Tendonitis, back pain, and carpal tunnel syndrome are three common ailments reported by employees who spend most of their time sitting at a desk. (Photo: Lightfield Studios/Adobe Stock)
In 2022, a nurse in New York filed a workers’ compensation claim alleging she had suffered shoulder and knee injuries due to repetitive use of those body parts on the job.
The case went all the way to the Supreme Court of the State of New York, which ruled this summer that the nurse’s injuries were compensable, reversing an earlier lower-court decision. The verdict sets a precedent that could increase risk exposure to repetitive use injuries (RUI) for employers and insurers nationwide. RUIs are among the most multifaceted workers’ compensation claims, filled with gray areas that can extend the tail of a case for years and drive-up costs exponentially.
Unpacking the complexity
To understand the intricacy of an RUI claim, take the example of a construction worker whose duties require the regular use of a jackhammer. After years on the job, the employee hurts his shoulder, and his doctor attributes it to repeated jackhammer use.
The challenge is trying to prove the cause and effect. Unlike a fall from a ladder that results in a back injury, RUIs are not tied to a specific incident. They have no defined date, time or location. The burden of proof is on the doctor to prove beyond a shadow of a doubt that jackhammer use caused the claimant’s injury. That means documenting how frequently the employee used the jackhammer, for what tasks, in what manner, and over what time span during a typical day, week or month. When this type of medical attribution is lacking, RUI cases often start to fall apart.
Understanding the exposure
Another challenge of RUIs is that they can happen in almost any industry. In healthcare, nurses and home health aides who have to support patients every day are at risk. So too are airline workers who routinely push overloaded carts and lift heavy baggage. Even retail workers who are on their feet all day and regularly lift and bend while stocking shelves could suffer RUIs.
Office workers are not immune, either. Tendonitis, back pain, and carpal tunnel syndrome are three common ailments reported by employees who spend most of their time sitting at a desk while performing their work responsibilities.
Weighing the true costs
When not managed properly, an RUI case can become expensive quickly. The very nature of a RUI opens the door to injury creep. For example, consider the case of a claimant who repeatedly bends over while working. What starts as lower back pain can escalate rapidly to upper-back pain, knee injuries and leg injuries.
Additionally, litigation for RUIs is highly nuanced. Cases are also highly dependent on the claimant’s recall of when they first experienced symptoms, when they began consulting with doctors, and which specialists they saw. Building a defensible case means collecting copious amounts of medical records, along with multiple employer and medical witnesses who can testify to the employee’s job tasks, scope of work, and record of care. The claimant will likely be asked to testify, as well.
All this time, the clock is ticking to meet the state-mandated statute of limitations. In states such as New York and New Jersey that see a higher number of workers’ comp claims, the statute of limitations is relatively short—two years from the date of injury.
Mitigating the risks
Employers, their risk managers and carriers can all take steps to keep workers healthy, reduce RUIs and lessen the likelihood of costly, complex RUI claims.
Policyholders should partner with third-party experts to assess the ergonomics of their workplaces. Ask them to review how employees bend, lift, carry, reach, and stand during a typical workday. Then ask the consultant to create a written report that can be shared with managers and directors. This will give employers defensible information they can use in the event of a claim.
A smart next step is for the policyholder to ask the same third-party firm to offer recommendations on how to reduce strain on workers’ bodies. Their risk managers can then take those insights and implement them into a company’s existing worker education and injury prevention programs to improve employee safety.
Carriers, meanwhile, should instruct their clients about the importance of requesting Independent Medical Examinations (IMEs) performed by board-certified specialists for any RUI claim. Ask doctors to go beyond collecting a claimant’s medical records by also gathering information about their full work duties and hours of work. This extra step will help link the claimant’s injury to their work duties.
Stopping RUIs before they start
RUIs may seem like soft claims, but they turn into hard dollar losses quickly. The best way to prevent costly and lengthy claims is to prevent them from happening. Collaboration among employers, risk managers, carriers, agents and brokers can help educate workers on potential risks and create safer workplaces across industries.
Sarah Thomas is managing partner at Jones Jones LLC where she leads the firm through the evolving technicalities of workers’ compensation and insurance defense law. She can be reached at 212.776.1808 or https://jonesjonesllc.com.
Opinions shared in this piece are the author's own.
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