By Sebastian Grasso

Three Primary Physical Injury Types

In my experience there are three primary physical injury types seen in workers’ compensation cases (psychological not included). Acute injuries, where there’s an accident and a body part is broken, cut, bruised, or burned. Cumulative musculoskeletal injuries, these injuries occur over time due to repetitive wear and tear. Then there is the acute musculoskeletal injury. The acute musculoskeletal injury is tied to a specific event and may or may not be associated with the work environment. An example of this type of injury is the, “I felt a pop in my back when I bent over to lift” or “I slipped when walking down the ramp and hurt my shoulder when I grabbed the rail to keep from falling”.

What is the Acute Musculoskeletal Injury?

The acute musculoskeletal type of injury is often just as subjective as a cumulative trauma injury. The challenge for successful return to work, is identifying the risk factors that are not associated with the “injury event” but will still impact the worker’s ability to recover at work. Let’s use the example above where a worker strains their right shoulder after they slip going down a ramp and grab a rail to keep from falling. The injured worker works in a manufacturing position and returns to work with the restriction of no reaching/lifting above shoulder height. At work, the injured worker returns to their original position and continues to complain of right shoulder pain, even though they are not reaching above shoulder height.
This scenario causes frustration for all parties. The employer is frustrated because they feel they did their part by making an accommodation and might think, “there must be an ulterior motive of the worker”. The worker is frustrated because their pain is real, and they can sense the suspicion of their superiors. While the claims adjuster is frustrated because they anticipated a successful Return-to-Work outcome and will now have to manage the frustrated parties and plan for ongoing indemnity benefits.

The Solution Still Lies in the Work Environment

The solution for Return-to-Work continues to lie in the original work environment. Often there are one or more tasks that when the worker is healthy do not cause pain or discomfort, yet will cause continued discomfort after an injury. In the example above, something else in the work environment not associated with “the event” is impacting the worker’s recovery. Maybe the injured worker is reaching for controls below shoulder height and the force to manipulate the controls is causing ongoing discomfort, or maybe a door that they open in the plant sticks and the force required to open that door several times a day is the culprit to the ongoing pain. We won’t know until a specialist evaluates the work environment.

Failing to identify the underlying true risk factors causing the continuation of the worker’s pain and discomfort can result in the worker potentially going out of work a second time. A Job Fit Accommodation specialist is an expert in thoroughly analyzing a work environment from the perspective of the injured body part and identifying the underlying factors contributing to their discomfort, often, even after accommodations have been made by the employer for the initial injury. Be sure to get the specialist into the work environment before the injured worker goes back out on Temporary Total Disability for a second time. The proactive involvement of a specialist will help drive a Return-to-Work outcome, where the injured worker recovers productively at work without the frustration associated with a failed return to work.