Workers Comp Shoulder Injury

The shoulder is the body’s most flexible joint, allowing us to raise and lower our arms, swivel them front and back and turn them inward or outward to meet the demands of pushing, pulling, carrying, lifting and throwing all the things that come at us every day.

However, shoulders also are the most complex joint, with bones, muscle, tendons and ligaments twisted and tied up in a complex alignment that allows all that flexibility, but makes the shoulder very, very injury prone.

The Bureau of Labor Statistics says that 63,100 workplace shoulder injuries were reported in 2020, making it the third most-reported body part injury behind hands (102,350) and knees (66,650). Further research showed that 18%-26% of adults experience some form of shoulder pain in their lifetime.

“The shoulder is a very interesting joint,” said Malcolm Crosland, a partner in the Steinberg Law Firm in Charleston, S.C. “It can get pretty whacked out and people don’t know it because they aren’t feeling the symptoms, or they put up with the pain, thinking if they wait long enough it will just go away.

“The idea that you’re just going to play through the pain, is not a good one. Men are especially prone to that. If you’ve got inflammation in a joint and the pain is there for 2-3 weeks, it’s time to go see a specialist and get this taken care of.”

Crosland is past president of Workers Injury and Advocacy Group (WILG), a group of attorneys who represent employees in workers compensation cases. He has dealt with hundreds of sore, separated, fractured and broken shoulders in 36 years as a workers comp lawyer and appreciates that insurance companies cover the medical costs involved.

But Crosland also says injured workers may need someone else on their side to get the right medical treatment and all the benefits they’re due in a workers comp claim.

“The insurance company may be paying for medical treatments, but they have no obligation – zero, zip, none – to inform a worker fully of all the rights they have under their state’s worker compensation act,” Crosland said. “It’s not their duty to protect the worker. That’s why anyone who gets hurt on the job should consult an attorney.”

Average Workers Comp Settlement Amount for Shoulder Injury

There is no accurate way to predict what a settlement for a shoulder injury will be and neither insurance companies nor lawyers representing injured workers is inclined to guess. The safest thing to say is that settlement amounts for shoulder injuries in workers compensation cases will vary dramatically, depending on:

• Type of shoulder injury
• The severity of the injury
• Whether surgery was required

Many shoulder injuries can be treated in a matter of days or a week with rest, anti-inflammatory medicine and rehabilitation. If the pain persists and a worker can’t perform routine tasks associated with their job, they might reach a settlement in the $10,000-$25,000 range.

The next step in treatment could be all of the above, plus a cortisone shot or minor surgery to take care of the inflammation. The recovery period involved will be longer and the worker may qualify for partial disability so settlements could go up to the $25,000-$50,000 range.

If the damage is so severe the worker loses full range of motion or can’t lift more than 10-15 pounds – or any weight for that matter – without throbbing shoulder pain, the injury may be disabling. In situations like this, the settlements could go from $50,000 to as much as $100,000.

All those numbers depend on two crucial elements being part of the workers comp settlement equation: the degree of impairment to the injured body part; and what is the claimant’s disability.

Impairment is a measure of the injured body part’s ability to function as it was designed. Disability means you can no longer do the job the way you once did.

A separated shoulder, for example, might be painful for an accountant, but shouldn’t stop him from doing his job. However, the same injury to a construction worker who can no longer lift 10 pounds over his head, could result in permanent disability.

Doctors, most often those hired by the insurance company, make the final determination on whether a worker can return to his job, needs some sort of accommodation to do so, or can’t return to work. Crosland says a second opinion at this stage of the game, is always a good idea.

“It is always amusing to me that the insurance company’s doctor, looking at the same person, with the same injury and referring to the same guidebook, always comes back with a lower impairment rating than if I sent him to another doctor for a second opinion,” Crosland said. “Go to a doctor with no ties to the insurance company and you’ll almost always come back with a higher rating, sometimes significantly higher.”

Types of Shoulder Injuries in the Workplace

With so many moving parts, it is not a surprise that there are several types of shoulder injuries that occur in the workplace.

Torn rotator cuffs and labrum tears are the most common shoulder injuries. Other types of shoulder injuries include dislocated and separated shoulders, impingement, bursitis, frozen shoulder, fractures and torn cartilage.

The shoulder is the most flexible joint in the body, but that is what makes it the most unstable. Shoulders include three bones: the humerus (upper arm), the scapula (shoulder blades) and the clavicle (collarbone). Ligaments, tendons and muscles weave in between those bones.

The shoulder relies on all those parts moving in a coordinated effort that allows you to do commonplace things like lifting a box over your head, throwing a ball, or reaching out to break a fall. Get in an awkward position trying any of that, and there is a chance you’ll come away with a shoulder injury.

As people grow older, the areas that make up the shoulder degenerate and become soft. Any strenuous or repetitive activity involving lifting, carrying, pushing or pulling, can cause a tear.

Here is a look at shoulder injuries, what causes them and how they are treated.

Torn Rotator Cuff

A torn rotator cuff is a tear among the muscles and tendons that stabilize your shoulder and help rotate your arms.  It often happens as you get older and is a common injury among painters, window cleaners, carpenters and stock clerks who must lift boxes over their heads. Some athletes, especially baseball pitchers and tennis players, are very susceptible to rotator cuff issues.

The most common symptom is trouble raising your arm above your shoulder or being unable to lift things you could easily lift before. Left untreated, a torn rotator cuff can do permanent damage to your shoulders and the joint may deteriorate over time. Depending on the size of the tear, you may require surgery and need 2-3 months of rehabilitation.

Torn Labrum

The labrum is a piece of cartilage attached to the rim of the shoulder that helps keep the ball joint in place. It is vital to the stability of the shoulder as it helps keep the rotator cuff tendons and muscles in place. Injuries occur as people get older and the cartilage softens, usually as a result of overuse. Blunt force trauma also can cause a torn labrum and reduced range of motion for the shoulder.

A torn labrum can make the shoulder feel weak, less stable and painful. There are few symptoms other than pain or a popping sound when you move the shoulder. The injury is difficult to diagnose without an x-ray, MRI exam or, in severe situations, an arthroscopic exam.

A minor labrum tear can occur when the shoulder joint pops out of place. It usually can be popped back into place and treated with medication, cortisone shots or physical therapy. However, if rehab isn’t successful, or the injury is left untreated, it may need surgery to repair. The recovery time is at least 2-3 months following surgery.

Frozen Shoulder

Frozen shoulder happens when the tissues surrounding the shoulder become thick and inflamed and the pain becomes so great, it limits use of that body part.

This happens when an injury occurs to the shoulder and there is a medical condition that results in being immobilized for a period of time. Medical conditions like diabetes, heart disease, a mastectomy, a stroke or surgery that keeps you from moving your arms can lead to frozen shoulder This is especially true for women and anyone over the age of 40.

The symptoms for frozen shoulder are pain and stiffness that can be worse at night. Typically, the situation gradually gets worse over a period of 1-2 years, then eventually “thaws” and you recover your range of motion. This whole process can happen over a three-year period.

Treatment is usually pain-relief medication like aspirin or ibuprofen to treat the inflammation. Stretching exercises and some strengthening exercises also help recovery.

Shoulder Impingement

Shoulder impingement is a condition in which the tendons associated with the rotator cuff gets pinched while passing through the humerus and acromion areas of the shoulder. When the muscles and tendons in this area don’t slide easily, they get irritated and swollen.

The swelling causes pain and tenderness in the shoulder, making it difficult to get a full range of motion. Inflammation occurs, causing more swelling, more pressure on the tendons and more pain. Just raising your arm above your head or away from the side of your body is difficult.

Home treatments as conservative as aspirin or ibuprofen to reduce swelling and physical therapy may be enough. If pain persists, you may need cortisone shots and if it is more severe, surgery is possible.

Shoulder Replacement

Shoulder replacement is a surgical procedure to repair damaged parts of the shoulder and ease the pain caused by arthritis, damage to the rotator cuff, bone fractures and other conditions that cause chronic pain.

The procedure uses metal or plastic parts to repair the ball and socket areas in the shoulder. It should improve your shoulder strength and range of motion and lessen, if not eliminate, pain.

Complications such as dislocation (ball in the new joint comes out of the socket), implant loosening over time, nerve damage and infections can occur, but are very rare.

Dislocated Shoulder

Because the shoulder is the most mobile and flexible joint in the body, it can twist and turn in many directions, which makes it easy to dislocate.

A dislocated shoulder happens when the ball that sits in a socket of your shoulder blade, pops out of the socket. It’s most commonly associated with sports injuries, but also can be the result of sudden jarring in a traffic accident or falling awkwardly and trying to break that fall with an outstretched arm.

The symptoms for a dislocated shoulder are severe pain, numbness or weakness that goes down to your arm or hands and swelling or bruising around the shoulder. Doctors can pop the ball back into the socket, which provides immediate relief. After that, you may need to wear a sling to keep the shoulder in place until your range of motion improves.

Surgery is rare, but is an option if this happens repeatedly and there is damage to the bones, nerves and tissues surrounding the shoulder.

Fractured shoulder

There are three bones in the shoulder area – the humerus, clavicle (collarbone) and scapula. If one of the bones is cracked or broken, it’s considered a fracture.

This happens when you try to break your fall with an outstretched arm or receive a traumatic blow to your shoulder area in a car accident. It is more common in older people and causes pain and swelling in the shoulder area, making it difficult to raise your arm.

Doctors will use x-rays, MRIs or CT scans to identify the exact location and severity of the injury. Most often, the treatment is a sling to hold the shoulder in place while it recovers, followed by rehabilitation exercises to improve range of motion. If surgery is necessary, metal plates and screws are used to hold the bones in place while they heal.

Tendonitis in the shoulder

Shoulder tendonitis is an inflammation of the shoulder joint, typically the area around the rotator cuff or biceps tendon. The tendons in that area get pinched and become inflamed, causing mild-to-severe pain in the shoulder.

This usually is a sport-related injury, but can happen as the result of any action in which your arm moves repeatedly over your head, such as lifting boxes in a warehouse. You likely will feel the pain at night.

If the pain doesn’t subside, doctors will use x-rays, ultra-sound or MRIs to examine the shoulder joint and determine exactly where the problem is.

Age and general health are factors in treatment for tendonitis in the shoulder. Some patients can recover with rest, anti-inflammatory drugs and rehabilitative stretching and exercise. Most severe cases could require a cortisone shot and possibly surgery.

Bursitis in the shoulder

There is a fluid-filled sac in the shoulder called the bursa, which is there to protect the tendons and allow them to slide effortlessly between the bones. When excess fluid builds up, and the bursa sac get inflamed, the result is bursitis.

Bursitis is most often the result of overuse, too much lifting of the arm above the shoulder. If you have bursitis, you may notice swelling and redness in the shoulder area, and sharp or shooting pain when you exercise.

The most common treatment is rest and the use of anti-inflammatories like Motrin or Advil while applying ice packs. Cortisone shots are used when the pain is not resolved with other treatment. If shoulder bursitis becomes chronic and severely painful, you may need surgery.

Filing a Workers Comp Claim for a Shoulder Injury

There is nothing unusual about the process for filing a workers compensation claim for a shoulder injury. As soon as you feel pain with the injury, report it to your supervisor and ask that paperwork get started to make the claim. Then, go to a doctor or urgent care center and receive treatment.

The next best step might be to call an attorney and ask for a consultation on what benefits you qualify for and how to assure you receive them.

All shoulder injuries qualify for workers compensation. The problem will be proving that the injury happened in the workplace, which is why your next step probably should be to contact an attorney. Proving causation happened at the workplace is difficult with shoulder injuries and an experienced attorney will know what bases need to be covered in filing a claim.

The major problem to overcome is that most shoulder injuries are the result of gradual wear and tear, happening over the course of months, sometimes even years. Anyone doing repetitive work that requires lifting your arms over your head like painting or stocking shelves, is a good candidate to suffer a shoulder injury.

It’s unusual, however, for a single incident or accident to lead directly to a shoulder injury.

That leaves it to the worker and his/her attorney (assuming you have hired one), to prove that causation happened in the workplace.

Workers Comp Benefits for a Shoulder Injury

The two major workers compensation benefits – coverage for all medical treatments and compensation for lost wages – are both in play when someone suffers a shoulder injury on the job. While most people focus on the dollar amounts they’ll receive in wage compensation, Crosland suggests you look closer at the medical benefits.

“The best component of workers compensation is paying for all your medical treatments,” he said. “There is no insurance I’m aware of anywhere that pays all your medical bills down to the last penny at no cost and no deductible for the injured worker.

“And in some cases, the insurer will provide for future medical treatment, if necessary. That is a pretty good deal.

The medical benefits workers compensation should pay for include:

• All doctor visits
• Prescriptions for pain relief
• Surgery
• Medical equipment
• Physical therapy
• Transportation costs

The Bureau of Labor Statistics says that if you don’t have surgery, the average recovery time for a shoulder injury is three weeks, which puts wage compensation in play. The amount you receive depends on your state, but in most cases, it’s fair to think you will receive 66.7% of your average weekly wage while the injury heals.

Those wages are paid until your doctors says you have reached Maximum Medical Improvement. After that, you may receive permanent partial disability benefits or permanent disability benefits, depending on the severity of the injury.

And don’t forget that you are not able to return to your old job, you are entitled to vocational benefits to train for a new position.

If you choose to take a settlement, make sure you have factored in any future medical costs that may arise. It is wise to consult with doctors to determine if more testing, more office visits, and possibly more surgery is a possibility. All of those should increase the value of your settlement.

Work Restrictions for Shoulder Injury

The pain threshold for workers with a shoulder injury varies dramatically and is a huge factor in the work restrictions that apply. Some workers consider shoulder pain part of the job and learn to live with it. Other feel the aggravation in any movement and want to be accommodated by rest or, perhaps moving to another job until the injury has completely healed.

Physical demands on the worker should be adjusted for size and fitness. Restrictions on lifting, pulling or pushing would be common for workers dealing with shoulder injuries. Shoulders are aggravated most often by raising the arms overhead, so the first restriction would be how much weight – if any – a worker should try to lift over his/her head.

Using an outstretched arm is another barrier for people with shoulder injuries and the same is true for forceful activities involving the arm such as operating a drill or other heavy equipment.

It is up to the employee and supervisor to determine what actions cause pain and whether activity common their work area causes more pain to the shoulder.

• The cost of any reasonable and necessary medical expenses you incur as a result of your shoulder injury.
• The cost of vocational rehabilitation services, such as education or retraining, which you may qualify for if your injuries prevent you from earning a certain percentage of your pre-injury wages.
• Temporary disability benefits if you cannot return to work in your usual capacity for a temporary period. Partial or total temporary disability benefits are capped at two-thirds of the difference between your pre-and post-injury income or the statewide maximum.
• Permanent disability benefits if you reach maximum medical improvement and are still unable to return to work. If you are permanently disabled due to a rotator cuff injury, you could receive up to two-thirds of your average weekly wages, up to the state maximum, for the duration of your disability.

What Impacts the Value of Rotator Cuff Cases?

Several variables can impact the value of your rotator cuff injury settlement, such as:

• The severity of your rotator cuff injury
• Whether you suffered a partial or complete tear
• Your age at the time of your injury or diagnosis
• Your medical history, including any pre-existing conditions
• Whether you required surgery to treat your injury
• Your wages at the time of your injury or diagnosis
• Your employer, their insurance provider, and how they handle your claim

Can a Rotator Cuff Injury Lead to Permanent Disability?

In some cases, yes. Severe rotator cuff injuries involve a significant or complete tear in one or more structures in the rotator cuff. A severe rotator cuff tear can lead to a permanent loss in a person’s range of motion.

When a person’s ability to move their arm or shoulder is limited or lost, they may not be able to perform the same tasks they were capable of before their rotator cuff injury.