If you’re like most people, you don’t devote much time to thinking about your shoulders. But after you’ve hurt your shoulder, you quickly come to realize just how much you use your shoulders. When every motion — from standing up to laying down — is painful, you understand just how important shoulders truly are.
There are many ways that you can injure your shoulder, from getting hurt while playing sports to falling and hitting your shoulder. Too often, shoulder injuries happen at work. This may happen due to lifting a heavy object or simply performing repetitive work with your shoulders.
If you have suffered a shoulder injury at work, you may be entitled to workers’ compensation benefits for your medical treatment, lost wages, and disability. Insurance companies often fight claims for shoulder injuries, arguing that your injury is due to other factors, such as arthritis. A New Jersey workers’ comp attorney can advocate for you throughout the process, from the initial application to any hearing or appeal.
Common Shoulder Injuries
The shoulder is a large, complex joint that connects the upper arm bone (the humerus) to the shoulder blade (scapula). It is a ball and socket joint, which means that the ball part of the humorous glides within the cup-like socket of the scapula. The humerus fits loosely into the scapula, which allows for a wide range of motion — but can make the shoulder more vulnerable to injury.
There are a number of important parts of the shoulder, each of which works to make the shoulder function properly. This includes:
- Rotator cuff: a combination of muscles and tendons that center the humerus within the socket
- Bursa: small, fluid-filled sacs that cushion the joint
- Labrum: a cuff of cartilage that forms a cup for the head of the humerus inside of the socket
An injury to any of these parts can cause serious pain and may lead to disability.
While the shoulder can be injured in a number of ways, the most common shoulder injuries are:
- Torn rotator cuffs
- Sprains and strains
- Frozen shoulder
Treatment for shoulder injuries (other than fractures) typically starts with resting the injured joint. If this fails to improve the symptoms, an orthopedic surgeon may prescribe medications and/or physical therapy to reduce pain and swelling. In some cases, surgery may be necessary to repair a tear or otherwise address the problem within the shoulder.
Workers’ Comp for Shoulder Injuries
Workers’ compensation is a type of insurance that allows an employee to seek benefits if they suffer an on-the-job illness or injury. Because there is no need to prove fault in order to receive benefits, workers’ comp is considered a no-fault system. Both Pennsylvania and New Jersey require employers to carry workers’ compensation insurance for their employees.
If you have suffered a shoulder injury at work, then you may be eligible for workers’ compensation benefits. You will need to prove that your shoulder injury is work-related. Workplace shoulder injuries may be caused by:
- Blunt trauma to the shoulder, such as being hit by something
- Lifting heavy objects
- Falling onto the shoulder
- Repetitive work, particularly if it involves lifting your arms over your head
To qualify for workers’ compensation, you will need to demonstrate that you have been diagnosed with a particular condition, such as a torn rotator cuff, and that this condition is the result of your job duties.
For example, if part of your job involves lifting heavy boxes or other objects, you may develop bursitis — an inflammation of the fluid-filled sacs that cushion your shoulder joint — over time. You may also tear your labrum or rotator cuff while lifting something heavy. An orthopedic surgeon can diagnose your condition based on a physical examination and tests such as an MRI.
If you have been diagnosed with a rotator cuff tear, you will likely have a number of restrictions on what you can do. This will likely include a limit on lifting any objects — let alone something that is over 10 pounds. In this situation, you may need extended time off of work in order to seek medical treatment and recover.
Workers’ comp insurance companies will often fight shoulder injury claims that are not directly related to a trauma, such as falling on your shoulder or being hit by a falling object. The insurer may argue that there are other reasons why you tore your rotator cuff or have bursitis — such as activities that you engage in outside of work, or even just wear and tear on your joints over time. They may even request an independent medical examination (IME) to prove that your injury is not work-related. This is why having a skilled attorney is so important; they can put together a strong argument for why your injury was caused by your work.
Elements of a Shoulder Injury Settlement
In New Jersey, there are five types of benefits available to workers who have suffered a workplace injury or illness: (1) medical benefits; (2) temporary total benefits; (3) permanent partial benefits; (4) permanent total benefits; and (5) death benefits. The total value of a workers’ comp case will depend on a number of factors, including the type and severity of the injury.
Most workers’ comp claims end in a settlement. In New Jersey, there are two types of workers’ compensation settlements. Section 20 settlements are full and final resolutions of your claim. Section 22 settlements will allow you to reopen a claim in the future, if necessary.
With a Section 20 settlement, you will receive a lump sum from the insurance company. In exchange, you will give up your right to all benefits related to your claim, including future medical care. These settlements are only available in situations where the insurance company has denied your workers’ compensation claim or disputed part of your claim.
In contrast, any workers’ comp claim can be settled with a Section 22 settlement. With this type of resolution, both parties agree to a specific permanent disability rating; the insurance company will then pay benefits in installments based on the New Jersey schedule of benefits. You do not give up your right to future medical care with this type of settlement and can reopen the claim if your condition worsens.
Any settlement must be reviewed and approved by the New Jersey Division of Workers’ Compensation. Depending on the type of shoulder injury that you have suffered and if you are permanently disabled as a result of your injury, your settlement may contain benefits for medical care, temporary or permanent total benefits and/or permanent partial benefits.
Ready to File? Contact Us Today.
If you have suffered any type of injury at work, including one involving your shoulders, you may be entitled to workers’ compensation benefits. Unfortunately, insurance companies often balk at paying workers what they are owed for their on-the-job injuries. An experienced New Jersey workers’ comp attorney can advocate for you throughout the process.
Since 1995, Bross & Frankel has represented workers who have been hurt or become ill at work throughout New Jersey and Pennsylvania. Our team is dedicated to helping people like you get the benefits that you deserve. To learn more or to schedule a free claim review, call our office today at 856-795-8880, or contact us online.