In 2007 Carom Data, LLC reviewed hundreds of Workers' Compensation claims and several liability claims where the original injury was diagnosed as a shoulder strain or sprain. Then, ninety days to six months later, the shoulder strain turned into a cervical multi-level surgical procedure for disc removals and fusion. How does a shoulder injury turn into a neck injury? Simple! The source of the shoulder pain is elusive.

When the attending physician is unable to solve the pain problem, but has exhausted all diagnostic opportunities with the shoulder they will search for another source of pain.

The first thought is that perhaps the worker REALLY hurt his neck during the accident and this is “referred” pain coming from issues with a cervical disc. Next, the doctor orders a cervical MRI which shows degenerative disc disease and the need for a multilevel fusion.

How is this work related? It most likely is NOT work related, but too often we forget that physician's are not in the business of determining compensability, they are in the business of treating patients….so they treat. When asked if it is work related, the typical answer is “No, but the condition was aggravated by the work related injury.” That is sufficient to make it compensable in most jurisdictions. Is there a defense for this? Yes, and that is the subject of next month's Savings Hint.