Why Michigan Workers Comp Claims are Denied for Back, Neck, Shoulder or Knee Injuries

Some of the most difficult workers comp cases involve injuries to the back, neck, shoulder and knee. It is typical for employers and insurance companies to avoid accepting responsibility for these injuries because of the potential for lifetime workers comp benefits or findings of arthritis. An experienced workers comp attorney provides helpful descriptions of each injury and suggestions to help injured workers protect themselves.

Injury to the lumbar (back) and cervical (neck) spine from work

Spinal injuries can be devastating when they result in permanent work restrictions and a loss of substantial earnings. An individual who has always done heavy work might be forever limited to a sit down job and paid much less. This transition can be extremely difficult without proper retraining and vocational assistance.

Surgery could also be required for a herniated disc and recovery can take months or years. Common surgeries include laminectomy, discectomy, and spinal fusion. Some individuals never return to work because of chronic pain or other symptoms.

The Mayo Clinic provides an overview of these types of work-related injuries:

A herniated disc refers to a problem with one of the rubbery cushions (discs) between the individual bones (vertebrae) that stack up to make your spine. A spinal disc is a little like a jelly donut, with a softer center encased within a tougher exterior.

Sometimes called a slipped disc or a ruptured disc, a herniated disc occurs when some of the softer "jelly" pushes out through a crack in the tougher exterior. A herniated disc can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg.

Sometimes, using your back muscles instead of your leg and thigh muscles to lift large, heavy objects can lead to a herniated disc, as can twisting and turning while lifting. Rarely, a traumatic event such as a fall or a blow to the back can cause a herniated disc.

Why back and neck injuries are denied by workers comp

Injuries to the back or neck cancause controversy because they are hard to diagnose and treat. It is difficult to pinpoint the exact source of pain and even more difficult to prove that a work injury was the cause.

You may find yourself having to prove that you actually got hurt. This is especially true if you have a preexisting condition. This is why it is critical that you report any injury to your employer when it happens and seek appropriate medical treatment. Insurance companies will tell you that your back or neck pain is just part of the aging process. If the insurance company tells you that you just have degenerative disc disease, be sure to get a second opinion from a doctor that you trust.

This is especially true when you have been diagnosed with a herniated disc, disc protrusion, ruptured disc, slipped disc, nerve damage, pinched nerve, sciatica or radiculopathy. If you were working without a problem until an injury, this is good evidence that workers comp should pay.

Injury to the shoulder from work

We see many individuals who have suffered a shoulder injury at work and are denied workers compensation benefits. These injuries tend to occur from lifting or repetitive arm activities. This is especially true for individuals who do throwing and overhead work.

Insurance companies frequently dispute these types of shoulder injuries because of incidental findings of arthritis. Almost everyone has some arthritis and it does not mean that you did not suffer a real injury at work.

Watch out for increased pain symptoms and report any injury when it occurs. You may have developed a torn rotator cuff or a torn labrum.

Injury to the knee from work

Employees who suffer knee injuries at work are often denied Michigan workers compensation benefits. These types of injuries tend to occur from any activity that causes you to twist or rotate your knee. Activities such as kneeling, pivoting, squatting, lifting, or sudden stops and turns can cause injury.

Insurance companies frequently dispute these claims because of incidental findings of arthritis. Almost everyone has some arthritis and it does not mean that you did not suffer a real knee injury at work. Watch out for increased pain symptoms, swelling, and stiffness. Be sure to report any knee injury when it happens to your employer. You should also ask for workers compensation benefits.

You are entitled to prompt medical care for your knee injury. Some individuals heal with just physical therapy while others need surgery. All reasonable and necessary medical treatment should be paid under workers compensation.

Don't let the insurance company doctor tell you that it is just degenerative changes in your knee. You have the right to choose your own doctor after 10 days. You may have a torn meniscus or internal derangement of the knee. Find a doctor that you trust and get appropriate medical care.

You are also entitled to lost wages if you cannot work because of your knee injury. You will get approximately 80% of your after-tax average weekly wage for as long as you are disabled.

Get all the benefits that you deserve under workers comp

Workers comp pays unlimited medical treatment for your work injury. You are also entitled to vocational rehabilitation services to help you get back to work. As long as you are disabled, you will receive weekly wage loss benefits equaling approximately 80% of your after-tax average weekly wage.

Even if you are currently getting benefits, you should speak with an experienced workers comp lawyer. Many people are not aware that they are entitled to mileage reimbursement and attendant care benefits. The insurance company will never tell you that your relatives could get up to 56 hours per week of compensation just to help you around the house.

For additional information on Michigan Workers Comp law including time limits and what to do if your claim is denied, visit the Michigan Workers Comp Lawyers website.