In Focus | Shoulder Injuries | Mahony’s Lawyers Adelaide.
Shoulder injuries remain one of the most common type of injuries sustained at work. As workplace injury lawyers we are often asked whether someone is eligible for compensation on account of their injury. Today we look at the method of prescribing compensation under the Return to Work Act 2014 (SA) (the Act) for common shoulder injuries.
Section 22 of the Act provides a mechanism for assessing permanent impairment suffered as a result of workplace injuries. An eligible worker is entitled to an assessment by an accredited specialist (not just any doctor can perform the assessment which used to be the case prior to 2009) for their compensable injury.
Whilst section 22 of the Act provides the framework for how the assessment of impairment is to occur, it is really the Impairment Assessment Guidelines (IAGS) and the American Medical Association Guidelines edition 5 (AMA 5) which do the work.
The IAGS have gone through a number of iterations since their commencement. There are technically 2 versions of the IAGS but the second version only applies to injuries which occurred on or after 24 August 2021 where a worker had already selected their assessor prior to 1 August 2022 or were already part way through their assessment, otherwise the first version (March of 2015) is used.
The IAGS refer to various parts of the body and state in detail how the assessor is to conduct the assessment according to the individual body parts. A shoulder injury comes within Chapter 2 (the upper extremity” chapter) of the IAGs and Chapter 16 of AMA 5.
When the assessor conducts this assessment, the IAGS direct that the method of calculation of impairment is that contained within Chapter 16 of AMA 5. Specifically page 451 makes reference to how the clinical assessor should calculate their findings. AMA 5 directs that an injured worker’s abduction, flexion, extension, abduction, adduction, internal and external rotation should all be measured and then calculated according to the criteria provided.
It is important to note that the IAGS cure or regulate how the AMA 5 is applied. The IAGS were developed in consultation with a number of medical practitioners and stakeholders. Therefore, AMA 5 does not always provide the ultimate answer to an injured worker’s impairment and what the IAGS have to say in their place prevails.
The IAGs state that an injured person’s “range of motion” (ROM) is often the most suitable means of evaluating impairment. It impresses upon the assessor that:
- When calculating impairment for loss of ROM it is always important to compare measurements of the relevant joint in the unaffected or “normal contralateral shoulder”. This is then used as a base line and used to subtract the injured shoulder. If the other shoulder or “normal shoulder” is not normal,this other shoulder should not be used.
- A goniometer or inclinometer must be used.
- Measurements should be taken from active range of motion (this is compared to passive range of motion) and tested with consistent repetition. It is often considered that 3 assessment must be performed.
Given that the range of motion is typically the most preferred means of assessment, consideration of passive and active motion is a relevant consideration for the clinical assessor. It is important to note that the assessment is to be conducted using the assessor’s clinical judgment. The passive and active movement is assessed on the day of the assessment. Like someone’s cold symptoms (which can wax or wane or be worse or better on any given day or at any given time) so too can a person’s symptoms and therefore their ability to function. The range of motion is effectively an ability to function part of the upper extremity.
Whilst a range of motion assessment is a preferred means of assessing a worker’s level of impairment, given a person’s symptoms are inherently variable, this could bring about different assessments on any given day or at any given time of the day.
Therefore, one has to be extremely careful to ensure that this is clearly articulated to the assessor prior to the appointment. It is recommended that legal advice be obtained prior to the assessment to carefully scrutinise the letter to the accredited specialist.
Whilst shoulder injuries remain one of the most prevalent injuries that can occur during the course of one’s employment, there is a potential for permanent impairment (whether or not surgery has occurred).
Injured persons seeking compensation for a shoulder injury should seek immediate advice. Those that are involved in their treatment may benefit from further explanation of this topic in more detail.
Please contact Mahony’s Lawyers on 1300 624 669
*the above should not be construed as legal advice and we invite you to contact mahonys lawyers to see how this applies to your circumstances.