Maryland work accidents that result in both neck and shoulder injuries may require the advice and involvement of a workers compensation attorney.
Why are combined shoulder and neck injury cases complicated?
Maryland workers compensation cases are diluted by legalese regarding the particular body part that was injured. The initial claim form asks which body parts were hurt, the treatment is often authorized for only one body part despite two injuries, compensation paid is determined by which body part was injured, and the particular body part(s) injured may be the factor that leads an insurance company to either accept or deny the claim from the beginning.
For the remainder of this article I will use the following Example for demonstrative purposes:
Injured Maryland worker JOHN falls off of a heavy machinery and injures his shoulder and neck area. He is seen by a well respected and qualified orthopedic surgeon who performs an MRI and quickly discovers a complete tear of a shoulder ligament. Surgery is performed and physical therapy is obtained for 4 months. Five months after the accident it is discovered that the injured Maryland worker JOHN also herniated a disc in his neck.
Complication: Initial diagnosis often includes only one body part
From what I have seen symptoms for a shoulder injury often mimic the symptoms of a neck injury. (Note: I am no doctor so take this for what it is worth coming from a Maryland Workers Compensation attorney.) Like in JOHNS case the initial and accurate diagnosis can sometimes include only a shoulder injury, or only a neck injury, not both. From the medical side of the case this may not be such a problem. Fix the shoulder, then if symptoms persist continue treatment and fix the neck. From a legal perspective this may create a problem.
Complication: Adding a Body part to a Maryland Workers Compensation Claim Form
Once it is discovered that additional body parts were actually injured in the accident a claim amendment form must be filed with the Maryland Workers Compensation Commission. This is a relatively strait forward process and entails filling out a simple form. When JOHN realizes he also has a neck injury he would file a claim amendment form adding the neck. The legal ramifications are not so strait forward.
Once an additional body part is added the liability and financial exposure of the Maryland workers comp insurance company increases. This means workers comp will fight the addition of the body part which results in delays in treatment and will necessitate a hearing. If the injured worker is unrepresented when treatment is denied they should seek counsel.
Most likely, the Maryland workers comp insurer will schedule an Independent Medical Evaluation (IME) to determine if the neck injury was a result of JOHN’s fall from the heavy machinery. The IME may take place 6 or 7 months after JOHN was initially injured.
Complication: Medical Records revolve solely around one injured body part
From the very first doctors appointment both JOHN and his doctor thought the torn ligament discovered on the MRI was the only reason he was having pain and symptoms. All the medical records indicate that he sustained a shoulder injury. It is clear he sustained a shoulder injury.
What was not clear is that he also had an injury to his neck. After review of the medical records there is no mention of the neck until five months after the injury because the torn ligament in the shoulder was quickly discovered and treated.
The lack of mention of the neck creates an argument for the insurance company and their attorney- why would someone waited 5 months to obtain treatment if they were truly injured? This will also provide the IME doctor just the evidence he needs to form the opinion that the neck was not injured in the accident.
The Hearing before the Maryland Workers Compensation Commission to determine if both the neck and shoulder were injured in the accident.
At the hearing the defense attorney will argue that the neck was not treated for an extended period of time. By the time the hearing takes place it will likely be 8 to 9 months after the accident. The IME will be presented which may indicate that the neck is not related to the accident because there was no treatment for an extended period of time, no mention of the neck in the medical records, and even if the neck was injured no treatment is necessary because it has been so long. With this evidence, the Maryland Workers Compensation Commission may rule against the injured worker at the hearing and result in the neck not being a covered body part.
If you have been injured on the job in Maryland and sustained a shoulder and/or neck injury contact Maryland Workers Compensation Attorney Andrew M. Rodabaugh! He can help you navigate your case competently and expeditiously.