If you get hurt at work and go to the hospital for treatment, you might be surprised to find out you have a torn labrum. The labrum is a piece of cartilage around the socket of your shoulder joint, and these tears can result in pain, limited mobility, and, if left untreated, worsened condition.
This injury could keep you from work and even require surgery. These expenses are often covered under Workers’ Comp, but getting full benefits may require help from an attorney.
Call Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers today at (267) 651-7945 for a free case assessment.
Is a Torn Labrum Covered Under Workers’ Comp?
Work tasks are one of the most common causes of labrum tears, meaning these injuries are often covered through Workers’ Comp if the required conditions are met.
Injuries Within the Scope of Your Work
Only work-related injuries are covered. This often means that it came from a work task. For example, lifting, climbing a ladder, or reaching up to paint or perform construction tasks could be a common – and often-repeated – work task for you.
Labrum tears often come from exertion or repetitive tasks like these.
Injuries from Work Condition
If the injury happened because of dangerous conditions at your workplace, that also makes it work-related. For example, an injury during a slip and fall or fall from an unstable catwalk or scaffolding could be covered.
Disabling Injuries
Injuries can receive medical care coverage as long as they are work-related, but they need to take you out of work for at least 7 days to qualify as “disabling” and get you wage-loss benefits.
What Workers Qualify for Workers’ Comp?
Most employees are covered from Day 1 of their job. This rule carves out an exception for federal workers – who use a separate system – and casual employees – who have no ongoing relationship with the employer. It also does not cover realtors or independent contractors, who are essentially considered self-employed.
What Medical Care is Covered Through Workers’ Comp for a Torn Labrum?
All medical care to treat a work-related injury should be covered.
CAT Scans and MRIs
Labral tears often need CAT scans or MRIs to confirm they exist and determine a treatment plan. This makes this care a necessary part of your treatment and means it should be covered.
Diagnosis
Going to a doctor to figure out what is wrong should be covered.
Surgery
Many labrum tears require surgery to repair the tear. This is expensive, and you should not have to pay out of pocket for the surgeries if the injury was work-related.
Physical Therapy and Rehab
Most labrum tears require ongoing physical therapy and rehabilitation after surgery to continue the healing process, regain full range of motion, and reduce pain.
Medication
Pain medication and potentially muscle relaxers will often be used in treatment.
And More
There may be other needs that Workers’ Comp should also cover.
What Doctors Can You See Through Workers’ Compensation for a Torn Labrum?
Workers’ Comp limits what doctors you can go to.
Panel Doctors
Employers and insurance carriers are permitted to choose a panel of doctors they allow you to see. This must include at least a couple of physicians, but other “doctors” might be what we call “Workers’ Comp doctors,” who might not have the same level of certification or training.
90-Day Rule
In the first 90 days of treatment, you have to use these panel doctors. These doctors should be qualified, but they might be busy with Work Comp cases and might not devote as much personal attention to you as your chosen doctors would.
Exceptions
You can go off the list for a few reasons.
The most common is when you need surgery – which allows you to get a second opinion. However, the panel doctor still has to be the one to do the surgery if your chosen doctor agrees with the treatment plan.
If you need a specialist that is not listed, you can typically choose your specialist.
Choosing Your Own Doctors
After that 90-day period, you can see whatever licensed doctors you want to carry out the treatment plan.
What Benefits Does Workers’ Compensation Cover for a Labrum Tear?
Workers’ Compensation pays the following benefits – which might not all be available for a labrum tear.
Medical Benefits
The cost of all medical care should be covered.
You may need outside exams to gather evidence, which is not covered. However, once we win your case, we can recoup those expenses.
Lost Wage Benefits
If you miss work or face reduced working hours because of your injury, you should be able to recover the lost wages, in part. Typically, the rate is 2/3 of your pre-injury average pay, with caps and floors.
If you work partially, you get 2/3 of the difference in wages, but you cannot get more in total compensation than you would if you were out of work entirely.
Specific Loss Benefits
Specific loss benefits are only paid for permanent amputation, permanent lost function, lost hearing, lost vision, or serious facial scars. If you suffered one of these alongside your labrum tear, you may qualify for benefits for that injury.
However, torn labrums typically do not qualify for specific loss benefits on their own.
How Long Do You Have to File for Workers’ Comp with a Torn Labrum?
You must notify your employer of your injury within 21 days of the accident that caused it or the time it became severe. You do not necessarily need to wait to learn everything about the injury and your treatment needs at that point; you just have to notify them.
Then, they investigate and grant your claim if they agree it was work-related and disabling. If they deny you, you get 3 years from the date of injury to file a formal claim with the state, known as a Claim Petition.
Contact Our Workers’ Comp Lawyers in Pennsylvania
Call Cardamone Law’s Montgomery County, PA Workers’ Comp lawyers at (267) 651-7945 to get started on your case.
