Shoulder Injuries & Workers' Compensation in PA

It’s impossible to go through a day at work without using your shoulder. It doesn’t really matter what type of job you have – office worker, construction worker, painter, wallpaper hanger, auto mechanic – at some point during the day, you will need to engage in an activity that will require you to use your arms and thus your shoulders. Those activities include reaching overhead to remove a heavy box, hanging wallpaper, working under a lift on an automobile, restocking shelves that often require you to reach very high or very low, or standing for long periods with your hands above your head as you work on an overhead project.

As we age, it’s natural that all these activities take their toll on the muscles and tendons in our shoulders. This process can be exacerbated or aggravated, however, by the type of work that we do. Shoulder injuries are one of the most common injuries suffered on the job. The more your job requires you to use your arms and thus your shoulder, the more likely it is that you will experience a shoulder injury of some kind. Injuries like rotator cuff tears, shoulder impingement, dislocated shoulders, SLAP tears or what is known as a frozen shoulder are the frequent subject of workers’ compensation claims in Pennsylvania.

If you have suffered a shoulder injury at work, you may be eligible to receive workers’ compensation benefits. This is true even if you’ve already had some wear and tear in your shoulder or if you’ve developed arthritis. If a workplace injury aggravates or exacerbates these already existing conditions, you may still be eligible for benefits.

How the Shoulder Works

Your shoulder is one of your body’s most complex and largest joints:

• Three bones work together in your shoulder — your collarbone or your clavicle, your shoulder blade or scapula, and your upper arm bone or your humerus.
• These bones are held together by a group of muscles and tendons. These muscles and tendons are known as the rotator cuff. Your rotator cuff provides support to your shoulder as well as allowing the range of motion you need to lift an object or to reach over your head, for example.
• The bursa is a small liquid-filled sac that protects and cushions the tendons of your rotator cuff.
• A bony structure off the scapula is known as the acromion.
• Your shoulder joint is the place where your upper arm fits into your scapula. This shoulder joint is cushioned by the glenoid labrum, a cartilage structure. This structure forms a cup into which the humerus bone fits.
• Your upper arm bone fits loosely into this cartilage cup. It’s what allows you to have such a great range of motion with your shoulder. This loose fit, however, also makes your shoulder more vulnerable to injury.

Different Types of Shoulder Injuries

Since we use our shoulders while doing so many different tasks at work, there are numerous ways in which we can injure them. Some of the symptoms of a potential shoulder injury include:

Shoulder injuries include:

1. Rotator Cuff

If your job requires you to perform repetitive, intense motions on a routine basis, you may at some point develop a rotator cuff injury. A dull ache that radiates from deep in your shoulder describes the pain associated with a torn rotator cuff. An individual with a torn rotator cuff will find it difficult to reach overhead such as when they comb their hair or reach behind their backs and may feel weakness in their arm.

Torn rotator cuffs often make it difficult to sleep, especially if you turn onto the injured shoulder.

A torn rotator cuff may be caused by a substantial injury or by progressive wear and tear on the tendons. This is particularly the case if a worker is required to do repetitive overhead tasks or lift heavy objects over a long period. This could irritate or damage the rotator cuff tendons.

If you don’t treat a torn rotator cuff, it could lead to permanent weakness in your arm or a permanent loss of motion.

A doctor will probably perform an MRI to determine if you have a rotator cuff tear and to determine how extensive it is. Most treatment tends to be conservative at first, and involves pain medication, performing physical therapy exercises or otherwise resting the arm in a sling.

If physical therapy fails to improve the tear, surgery is the only option. If you require surgery, you will need to wear a sling following the operation for one to two months, and then you will need to undergo physical therapy for two to three months to regain full motion. Your doctor will likely then place restrictions on you for two to three more months. If therapy goes well, there is a chance that you could be released to do normal medium or heavy lifting again in four to eight months after surgery. In many cases, however, the doctor may place permanent restrictions after a rotator cuff injury suffered on the job.

2. Labral Tear Injuries – SLAP Tears

Your glenoid labrum enhances your shoulder’s stability, but it is susceptible to tearing. Like a rotator cuff tear, it also produces deep pain in the shoulder. A labral tear may also result in a painful catching or clicking sensation when you move your shoulder.

One type of labral tear is known as a SLAP tear. SLAP stands for a Superior Labrum Anterior and Posterior. Often SLAP tears are made worse by a tear in the bicep tendon that attaches to the labrum.

Labral tears require physical therapy. If physical therapy doesn’t work, then they will require surgery. Typically, it will be several months before you can return to normal physical activities after an operation to repair the labrum.

3. Dislocation

Since your shoulder is your body’s most mobile joint, it is quite susceptible to dislocation. When your humerus pops out of the cup form by the labrum cartilage, this is known as a dislocated shoulder.

Often a dislocated shoulder injury will be obvious. It can result in an inability to move your shoulder and in intense pain. There may also be swelling or bruising. On occasion, the pain may be severe enough that the muscles in and around the shoulder may spasm as a result of the dislocation.

You can dislocate your shoulder in many ways – backward, forward, downward, completely or partially. It usually takes a sudden blow to dislocate your shoulder as might occur in a slip and fall accident at work or if something fell on your shoulder from a higher level. A shoulder dislocation may result in prolonged shoulder instability or damaged nerves and blood vessels around the shoulder joint.

A dislocated shoulder is treated with physical therapy. If that does not work, the injury may require surgery. If a shoulder has been dislocated once, it may happen again rather easily. This is why it is necessary not to rush back to work after a dislocated shoulder, or you could easily re-injure the shoulder.

4. Frozen Shoulder

Also called adhesive capsulitis, frozen shoulder is a condition that can be experienced after any of the above injuries. Any medical procedure that requires you to wear your arm in a sling for a prolonged period and prevent you from using your arm increases the chances that you will suffer frozen shoulder.

Different ways to treat frozen shoulder include:

• Physical therapy that focuses on frozen shoulder includes range-of motion-exercises
• Steroid injections
• Medication
• Arthroscopic surgery

If surgery is necessary, it also requires three to four months of limited use of the arm.

5. Other Injuries

Other possible shoulder injuries include:

Common Ways to Injure Your Shoulder at Work

The more you use your arms in your job, the more likely it is that you will suffer a shoulder injury at some point. The Bureau of Labor Statistics (BLS) reported in December 2015 that shoulder injuries accounted for 8.2% of all work-related injuries — a total of almost 89,000 injuries. Shoulder injuries also accounted for the highest number of median days away from work at 26. Only injuries to the back, the knee and the hand accounted for more overall work-related injuries.

Some of the professions in which shoulder injuries are more common include:

• Retail jobs that require consistently stocking items or moving or lifting boxes
• Construction workers
• Mechanics, particularly auto mechanics who work on cars on lifts
• Manufacturing employees
• Entertainers such as dancers who constantly move their arms and shoulders
• Professional athletes
• Roofers
• Plumbers

Common ways in which you can injure your shoulder at work include:

• Dislocating your shoulder in a slip and fall accident.
• Repeatedly lifting heavy objects.
• Hanging drywall or wallpaper.
• Repairing an automobile on a lift.
• Reaching awkwardly for a tool or piece of equipment that is needed to finish a job.
• Having a box or a piece of equipment fall on your shoulder from a higher shelf in a warehouse or a retail setting.
• Using power tools or heavy machinery regularly that involve continual motion and vibrations.

What to Do If You Injure Your Shoulder at Work

If you suffer a work-related injury, the first thing to do is seek immediate medical attention and report your work injury to your Employer. Remember to tell any medical professional who treats you that your injury is work-related. There is a very good reason for doing this. If you seek medical attention as soon as possible and notify the doctor that it is a work-related injury, this makes it much more difficult for your employer’s insurance company to argue that your injury is not all that bad and that you do not require workers’ compensation.

• Any time you suffer a work-related injury, including an injury to your shoulder, you should report it to your employer or supervisor as soon as possible. This is true whether you have injured your shoulder at your place of work or if you are working on a job off-site.
• It is critical that you notify the correct person, such as your direct supervisor or your company’s nurse. If you tell a coworker that you think you’ve injured your shoulder, this does not qualify as notifying your employer of a work-related injury.
• Under Pennsylvania law, you have 120 days to notify your employer of your injury. However, you should never wait this long. In almost every case, you should notify your employer as soon as possible, preferably right away or within a day or two of the accident. If you notify your employer within 21 days, and if you are eligible for workers’ compensation benefits, you will receive benefits that date to your accident.
• If you report your accident to your employer after 21 days, and you are eligible for workers’ compensation benefits, you will begin to receive benefits from the day that you report your injury.
• It is never a good idea, however, to wait several weeks or even one or two months to report your injury to your employer. This makes it much easier for your employer’s insurance company to argue that your injury was not serious and that you don’t need workers’ compensation because you didn’t report your injury in a timely fashion. It never pays to try to tough it out or be a “company man.” If you’ve been injured on the job, report it as soon as possible.
• The best way to report your injury is in writing. If your shoulder injury means you are unable to write, get a family member or friend to write out a report for you that you can give to your supervisor or employer.
• After you report your injury, your employer may require you to choose a doctor from a list of several physicians they have posted at your job site. You are required to see this doctor for the first 90 days of treatment. Once this 90 day period has ended, you may see any doctor you wish, including your regular doctor. You need to notify your employer’s insurance company, however, within five days of moving to a new doctor.

Workers’ Compensation in Pennsylvania

The Pennsylvania government created workers’ compensation in 1915. The goal was to protect both injured workers and employers. Before 1915, a worker injured in a job-related accident could sue their employers but doing so was a roll of the dice. If they won the case, they could be compensated for their injury. Injured workers, however, did not always win their cases. Meanwhile, employers faced the same dice roll. Sometimes they would win the cases, but if the workers won, it could get expensive. Workers’ compensation was created to ensure that injured workers could receive benefits without having to go to court and employers would not have to pay exorbitant costs for losing a court case.

Every company in Pennsylvania that employs at least one person must carry workers’ compensation insurance. Pennsylvania’s workers’ compensation system is a no-fault system. This means it doesn’t matter who was at fault for a work-related injury – the employee or the employer – a worker is still entitled to receive workers’ compensation benefits. To receive those benefits, however, the worker gives up the right to sue their employer.

If it is determined that you are eligible to receive workers’ compensation benefits for shoulder-related injury, compensation includes lost wages and medical expenses related to the injury. Lost wages are calculated by taking two-thirds of your average weekly wage. State limits dictate how much you can receive in compensation. In 2019, the most an injured worker can receive weekly in lost wages benefits in Pennsylvania is $1,049.

Depending upon the severity of your injury and which body part was involved, your lost wages benefits could fall into one of the following categories:

1. Total Disability

If your doctor has determined that you have suffered a total disability as a result of a work-related injury, your workers’ compensation benefits will continue during the extent of the disability even if it lasts the rest of your life. After 104 weeks, however, your employer’s insurance company can request that a physician give you an Independent Rating Exam (IRE). This is a very contentious issue. The Pennsylvania Supreme Court ruled in 2017 that this procedure was unconstitutional. The legislature reinstated the law, however, in 2018 after much lobbying by employers but lowered the threshold that you need to meet to continue to receive lifelong workers’ compensation benefits. Before 2017, that threshold was 50%. Currently, it is 35%, which is still very high.

If the doctor finds that you are less than 35% permanently disabled, you will be placed on workers’ compensation partial disability. Partial disability benefits only last for 500 weeks or about nine and a half years.

2. Partial Disability

If a doctor finds that you have a partial disability, you may be able to return to your previous job. The doctor may only allow this, however, with some medical restrictions. If your employer is required to find you a new job that fits these medical restrictions, and it pays less than your previous job, workers’ compensation will pay two-thirds of the difference between the old job in the new job for as long as you need to work with these medical restrictions.

3. Specific Loss Awards

If your injury results in the loss or the disfigurement of a body part, you can receive benefits for a certain number of weeks depending upon which part of the body has been injured.

Steps for Filing for Workers’ Compensation in Pennsylvania

After you have notified your employer of your work-related injury, your employer and their insurance company have 21 days to accept liability for the injury.

• If they refuse to accept liability, they will send you an official denial, known as a Notice of Workers’ Compensation Denial. They may also send you a temporary acceptance that lasts 90 days, during which you will receive workers’ compensation benefits. After this 90 day period, however, they may affirm or deny your injury.
• If your employer denies your initial claim, you need to file a claim petition. An injured worker has three years from the date of their injury to file a claim petition. The Bureau of Workers’ Compensation in Pennsylvania will then assign a workers’ compensation judge to your case. The judge will notify you and your employer of the time and the date of the hearing(s).

This process can last anywhere from several months to two years depending on how many hearings are held. Anytime during this process, you can reach a settlement with your employer’s insurance company.

Settling Your Shoulder Injury Claim

If you decide to seek a settlement with your employer’s insurance company, it’s important to talk to a workers’ compensation attorney before you do so. A settlement can involve many complications including determining future medical costs, your tax situation and making sure that the settlement will provide enough income for you and your family in the future. While workers’ compensation benefits are tax-free, there may be tax implications if you are also receiving Social Security.

There are many reasons to seek a settlement:

• You may find the workers’ compensation process annoying and tiring.
• You found another job.
• Disputes between you and your employer’s insurance company have prevented you from receiving eligible benefits.
• You need to pay for medical expenses and other bills.
• Often workers will wait to ask for a settlement only after their doctor has told them that they have reached Maximum Medical Improvement (MMI), which is the point at which they will not recover any more than they already have. This will provide them with a better idea of what their future costs may be.

You also may decide, however, not to accept a settlement. Here are some reasons to refuse a settlement:

• Your employer’s insurance company has made an inadequate settlement offer.
• You return to your old job, and you like your position, but the employer’s insurance company says they will only offer you a settlement if you quit first.
• Medical costs are uncertain, especially if you may need surgery. This is especially the case if you have no other form of medical insurance.

Let the Experienced Workers’ Compensation Lawyers at Calhoon and Kaminsky P.C., Help You With Your Injured Shoulder Claim

If you decide to seek a settlement with your employer’s insurance company, negotiations can be complicated and frustrating. Remember — the goal of the insurance company is to pay you as little as possible or nothing at all if they can. So whether you are deciding to seek a settlement or your employer’s insurance company has denied your initial claim, you should seek out the advice and help of the experienced workers’ compensation lawyers at Calhoon and Kaminsky P.C.

Our lawyers know the tricks that insurance companies try to play. They can also help you gather the evidence and the documentation needed to reach a fair settlement.

We offer a free evaluation, and if you are unable to travel, we will come to you to discuss your claim. Our goal is to make sure that each and every one of our clients receive the benefits to which they are entitled. You can call us anytime at 717-695-4722 or visit our contact us page to let us know about your case and how we can get in touch. A member of our team will contact you as soon as possible.