. While an EMG cannot reveal anything about how a nerve looks, this study can evaluate how a nerve functions. A bone scan can be used not only for evaluating bone (such as a fracture), but is also helpful in diagnosing CRPS/RSD. Other diagnostic studies available to today's physicians include, but are not limited to, CT scans, myelograms, discograms, venograms, and PET and SPECT scans. So, to answer your question, the type of test a doctor might order depends on the suspicion the doctor may have as to the origin of the problem. Perhaps the more important concept is to be treating with a physician you trust.