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  1. #1
    Join Date
    Apr 2008
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    308

    Default What Does This Mean

    My workers compensation claim was made in the State of: NC
    The IC has already paid for carpal tunnel release surgery in my right hand, and has approved for surgery in my left hand for later this month, but are denying any claim for capal tunnel syndrome? I have neck and back injuries that they already have also accepted as part of my claim. Does anyone know what their is behind their denial to carpal tunnel, while paying for the surgeries. Will I be entitled to ratings on each hand as a result of each surgery?

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
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    18,021

    Default Re: What Does This Mean

    Could be they are approving treatment/surgery to your neck injury, and nerve impingement from the neck affecting your wrists. Even though the nerve is in the wrist they are relieving. They are not accpeting the diagnosis as compensable. Differnt than providing treatment to a body part.

    Unless the carpal tunnel condition is accepted as industrial, no it won't be included in a impairment rating.

    The same as where a C&R is used to settle a claim. The parties are only agreeing to the settlement, IW agrees to accept a dollar amount as offered by the carrier to walk away from the claim. ER/IC does not admit to any liability for the injury, even though benefits may have been provided for a number of years. Even though the amount might be calcuated to the % of impairment and/or future medical needs.
    The allocation in the settlement documents is there for future use IF there were to be another industrial injury, That ER would only be liable for the PD due to the next injury...this rating would be subject to apportionment to the next claim. The allocations also protect the IW when Medicare eligible..if there is future medical money, then only that portion of the lump sum would have to be exhausted prior to Medicare providing benefits to the injured body parts in the claim.

  3. #3
    Join Date
    Apr 2008
    Posts
    308

    Default Re: What Does This Mean

    Very well explained, and I beleive that is exactly what they are doing. But if the neck injury is effecting arms and hands wouldn't they be assigned a disability rating. Ohterwise, how would you differentiate a ratings on the neck from one that has caused nerve damage to extremeties versus a neck njury that has no effect on ones extremeties. Thought ratings incorporated not only injured body part but all body parts effeted by the original injury.

  4. #4
    Join Date
    Feb 2007
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    Calif
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    18,021

    Default Re: What Does This Mean

    how would you differentiate a ratings on the neck from one that has caused nerve damage to extremeties versus a neck njury that has no effect on ones extremeties. Thought ratings incorporated not only injured body part but all body parts effeted by the original injury.
    The neck has a great deal to do with all of your body parts... it's from the brain stem through the neck/cervical the nerves move that control the upper extremeties including arms/elbow, wrist, hand/fingers... C-1/C-7 control everything from your head to about breast bone.

    When you claimed your injury, (presumably) it was based on your neck. The body is divided up into 'ratable' body parts...head, neck, upper extremeties, lower extremeties, but leg, ankle, foot as well as hands/fingers can also be scheduled injuries vs whole person. It would depend on how you are rated, scheduled or whole person whether you could consider your wrists include with the neck in a WPI.

    If your wrists were not accepted as compensable to the org injury, you could receive treatment to the nerves as they are part of the neck. It gets confusing. As you can see below, the arms/hand are included in the rating of Cervical Spine.
    The Spine
    Cervical Spine
    Note on rating of back injuries: the statutes, as written, refer to the back, not the spine. When rating impairment to the spine, always refer to it as the back (percentage of the back, not percentage of the spine.)

    A. CERVICAL SPINE FRACTURES

    Single, healed, with little or moderate anterior compression and without neurological findings
    Body = 10%
    and/or posterior elements—arch, transverse process (additional) = 5%
    Two or more vertebrae, each additional = 50% of above
    Add, for neurological
    Quadriplegia = 100% of man
    Nerve root, one arm, or both arms: Functional rating is added to cervical spine percentage.
    B. CERVICAL DISC

    Anterior discectomy, with or without fusion—free of neck and arm pain—no weakness = 5%
    Postoperative—with recurrent episodes of significant cervical and arm pain associated with objective findings = 10-15%
    Posterior laminectomy—removal of ruptured disc—free of neck and arm pain—no weakness = 5%
    Postoperative—with recurrent episodes of significant cervical pain associated with objective findings = 10-15% http://www.comp.state.nc.us/ncic/pages/ratinggd.htm
    If you follow the above link, you'll see where Upper Extremities the hand is also addressed/rated.
    Upper Extremities
    The individual member is to be rated. If damage is limited to the digits distal to the metacarpophalangeal joint, then the digit itself should be rated. If there is anatomical damage proximal to the metacarpophalangeal joint, a rating for the hand should be given, including any consideration for the digit as a percentage of the hand. If anatomical damage includes an area proximal to the elbow joint, the disability rating should be for the arm and include any percentage which would have otherwise been credited for the hand or digits.

    A. "ANKYLOSIS" AND "LIMITED MOTION WITH PAIN."

    Fingers
    Ankylosis of distal IP joint (in optimum position) = 35% of digit
    Ankylosis of proximal IP joint (in optimum position) = 50% of digit
    Ankylosis of metacarpal-phalangeal joint (in optimum position) = 45% of digit
    Any of the above in malposition = up to 100% of digit
    Wrist
    Ankylosis in optimum position = 35% of "hand"
    Ankylosis in malposition = up to 100% of "hand"
    Limited motion, mild = up to 10% of hand
    moderate = up to 20% of hand

    severe = up to 25% of hand
    So you don't have to have a specific injury to hand/wrist for these to be addressed in a Cervical Spine injury.

  5. #5
    Join Date
    Apr 2008
    Posts
    308

    Default Re: What Does This Mean

    Thanks, BVIA....Alot of infomation. I think mst of this as missed and not taken into consideration when the surgeon and the ime gave me a rating and made no mention of these other issues, but rest assured, I will certinly ng them up. Thanks again.

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