By: Nathaniel Hofman, Esq.

Cumulative trauma injuries can be particularly tricky in the context of workers’ compensation. Commonly, there is no specific “onset” of injury, and subsequently there are often disputes over reporting. An employee can have minimal complaints of pain or discomfort that do not appear to rise to the level of injury, but for workers’ compensation purposes they are significant. Using carpal tunnel, a common repetitive stress and cumulative trauma injury, as an example, the following are some tips for employers in identifying, managing, and resolving such injuries:

(1) Document, document, document!

If your employee has a complaint about pain or discomfort in any part of their body caused by the nature of their work, write it down. Ideally, an employer should fill out an incident report and have the employee sign the report. Any conversation between an employee and a supervisor, line lead, or manager that includes complaints of pain needs to be documented. Even if the conversation is about an injury outside of work, it should be documented. This can prevent a non-work injury from becoming a work injury. In the case of carpal tunnel, an employee who reports any kind of issue with their hand or wrist should be sent to fill out a report. This report benefits the employer and the employee. The employer is notified, early and hopefully before medical intervention becomes expensive, that the employee is having issues with their job duties. The employer can provide an accommodation if available, which may resolve the medical condition or prevent it from getting worse. Documentation of the injury allows a formalized dialogue to begin, and can help both employer and employee avoid the burden of further damage and treatment.

(2) Respond to the Issue

If your employee comes to you with complaints of pain, listen. If nothing else, being patient and hearing a complaint will make an employee feel valued, which is an intangible benefit that helps in the claim resolution process. The simple action of placing an employee in a different position that is less repetitive or requires less use of the extremity can prevent further damage, expensive treatment, and time off of work.

(3) Authorize Treatment Early

Sending an employee for medical treatment early can significantly decrease the cost of medical treatment and reduce the likelihood the employee will be out of work due to a cumulative trauma injury. In the case of carpal tunnel, early medical intervention can result in a brace being issued, simple stretching exercises being recommended, or in some cases physical therapy will be ordered to relieve symptoms. These treatments are preferable to surgical intervention down the road if the condition is left untreated until more serious symptoms manifest. If the employee requires a carpal tunnel release surgery, the cost of treatment will then include the surgery itself, prescription medications, physical therapy, a brace, and any complications and subsequent treatments. Indemnity benefits could also need to be paid for any time off of work. These extra costs can be avoided by responding to an injury early on; it is easier to put out a match than a bonfire.

(4) Determine Whether Complaints Involve a Legitimate Injury

While there are cases where an employee is not totally honest with an employer about a cumulative injury, it is often less expensive to presume there is an actual injury and respond accordingly. If an employee complains of symptoms of carpal tunnel syndrome, a treating physician has tests that provide objective results that will confirm if the employee in fact has carpal tunnel.

These simple actions can prevent a cumulative trauma injury from progressing into a surgical claim, and prevent longer-term medical issues for employees. By following these actions, an employer can avoid prolonged absences by the employee and expensive treatments.