Workers
Compensation injury to cervical spine. Claimant is self-employed
and reported an injury to her left shoulder and
upper arm when moving a file cabinet in her home office. The orthopedic
surgeon’s examination was entirely within normal limits. However,
an MRI of her neck was ordered, only three days after the injury.
The MRI showed evidence of C5-6 disc degeneration and protrusion
and C6-7 disc degeneration. Surgery was discussed. An EMG showed
mild left carpal tunnel symptoms but no evidence of a pinched nerve
in the neck. A cervical decompression and fusion was recommended
due to her pain, weakness and decreased sensation. The file was sent
to Joan for review prior to authorizing such surgery. The file cabinet
was actually a small cart on wheels with slots for hanging folders.
It became immediately clear that this type of reaching injury with
the left hand most likely did not cause a cervical disc herniation.
However, the surgeon insisted that it could have happened, especially
in light of the fact that she had no previous problems with her neck
whatsoever. Joan requested medical records from her family physician
for five years prior to the date of loss. There was no documentation
of any problems with her neck or upper extremities. However, buried
in all the medical records and laboratory studies, there was one
lab study result on cerebrospinal fluid for protein, glucose
and bacteria. Joan noticed this to be the typical lab specimen submitted
following a myelogram procedure. Joan recognized that the ordering
physician’s name on the lab studies was a local neurologist and
his office was contacted to obtain medical records. Voluminous medical
records were received regarding the claimant’s complaints
of neck and left upper extremity pain, including a CT/Myelogram performed
three years earlier for the same symptoms that she was complaining
of at this time. The claimant had flat out denied any previous problems
with her neck or upper extremities. Based on Joan’s review and
recommendations, the claim was determined to be non-compensible.
Workers
Compensation injury to cervical spine. Claimant is self-employed
and reported an injury to her left shoulder and
upper arm when moving a file cabinet in her home office. The orthopedic
surgeon’s examination was entirely within normal limits. However,
an MRI of her neck was ordered, only three days after the injury.
The MRI showed evidence of C5-6 disc degeneration and protrusion
and C6-7 disc degeneration. Surgery was discussed. An EMG showed
mild left carpal tunnel symptoms but no evidence of a pinched nerve
in the neck. A cervical decompression and fusion was recommended
due to her pain, weakness and decreased sensation. The file was sent
to Joan for review prior to authorizing such surgery. The file cabinet
was actually a small cart on wheels with slots for hanging folders.
It became immediately clear that this type of reaching injury with
the left hand most likely did not cause a cervical disc herniation.
However, the surgeon insisted that it could have happened, especially
in light of the fact that she had no previous problems with her neck
whatsoever. Joan requested medical records from her family physician
for five years prior to the date of loss. There was no documentation
of any problems with her neck or upper extremities. However,