Workers Compensation Settlement Pursued for Carpal Tunnel Syndrome*
Case
Summary:
This is a review of a workers compensation
settlement appeal. The case originated as a claim for workers comp
benefits filed by a
woman who developed Carpel Tunnel Syndrome.
The woman had received a
settlement
from workers comp for her Carpel Tunnel, but she
felt the settlement underestimated her disability. Using her own
resources, she paid to have an independent doctor re-examine her injury
and then filed an appeal based on the doctor's findings.
Statement of Facts...
Wilma Roget was a 27-year-old single mother of
four. Roget completed
secretarial school in 2007. At or about the time of her graduation she
was hired as a receptionist at Talmage and Associates, P. C. There her
duties included answering multi-line telephones, mail sorting,
appointment monitoring, and some light typing.
She
began her job in
excellent health with no significant physical impairments.
Roget
worked for the law
firm as a receptionist from April 2nd, 2007, through May
1st, 2009. In 2009 she was promoted to the position of legal secretary
and was assigned to work for a specific attorney in the firm. After
about a year, Roget was promoted again, this time to the position of
paralegal.
About a year into her position as a paralegal,
Roget began to
experience intermittent discomfort in her right wrist. At first she
thought little of it. When the discomfort became impossible to ignore,
Roget would take short breaks. As the weeks passed by Roget's
intermittent discomfort in her wrist gave way to acute discomfort and
pain. Although the breaks she took helped somewhat, her discomfort and
pain seemed to persist for most of her working day.
Roget notified the attorney
for whom she worked that she was unable
to continue to type the attorney's legal pleadings at the same rate she
had been for the last year or so.
She
explained to the attorney how her
once intermittent discomfort had given way to acute pain.
Roget told
the attorney she was unable to work for more than three hours a day.
Even that amount of time, Roget said, produced severe discomfort and
pain.
The attorney, sympathetic to Roget's plight,
referred her to the
firm's workers compensation benefits advisor. The advisor, in turn,
sent Roget to one of the insurance carrier's approved orthopedic
surgeons.
The orthopedic surgeon ordered an MRI of Roget's
right wrist. The
MRI showed the fibrous tissue surrounding Roget's wrist's median nerve
was swollen. It was clear on the MRI that Roget's claims of discomfort
and pain were credible. Relying upon the findings of the MRI, the
orthopedic surgeon diagnosed Roget's condition as "Carpal Tunnel
Syndrome."
"Carpal
Tunnel Syndrome"
is caused by the tissue
surrounding the wrist becoming inflamed. This inflammation
causes the
tissue to press down on the nerves running through the wrist, which in
turn causes the subject to feel pain in their fingers and
hand. The
syndrome can be brought on by a person doing any kind of repetitive
motion with their hands, especially typing.
The doctor's diagnosis and prognosis were
communicated to the
workers compensation insurance
representative. The
doctor estimated
Roget's disability at 12% and recommended Roget be
assigned, at least
for the time being, to light duty which did not include typing. The
insurance rep notified the law firm,
and shortly thereafter Roget was transferred to the filing clerks'
pool.
With the transfer to the filing pool came a
reduction in Roget's
pay. Roget complained to the law firm that she believed her workers
compensation settlement was unfair. She said it was demeaning,
especially after all the years she served the firm loyally.
Roget
also
told the law firm she couldn't survive on the reduced pay,
even with
the additional 12% disability pay she was now receiving.
Although empathetic, the firm told Roget business
was slower than
normal, and only because of her many years of loyalty to the firm were
they keeping her on as a filing clerk. They told Roget her only
alternative was to resign from the firm.
The Appeal...
Roget served notice upon the workmans comp
insurance company
and the firm she was appealing the workers compensation settlement
award rating of only 12%. She asked for the authority to see another of
the insurance company's approved orthopedic surgeons.
When she went to
see the newest orthopedic surgeon, the surgeon first examined the
results from the MRI taken only 2 months before. At her request, the
newest surgeon ordered another MRI. The latest MRI confirmed the first
surgeon's diagnosis of Carpel Tunnel Syndrome.
After an extensive
consultation and Roget's performance of a number of agility and
physical limitations exams, the
new orthopedic surgeon classified
Roget's disability at 22%. Although better than 12%, Roget
still argued
her disability was a minimum of 80%.
Frustrated, Roget sought out her own orthopedic surgeon.
She paid
for the surgeon from her own pocket. Determined to prove her disability
was much greater than the 22%, she requested the doctor order an MRO
and a CAT Scan exam as well.
Unfortunately for Roget's appeal, the CAT
Scan offered no new evidence of disease or injury to the muscles,
tendons, or fibrous tissue in her right wrist or forearm. Her own
orthopedic surgeon was only able to increase Roget's disability to
25%.
Her appeal was heard by members of the workers
compensation board's
appellate body. After reviewing all of the medical evidence from the
three surgeons, the
workers compensation insurance company increased
Roget's disability to 25%. They would go no higher.
Roget, frustrated with the insurance
company's decision and her
inability to survive on her decreased pay, gave the firm thirty-days'
notice. During that time she searched for, and found a job with another
law firm as a paralegal.
Her pay rate there was higher than it was when
she was working as a paralegal for the first law firm. The new firm was
larger and, because of the existence of a substantially larger
secretarial pool, Roget was able to work as a paralegal with a minimum
of typing.
Important
Points...
- Workers compensation settlements
are normally subjective. Because of
the relatively intangible nature of diagnosing disability percentages,
workers compensation awards are often lower than employees expect.
Regrettably, sometimes those employees' only recourse after exhausting
the workers compensation appellate
process is resigning from their job.
- Carpel Tunnel Syndrome is a real,
and often quite painful
affliction. Those who in the past saw it as an excuse
rather than a
real injury, are now, with the burgeoning amount of medical evidence,
rapidly changing their minds and their understanding of the seriousness
of the injury.
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*This
case example is for educational purposes only. It is based on actual
events although names have been changed to protect those involved. Any
resemblance to real persons or entities is purely coincidental.
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