more information torn rotator cuff

[wolfsong452]

Cycler Wrote:it means you have some very mild restricted range of motion ( ROM) of the shoulder ( that's what those numbers are measurement in degrees..) with minimal loss of external rotation strength ( grade 4 on a 5 point strength scale), typical of a mild but stated to be chronic rotator cuff problem. MMI means this is as good as you are going to get. ( MMI)

ok ?

thank you,

What I don't understand, is why the heck do they call this a

[/u]Chronic[u]

Rotator Cuff tear?

Also, if it's mild, it sure in the heck hurts like CRAZY!

Another thing,

if it's mild, then why did the doctor say the tendon was torn in such a way that it was impossible to repair it?

Due to the atrophy of the tendon and muscles?

Docts can be so confusing.

I am glad that my arm is considered a mild MMI

That's the best news I've got so far!

[Cycler]

Much of the opinion offered in medical reports, ESPECIALLY in Workers Comp cases, reflects not only the training level and relevance of the writer but also his bias, inadvertent or not.

In other words, a general orthopedist of a certain age may have a completely and likely outdated concept of shoulder pathology and injury than a recent grad of a sports medicine fellowship ( orthopedists who are further trained in shoulders and knees on professional athletes, etc).

The opinion of a non-specialists may drift even farther afield such as when an IME etc is performed by an " occupational medicine " Dr. who is non-residency trained but simply an employee of an "Occupational Health" clinic and was previously a family doc or such.

Not that this has anything to do with your case but you asked how can who or what say this or that and the answer isn't really any more than "because they can" which has nothing at all to do with whether or not that opinion is actually correct.

A Google search on rotator cuff tears and shoulder function does inform that while pain persists the motion and much of the strength is compensated for by other muscles.

[wolfsong452]

Cycler Wrote:Much of the opinion offered in medical reports, ESPECIALLY in Workers Comp cases, reflects not only the training level and relevance of the writer but also his bias, inadvertent or not.

In other words, a general orthopedist of a certain age may have a completely and likely outdated concept of shoulder pathology and injury than a recent grad of a sports medicine fellowship ( orthopedists who are further trained in shoulders and knees on professional athletes, etc).

The opinion of a non-specialists may drift even farther afield such as when an IME etc is performed by an " occupational medicine " Dr. who is non-residency trained but simply an employee of an "Occupational Health" clinic and was previously a family doc or such.

Not that this has anything to do with your case but you asked how can who or what say this or that and the answer isn't really any more than "because they can" which has nothing at all to do with whether or not that opinion is actually correct.

A Google search on rotator cuff tears and shoulder function does inform that while pain persists the motion and much of the strength is compensated for by other muscles.

Thank you for you help,

I'm supposing that this person who's a local Ortho doctor for the Indpls. Colts, would be someone who knows what he's talking about.

I would say he's in the middle or late 30's. Though I'm not a good judge of age. So I could very easily be wrong.

Now all I have to worry about is how the IC is going to evaluate what's been said.


Can anyone tell if the IC will take into consideration what my restrictions are?

What has been put into writing is this;

I'm not supposed to lift more than 15 pounds, from floor to waist,

the injuryed arm can only do light duty waist level activities only,

no reaching over head.

[Cycler]

I'm glad to hear you have an excellent ortho. At least you know that the outcome is truly as good as possible with your injury.

[wolfsong452]

Cycler Wrote:I'm glad to hear you have an excellent ortho. At least you know that the outcome is truly as good as possible with your injury.

yes,

it seems like the Ortho doctor is a good one.

Thing is, he's already told me, that surgery won't work.

My employer has already said no more PT.

I'm going to talk to the IC about the PT, as I'd like to try it with this doctor, as I feel they are more in the know that what my own doctor.

If not, then I'll have to do the PT at home, which is a real bummer.


Not to knock my own Ortho doctor, as they are probably very good.

Thing is, who'd you choose? someone who is one of the who's-who, in the Ortho or would your rather choose the local teaching Ortho?

I'm still trying to figure out what kind of settlement to expect, the scale thingy has me confused.

Also, does the IC take into consideration what restrictions are giving a person?

Or is it based TOTALLY on the MMI?

[Cycler]

surgery is not an option because the tendon retraction is permanent, the surgeon can't pull it down far enough to re-attach it. My understanding though is that PT can't help for the same reason, that there is no muscle to rehab and, by that line of reasoning, trying to can only cause more pain and wear and tear on the other structures that depended on that muscle for joint stability. It seems that it would make no difference who you choose.

[wolfsong452]

Will the IC take info account my restrictions?

or base everything totally on the MMI?

also, is an MMI the same thing as a PPI?

another thing, is the IC the same thing as WC?

or are they completely different situations?

[Cycler]

No idea about your state but the restrictions are generally not considered, only the measured functional impairment. You do have an atty right ?

[wolfsong452]

Cycler Wrote:No idea about your state but the restrictions are generally not considered, only the measured functional impairment. You do have an atty right ?

I am in Indiana,

It's been a year since my injury.

all the bills have been paid, which by the way were paid out of the employers personal account, not from the business account.

That was a goof on someone's part.

When this was found out, the employer went to his board of directors and asked to be reimbursed for their expenses. They were told they had to file a WC.

hee hee.

We'd talked about a settlement on our own,

Before we'd even got very far, in our settlement talk, I'd gone down and filed unemployment, which the employer did not challenge.

Then when the employer had talked to their board of directors and was told they had to file a WC.

THAT changed EVERYTHING.

The board of directors forced the employer to file a WC claim.

I feel this was to my advantage as the employer was not wanting to do a settlement on our own for very much.

I've been working this whole time, umtil this past month.

So now I'm dealing with the IC.

The IC has been really prompt, ONCE the claim ha been filed and once they've been able to confirm that I was an employee.

I felt that getting an attorney now, when things seemed good, was a bad idea.

Yet, I'm keeping a close watch on everything, and if it seems the least bit hairy, I suppose I can get an attorney then.

I hope now that the IC is taking care of everything, then they might pick up and pay me when unemployment runs out, or everything will be settled by then.

I've been to 2 different ortho doctors-surgeons, who've both have read the MRI's , one doctor was my own.

I was very happy with the 2nd doctor also with the PT that was with this 2nd doctor.

To bad the employer refused to pay any more medical bills or I'd have done more PT with this 2nd doctor.

This is something I'm going to talk to the IC about, to see if they'd allow me to do at least a few more weeks of PT, and even go to a pain management specialist, or however it's called.

So what now?

Is the IC the same thing as WC? or does the IC file the claim with someone else such as the WCB?

[wolfsong452]

here is more of an update.

I've been chatting with the IC and they are still TRYING to get information from my employer here in Indiana.

My accident was Oct. 2007, but nothing was filed with the IC until Sept. 2008. All due to the employer.

The bills have been paid, so that's good, but now we're talking about some type of settlement.


I have got the MMI from the treating Ortho Doctor, and he's giving me a PPI rating of only 5 %..

The insurance company told me what that would convert to in money, IF THEY even decide to pay it.

Funny thing, what with all my restrictions, the money amount doesn't seem like enough.

My employer refuses to allow me to come back to work, while I'm under restrictions. Which is forever.

I've talked to the IC about maybe a conflict of interest with the treating doctor, and them being influenced by an account with my employer.

I've also talked about more PT, and even another opinion, with another well known Ortho Doctor.

IC says no, I can pay for it on my own, but they don't have to accept it.

The IC did say that when everything finally gets sent to WCB then I can challenge the treating doctor's report.

I feel that the treating doctor did a good job, yet, his testing of how my MMI or PPI is, only lasted about 10 minutes.

I've asked the IC about getting another type of test, that usually takes about 2-3 hours to do. I can't remember the exact name for it, but it's some type of flexibility, or whatever type of test.
I've seen it done with a friend of mine, it's a very intense test.

Does anyone have any more suggestions?

I do already have a 10 % whole body PPI so now I've got the 5 % on top of that, along with OA, and Fibromayalgia.

oh bummer,

I'm off this week to talk to SS to see about getting disability, as this was something the IC suggested.

I know from what others have said on this forurm, how long these things take.

so bummer.