There is nothing funny about buttock spasms. Nothing at all. So, why I am chortling? I really can't tell you. I would suspect it is due to my deep understanding of the human psyche, juxtaposed with the irony of a unique malady that is rarely the topic of discussion within the workers' compensation community. Or it just could be that I can't read the word “buttocks” without it sounding in my head like Forrest Gump is speaking it. My wife, however, would probably chalk it up to my 10-year-old “grade school” humor and relative lack of finesse. As I think about it, she may have a point.
Here we are, nonetheless.
Last week reporter Frank Ferreri published on this site the article, “Court: Doctor Doesn't Have to See Buttock Spasms to Establish Injury.” I first became aware of the article when I received an email from our Chief Editor and Media Director, Nancy Grover. She asked if I had any issues with the headline. Now, when it comes to matters of discretion, I am probably the last person you should end up conferring with. She likely would have been better off just rolling the dice, flipping a coin, or consulting a psychic. Alas, organizationally Nancy really has nowhere else to turn for these matters. I was amused at the headline without any clue as to what it might be about. There has rarely been a more defined “damn the torpedoes” moment in our editorial history.
Mr. Ferreri wrote about an Arkansas workers' compensation case that resulted in the overturning of a denial of benefits by the Arkansas' Workers' Compensation Commission. The court determined that a doctor was not required “to actually observe a worker's buttock spasms” under Arkansas law, and that “objective medical evidence supported their existence without direct observation.” An Administrative Law Judge and the AWCC had ruled previously that in the absence of direct observation of said “buttock spasms” that there could not be an objective medical decision, therefore no determination for compensability could be made.
What a relief this decision must be for the medical community in Arkansas. I'm not sure any of those folks want to spend hours waiting around to see the uncontrolled twitching of a patient's Gluteus Maximus (see how I dressed it up there?). I seriously doubt there is a medical specialist trained in this specific pursuit. I do not recall ever hearing anyone saying they had an appointment with a Buttock Spasm Observer. Of course, if there was such a “Keister Meister” for this particular malady, they might end up inventing a brace or device to help control such spasms. That would make them a derriere farrier so to speak. Either way, it would be good to have someone who understands what launches the haunches in these matters.
Ok, I better stop while I am behind. Literally.
I suppose the legislature could take up the issue to try and further clarify it for the industry. That way they could make it a requirement under Arkansas law that any spasms in the buttockal region must be directly observable by someone trained to, well, observe them. I frankly think that would be a mistake. We have enough trouble getting access to proper specialists today. Throwing one more into the mix, especially for a job no one in their right mind would want to do, would only complicate and delay matters more.
No, it is best to let this court decision stand, and recognize that you do not always have to see a condition to know medically that it exists. And if you ever doubt that workers' compensation was intended to treat the whole person, this case should answer that question. There are very few industries where you can talk about objective medicine while getting cheeky about buttock spasms.
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Robert Wilson is President & CEO of WorkersCompensation.com, and "From Bob's Cluttered Desk" comes his (often incoherent) thoughts, ramblings, observations and rants - often on workers' comp or employment issues, but occasionally not.
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