Limb loss – Loss of any part of an extremity (arm or leg) due to surgical or traumatic amputation.

Limb differences – The congenital absence or malformation of limbs.

How often does this occur in the population?

• Approximately 1.7 million people with limb loss in the U.S., excluding fingers and toes (2007)
• Over 185,000 new amputations are performed each year in the U.S.
• Prevalence rate of limb loss is highest among people aged 65+
• Prevalence of congenital limb difference in 1996 was 25.64 per 100,000 live births.

What causes limb loss and limb differences?

Limb loss -  Can come about due to trauma, infection, diabetes, vascular disease, cancer and various other diseases.

Limb differences – the cause is mostly unknown, but it used to be attributed to the use of drugs, such as thalidomide by a mother during pregnancy.

How can I reduce the risk of amputation?

• Practice good safety habits when operating machinery
• Practice good foot hygiene and care
• Avoid smoking

Is there an increased risk for any health problems with limb loss?

Since the loss of a limb can decreased one’s physical activity, the risk of health problems associated with inactive lifestyle might be increased.  Residual limb and phantom pain, along with skin problems that come along with prosthesis use are also common.

What type of care is needed for people with Limb Loss and Limb Differences?

Prosthesis – Candidates for prosthesis use commonly make several visits to their prosthetic facility to obtain a fitting device.

Physical therapy – Often times, the individual must undergo physical training in order to use their prostheses and other devices without the help of someone else.

Emotional therapy – Some amputee victims need to speak with a counselor, so that they can properly cope with life without a limb.

Lower back pain is, generally speaking, any muscular or skeletal pain in the lumbar spine region, and whether it’s on the job or working out, almost everyone is affected by it at some point in their life.  A herniated disc, however, is where the gel-like substance between the vertebrae ( the disc) ruptures and slips into the spinal canal – a common cause of back pain.  Nevertheless, this should not be confused with a “bulging disc,” where the disc simply juts out from the spinal column.

What are the causes?

weak muscles – weak muscles (specifically abdominal) cannot adequately support the spine.

sedentary lifestyle – Not enough exercise leads to weight gain, which can put a great deal of stress on the discs.

aging – Unfortunately, the deterioration of the body is a natural part of the aging process, which includes the back muscles and the spine.

poor sleeping habits and posture – slouching when sitting and sleeping on your stomach are irresponsible ways to treat your back.  Instead, lie down with your stomach facing up, and sit up straight whenever possible.

What are the symptoms?

Muscle weakness – If the disc is affecting a nerve, it might interfere with your muscle reflexes.

Shooting pain in the legs – This type of pain is usually due to the disc pressing against a nerve.

Tingling or numbness – Apart from pain, the sensation of the legs or back “falling asleep” is commonly felt in patients with disc problems.

How is it diagnosed?

A back injury or herniated disc is properly diagnosed through a combination of…

• examination of your medical history
• physical exam
• X-rays
• MRI scan
• blood tests

What is done for treatment?

More often than not, if you have back pain – even a herniated disc, you probably don’t need surgery.  However, when all non-surgical options fail, surgery ought to be considered.

Non-surgical treatment

• Lie down on a bed or couch in a position that is most comfortable to you
• Use anti-inflammatory medication
• Apply heat (to reduce swelling and pain) and cold (to promote recovery).

Surgical treatment

Surgery is often considered when there is…

• Disc displacement or a “slipped disc”
• Narrowing of the spinal canal due to bone overgrowth
• Misalignment of one vertebra on another
• Rapidly progressing nerve damage
• Chronic pain that does go away with non-surgical treatment

Types of surgery

• Disectomy – Removal of the disc.
• Laminectomy – Trimming or removal of the vertebral bone.
• Partial laminectomy  – Removal of much of the degenerated disc material.
• Spinal fusion – The joining together of two or more vertebral bones with grafts or pins, which is done is more serious cases.

Recovery after the operation

Recovery after back surgery varies with the type of operation that is done.

• Disc removal -  Out of bed in three to four days, and released from the hospital in five.
• Spinal fusion – Released from the hospital after about 10 days, and may require several weeks to resume all normal physical activites.

How can I prevent lower back pain?

• Control your weight
• Stay active and strength your abdominal muscles
• Practice good posture
• Left heavy items with your legs, not your back

What happens to my body with paraplegia?

You may have one or more of the following symptoms:

• Inability to move or feel anything below the damaged area.
• Limp muscles, especially in the arms and legs.
• Inability to control your bowel (BM) or bladder (urine).
• Trouble breathing or you are unable to breathe on your own.

Who will treat me?

A team of health care workers workers will help treat your physical and mental ailments that have come about from paraplegia.

The team might include:

• Your regular doctor
• Neurologist
• Psychologist
• Physical therapist
• Occupational therapist
• Respiratory therapist
• Social worker.
• Speech pathologist

What tests will I need?

Tests help caregivers find out more about your spinal cord injury, and may also help caregivers plan your treatment.

You might need one or more of the these tests:

• X-rays: X-rays help caregivers see the part of the spine that is damaged.
• Neurologic tests: Caregivers may ask you questions and do other tests to learn what area of your spinal cord is injured.
• MRI: This test may be done to show where and how much damage has occurred.
• CT scan:  Also called a “CAT scan,” this test consists of computer that takes pictures of your neck and spine.  Your doctor will look at the pictures exactly what areas are injured.

What treatments will I receive?

hospital stay – You will need to stay in the hospital for a few days after the injury, so that your doctors can properly diagnose your injury and provide the initial treatment.

rehabilitation center – After you are dischared from the hospital, you will most likely have to go to a rehabilitation center, so that you can learn how to be as independent as possible.  During rehabilitation you will learn about:

• physical therapy – During physical therapy, you will receive training on how to make your muscles strong, and how to get around in a wheel chair.
• braces: You might need a brace if the ligaments that support your spine are injured. A special type of brace may be used if the injury is in your chest, or lower back area. These braces include a clamshell (plastic body jacket) or a plaster or plastic body cast.
• medication: Your caregiver will show you what medicine you need, and exactly how to take it.
• bowel and bladder programs: Being paralyzed sometimes makes you unable to control when your bowels and urine flow.  Your caregivers might show you the different methods for managing this.
• mental health – Simply learning how to emotionally cope with your injury can be difficult, but special caregivers will counsel you on how to push through, when you’re feeling down.
• new life skills – Your caregiver will provide you with occupational therapy, which basically teaches you how to use all of the special equipment that comes with being paralyzed.  They also might show you how to perform everyday tasks like getting dressed and eating  – easy tasks that need to be relearned, once paralyzed.

What type of surgery might I need?

You may need surgery to support the bones in your spine. Pieces of vertebra or disc may be pressing on the spinal cord or nerve roots coming out of the spinal cord, and you may need surgery to remove these pieces of bone.  Caregivers might use bone from your hip or metal rods to support your spine.  You may also need surgery or to help you move better.  Some of these procedures are called muscle tendon transfer, or functional electrical stimulation (FES).

As of 2007, the number of people in the U.S. living with spinal cord injury was estimated at approximately 255,702 persons, with a range of 227,080 to 300,938 persons.

How many new cases of spinal cord injury are there a year?

Not including those who perish at the scene of the accident, there is approximately 12,000 new cases each year. Since there have not been any comprehensive incidence studies of spinal cord injury in the U.S. since the 70’s, it is not known if incidence has changed in recent years.

What age does a person commonly obtain spinal cord injury?

Since 2005, the average age at injury is 39.5, but spinal cord injury happens frequently in young adults, as well.  With time though, the average age at injury seems to be increasing.

Who’s more affected by spinal cord injury, men or women?

Generally speaking, males.  Since 2000, 77.8% of spinal cord injuries reported, have occurred among males.

Are some races more affected by spinal cord injury than others?

Among people injured during 2000…

Caucasian:  63%

African American 22.7%

Hispanic: 11.8%

Other: 2.4%

What are the most common causes of spinal cord injury?

1. motor vehicle accidents

2. falls

3. acts of violence (like gunshot wounds)

4. sporting/recreational activities

What is the job outlook like for someone with spinal cord injury?

Around 57% of people with spinal cord injury reported being employed at the time of their injury. The post-injury employment outlook is better among people with paraplegia than among people that have tetraplegia.

How long do people with spinal cord injury usually stay in the hospital?

About 15 days in the hospital and about 35 days in rehab, but this all depends on the specific injury.

Where do people with spinal cord injury usually live?

Almost 90% of of all people with spinal cord injury who are discharged from the hospital or other medical care facilities, go  back home ( or with friends and family in other private residences).  Only about 6% are discharged to nursing homes. The remaining are discharged to hospitals, group living situations or other destinations.

Do people with spinal cord injury tend to be married or single?

Considering the youthful age of most people with spinal cord injury, it is not surprising that 52.5% are single when injured. Among those who were married at the time of injury, as well as those who marry after injury, the likelihood of their marriage remaining intact is a bit lower – when compared to the uninjured population. The likelihood of getting married after injury is also reduced.

What is the average yearly cost associated with spinal cord injury?

The average yearly health care and living expenses that are directly attributable to spinal cord injury vary greatly according to severity of injury.

What is the life expectancy for someone with spinal cord injury?

Although life expectancies for people with spinal cord injury continue to increase, they are still somewhat below life expectancies for those with no spinal cord injury. Mortality rates are significantly higher during the first year after injury than during subsequent years, particularly for severely injured persons.

If you have a spinal cord injury you might be able to receive compensation.  Don’t hesitate to contact J Franklin Burns, your georgia workers compensation attorneys.

Spinal Disc

It is a soft cushion that rests between each vertabrae in your spine. This spinal disc becomes firmer with age. In a young person, the disc is soft and elastic, but like many other structures in the body, the disc gradually loses its elasticity and is more vulnerable to injury. In fact, even in individuals as young as 30, some disc deterioration in about 30% of people, can be seen.  That is why people between the ages of 30 and 50 are the most at risk for herniation.

Symptoms of a Herniated Disc

• muscle weakness: Due to the nerve irritation, signals from the brain may be interrupted, causing muscle weakness.  This can be tested by examining reflexes.
• leg pain: commonly occurs in just one leg, and can be sudden or gradual.  It can get worse when you walk, sit, or stand, but might subside why you lay down and relax your spin.
• bowel and bladder problems:  If a patient is experiencing these symptoms, they may have cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency, and you should see a doctor immediately – if you have problems urinating, having bowel movements, or if you have numbness around your genitals.
• tingling sensations: People with herniated discs commonly feel tingling, numbness, or “pins and needles.”

How a Herniated Disc is Diagnosed

• physical exam – Your doctor will test your reflexes, sensations and muscle strength.
• MRI – will show detailed images of the condition of your bones and discs, as well as any neurological involvement.  An MRI will give an accurate picture of what might be affecting the spinal cord or nerve roots.  A physical examination is necessary to yeild the best results from an MRI.
• X-ray – X-rays might be taken to see if there is an initial problem with the disc.  However, they cannot really determine what the exact problem is, because X-rays do not detail soft tissue.

Treating a Herniated Disc

Most herniated discs heal on their own in about one to six months.  A vast majority of patients who have a herniated disc will improve within six months, after completing nonsurgical treatment.  For this reason, nonsurgical treatment is usually attempted before surgery is considered.

Nonsurgical treatment

• Medication to control pain and inflammation
• application of ice and heat to relax the muscles
• Doctor-recommended exercise to strengthen the back muscles
• Surgery is only necessary in about 10% of people with herniated discs.  These are people usually have severe nerve damage and perpetual pain.

Types of surgery

disectomy – removes a herniated disc from the spinal canal.

endoscopic microsectomy – has the same goal as a disectomy, but the incision is smaller, and it requires less tissues dissection.  Instead of the surgeon looking directly into the incision he/she looks through a camera because the incision is so small.

While jobs in construction and factory work usually cause full-on injuries, many people don’t realize that desk jobs can lead to back problems as well, if bad habits are kept.

Often times, there is no singular cause of back problems, and they usually are a combination of factors.  Of course, sudden accidents happen, but you can control your weight, fitness and flexibility, which will make you less likely to have back pain or become injured.

Work-Related Factors That Tend to Lead to Back Pain or Injury:

Repetition:  The number of times you perform a specific movement can lead to muscle fatigue, especially if it involves stretching to the limit of your range of motion.

Force: If your job is very physically involved, you might face back injury, if you frequently lift or move heavy objects.

Posture:  The position of your back when standing or sitting.  If you spend most of your time in front of a computer, you may experience occasional aches and pains from sitting for long periods of time.  Generally, your body can tolerate being in one position for about 20 minutes before you feel the need to adjust.

Stress: Pressures at work or at home can increase your stress levels, and lead to muscle tension, which may lead to back pain.

Ways to Avoid Injuries

Stay Active: Even if you move around a lot on your job, or your job requires physical exertion, you still need to exercise. Regular activity is your best bet in maintaining a healthy back.  You can do specific strengthening and stretching exercises that target your back muscles. These exercises are called “core strengthening,” as they work both your abdominal and back muscles. Strong and flexible muscles will help keep your back in shape.

Not Slouching: Poor posture exagerates your body’s natural curve and puts a great deal of stress on your back. Good posture relaxes your muscles and requires minimal effort to balance your body.

Standing: Every so often, rest one foot on a stool or small box. Try not to bend forward to do computer or written work.

Sitting: Choose a chair that supports your back. Adjust the chair so that your feet stay flat on the floor. If the chair doesn’t support your lower back’s curve, place a rolled towel or small pillow behind your lower back. Remove bulky objects, like wallets, from your back pockets when sitting, because they can disrupt the balance in your lower back.

Lift With Your Legs: Let your legs do the work, keeping objects close to your body, and ask for help if something is too heavy.  Never use your back as the major lifting force.

Adjust Your Work Space: How can you change repetitive work tasks to reduce the physical demands on your back? The goal is to decrease force and repetition while maintaining healthy posture. For instance, you might use lifting devices or adjustable equipment to help you lift loads.  If you’re on the phone a lot, try using a headset. Avoid putting the phone between your shoulder and ear to free up your hands for yet another task. If you work at a computer, make sure that your monitor and chair are positioned properly.

Adopt Healthy Work Habits

Reorganize your work to eliminate repetitive physical movements. Avoid unnecessary bending, twisting and reaching.  If you’re carrying something heavy, know exactly where you intend to put it, and whether that space is free from clutter.

Change your position often. Take a 30-second timeout every 15 minutes or so to stretch, move or relax. Try standing up when you answer the phone, for instance.

Be cautious by wearing low heels, and non-slip soles.  Remove anything from you work space that might cause you to trip.   .

Maintain proper coordination and balance by simply walking regularly.  Practice balance exercises to keep you steady on your feet.

Be Aware of Your Mental Health

When you’re under stress, it causes your muscles to tense, making you more prone to injury.  Try to minimize your sources of stress both on the job, as well as at home.  Perform deep-breathing exercises, take a walk around the block or simply talk about your stress with someone.  Depression and substance abuse also increase the risk that your  back pain will persist. Talk to your doctor if you think you may be affected by either of these issues.

If you have back injury and are unable to work, don’t hesitate to contact J Franklin Burns, workers’ compensation attorneys at law.

Carpal tunnel syndrome is a repetitive stress injury resulting from continuous, recurring activity involving the hands, wrists, fingers and forearms. When the same actions are performed over and over again, the tissues surrounding the median nerve (which runs down the inside of the forearm, through the wrist and into the palm of the hand) become inflamed and swollen. These swollen tissues put pressure on the median nerve, resulting in symptoms ranging from tingling, numbness and pain to loss of mobility, especially in the thumb.

Left untreated, pain increases and mobility decreases. Eventually, carpal tunnel syndrome symptoms can become so severe that sufferers find it impossible to grip items and perform simple tasks like opening jars, turning doorknobs and buttoning clothing.

Carpal tunnel syndrome is quite common and those who work on computers, as cashiers or in manufacturing facilities are at substantial risk. It has become such a prevalent problem in recent years that products claiming to ease carpal tunnel symptoms have flooded the marketplace.

Office workers suffering from carpal tunnel syndrome can seek worksite relief from furniture and computer accessories designed to be ergonomically correct. Companies like Ergonomics Made Easy and Ergo-Items.com offer a wide array of keyboards, mice and other items designed to help prevent and reduce aggravation of repetitive stress injuries.

For those working in warehouses, at cash registers, on assembly lines or in other non-office occupations where repetitive motions are part of the on-the-job requirements, braces, gloves and splints can provide some support and relief for mild carpal tunnel syndrome symptoms. A huge array of these kinds of products is available, and some even offer hot and cold options for additional soothing properties.

In addition to prescription medicines and cortisone shots offered by physicians, a number of over-the-counter pain relievers and herbal remedies are available that might help to ease discomfort and reduce swelling associated with carpal tunnel syndrome. The condition is so common today that supermarket giant Publix even has an entire page on its website dedicated to homeopathic remedies for carpal tunnel syndrome sufferers.

Exercises that stretch the muscles in the hands, wrists and fingers also can be helpful in decreasing the inflammation and swelling of carpal tunnel syndrome. The Cats Paw ergonomic hand exerciser is said to be the first non-surgical device for carpal tunnel syndrome treatment to be awarded a U.S. patent. Some simple stretching exercises like the ones demonstrated here can prove beneficial, as well, especially if they are done prior to engaging in repetitive motion work activity.

Of course, anyone suffering a repetitive motion injury related to work should take time off or be assigned different job duties to allow proper healing time. Like other job-related injuries, workers’ compensation is available for those hurt by repetitive motion work.

Due to the fact, however, that carpal tunnel syndrome and other repetitive stress injuries happen slowly over time, it can be more difficult to prove that they have occurred as a result of working environments or job duties. This is why those injured by repetitive motions at work should seek the help of an attorney specializing in workers’ compensation.

Attorneys well-versed in this field should have experience and a track record of proving that repetitive stress injuries are the direct result of workplace demands and conditions. A skilled attorney will be able to prove a worker’s case and secure workers’ compensation benefits for the employee so that he or she can take the time necessary to heal before carpal tunnel syndrome becomes a permanently disabling condition.

If you work in Georgia and have suffered a repetitive stress injury or other injury at work, you may be eligible to receive workers’ compensation benefits. Call the law office of J. Franklin Burns at 678-298-0323 for a free consultation.

You might ask why there is a difference, since the end result (the payment of money) is the same. The main difference is in the language of the settlement documents. A no-liability settlement includes a discussion regarding the injured worker’s accident and the insurance company’s denial of the benefits. It also covers the fact that all parties essentially wish to settle the case and that as part of the settlement, the parties agree that the case was not a compensable workers’ compensation claim. Injured workers often are upset by this agreement because they feel it makes then look like liars. In reality, nothing could be further from the truth.

In a no-liability settlement, the State Board of Workers’ Compensation’s file will include documents seeking income and medical benefits on the injured employee’s behalf. The settlement documents do not discount the original filing of the injured party’s claim or what litigation might have resulted. The settlement documents merely provide an opportunity for the injured worker to receive a financial payment in exchange for the dismissal of the claim.

The effect of the no-liability settlement is to have an order from the board finalizing the claim. The order approves the agreement that the claim was not a compensable claim. Unless the insurance company has paid income and medical benefits, the claim has not been accepted as compensable anyway, so agreeing to such a settlement is not contradictory to how the claim has proceeded thus far.

If a claim has not been accepted as compensable under workers’ compensation, a no-liability settlement is to the claimant’s advantage, because it provides the claimant with the possibility of using his or her own health insurance. Most health insurance companies will not pay for medical expenses related to a workers’ compensation claim.

When a workers’ compensation claim is denied, the injured worker’s health insurer might accept responsibility and pay for medical treatment. This does not provide a guarantee of any coverage by a health insurance provider, though. A disadvantage of the no-liability settlement is that it, like many liability settlements, does not provide any payment for future medical treatment. Kissiah, Richard C., Kissiah’s Georgia Workers’ Compensation Law, 3rd Ed. Vol. 1, 1.14[2], p. 79-81 (2006).

Employers and insurance companies like no-liability settlements because the no-liability settlements provide an order agreeing that such a claim is not compensable. It is a small victory, bearing in mind that they have to make a cash payment in order to secure this agreement. Kissiah, Richard C., Kissiah’s Georgia Workers’ Compensation Law, 3rd Ed. Vol. 2, 25.03[3], p. 1084-1087 (2006).

The no-liability settlement option provides some injured workers with an opportunity to settle their cases, avoiding the prolonged litigation that might be necessary in order to get their claims declared compensable. These settlements play an important role in the workers’ compensation system. For more information or for qualified help determining if a no-liability settlement is right for you, contact an experienced and knowledgeable attorney specializing in workers’ compensation cases.

Unlike workplace injuries, which typically are thought to be covered by workers’ compensation, workplace heart attacks are a bit of a grey area. Simply having a heart attack while at work is not enough. In order to have workers’ compensation handle medical bills incurred from a heart attack, medical evidence must show that the heart attack was caused by on-the-job conditions including stress, physical exertion or heat.

Medical records are critical in investigating a workplace heart attack. If the person suffering the heart attack had a previous history of heart disease, high cholesterol or high blood pressure, or if they have smoked or were overweight, a workers’ compensation claim most likely will be denied.

Of course, even if a claim is denied initially, it doesn’t mean that all hope regarding it is lost. Insurance companies aren’t in the business of approving claims and handing out money readily. They often resist taking responsibility for payment even when it seems obvious that they should, so having legal representation is paramount in a case as complex as workplace heart attack.

In the state of Georgia, denied workers’ compensation claims can be appealed with the Georgia State Board of Workers’ Compensation for up to one year following the date of an on-the-job heart attack. If you’ve had a workplace heart attack brought about by on-the-job conditions and have had a resulting workers’ compensation claim denied – or if you haven’t yet filed a claim at all – don’t hesitate to contact the law office of J. Franklin Burns, P.C.

The workers’ compensation attorneys at the law office of J. Franklin Burns have represented both insurance companies and workers, so they know the laws and systems inside and out. They are experienced and adept at handling all kinds of workers’ compensation cases, including those involving workplace heart attacks.

J. Franklin Burns’ attorneys even have a number of respected medical experts they consult with who routinely review client records to help determine if heart attacks have occurred as a result of workplace conditions. If it is found that your heart attack was the result of on-the-job stress, physical strain, extreme heat, or a similar situation, your attorney will fight for you to see that you get the workers’ compensation benefits you deserve.

This generally would leave the costs of the medical treatment resting on the employer where the worker was employed at the time of the injury. However, the employers, who genuinely thought they had competent coverage, may end up forced into bankruptcy if they have to take over the costs of these medical claims. This leaves those injured on the job without many viable or even understandable options.

The Department of Insurance and John W. Oxendine, the insurance commissioner, are investigating SEUS and the owner/executive M. Clark Fain III. It remains to be seen if any charges will be filed but even if Mr. Fain or any of the other executives at SEUS are criminally prosecuted, the company is bankrupt so that can’t help the injured workers.

If SEUS was the insurance company for your claim, you probably have a lot of questions and have received very little answers. This situation is rather unique and you will be best served by contacting an attorney immediately to help guide you through this process.

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