I have a lunch-and-learn presentation on my calendar for a client on the potentially costly topic of shoulder-related injury claims. My lunch-and-learn appointment got me thinking about the complexities of shoulder physiology and how these thorny claims figure into the insurance and workers compensation process.
Shoulder injuries are a topic MKC’s team regularly encounters…one that cuts across industry sectors — including sports, retail, and trucking — and many types of injuries. Here, for example, is a quick recap of some of the posts we’ve written on the subject and the key issues they demonstrate:
- Falls. Because of the nuanced differences in types of falls (e.g., trips, tumbles, slips, etc.) and consequential shoulder injuries, it’s important to create a 360-degree, narrative context for each claim. When working on a shoulder-related case, our MKC team looks at a standard set investigative questions, such as…the direction of the fall and exactly how the victim landed, and their final landing position (i.e., face down or on their back or side).
- Sports. SLAP (Superior Labrum Anterior to Posterior) tears are relatively uncommon…unless you spend a lot of time throwing a ball overhand. As we write in this post, however, “SLAP tears also occur from a traction injury to the arm, such as lifting a heavy object off the ground too quickly. Or, for the clumsy among us, a slip and fall onto an outstretched arm, or falling on a shoulder may cause a SLAP tear. Even bracing oneself, with arms outstretched, in a car accident can fray, or tear, the labrum.” This is akin to the kind of conditions we also see with repetitive motion injuries.
- Workers comp. In these cases, according to this post, we ask “if the type of injury the claimant reports matches the Mechanism of Injury. In a slip-and-fall-related claim — involving, say, a torn rotator cuff or other shoulder injury – we look for medical and historical evidence that the shoulder condition is the result of the fall in question…or, if there’s a possibility that it’s a result of an earlier, unrelated, recurring-use condition.”
In addition, motor vehicle accidents comprise a major source of shoulder-injury claims…claims that underscore the importance of looking closely at the Mechanism of Injury. As with fall-related shoulder injuries, we ask questions dealing with the MOI context, such as the type and location of impact, the speed at which the impact occurred, the amount of the impact’s intrusion into the vehicle and if the patient was restrained or not.