Retraining: When To Shift The Goal Posts?

Dr David Colvin workers compensation

30/11/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

During the recovery period, the patient, doctor, employer, insurer and rehabilitation provider need to agree on a rehabilitation goal. That is, to determine whether the patient is likely to return to their previous occupation or whether, as a result of the injury, there may be some permanent restrictions, which would prevent them from returning to that occupation. In the setting …

Fitness to drive

Dr David Colvin workers compensation

03/11/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Being fit to drive a motor vehicle is a critical milestone in the return to work process. The legal guidelines regarding fitness to drive are not as specific as we would like. Obviously safety for all those on the road is an overriding factor. If you have had arthroscopic shoulder acromioplasty or subacromial decompression then you will be able to …

Now The Other Shoulder Is Giving Out

Dr David Colvin workers compensation

02/11/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

A secondary condition is a condition that arises indirectly from the original injury. The Workers’ Compensation Act in Western Australia specifically excludes secondary psychological, psychiatric or sexual conditions. That is to say, if as a result of your injuries you become depressed, that secondary psychological condition will not be covered by your workers’ compensation claim. kl A decision on liability …

Meniscal tears and the arthritic knee

Dr David Colvin workers compensation

02/11/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Firstly, everyone has heard about the young footy player who has a twisting injury, keyhole surgery to tidy up the torn cartilage and he is back on the field in a month or so.  That is a tear in a normal cartilage as a result of excessive load or twisting force.  The second context in which we see meniscal tearing …

There Are No Light Duties, You Will Have To Sign Me Off

Dr David Colvin workers compensation

08/10/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

One area of conflict in the workers’ compensation scheme is the return to work process. During the time you are being treated for your work injury, you will be issued with progress medical certificates. These certificates will indicate whether you are totally unfit for work, fit to return to work with modified duties, or fully fit to return to your …

The Post-Operative MRI Scan

Dr David Colvin workers compensation

21/09/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Patients occasionally request follow up MRI scans in the recovery period. Often this is motivated by concern for their repair or reconstruction. They may have had a minor injury or aggravation and want the reassurance of knowing that everything is okay. Sometimes they want to see how things are healing. For example, post-operative scans on the shoulder almost always show …

My work injury is arthritis?

Dr David Colvin workers compensation

15/08/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

There is no diagnosis in the area of workers’ compensation injuries that causes more confusion and outright disbelief than the diagnosis of “osteoarthritis”.  How is it possible that I have never had a days knee pain in my life, I went to work, had an injury, now my knee is sore and you are telling me that it is osteoarthritis? …

The Over-Rehab Syndrome

Dr David Colvin workers compensation

21/07/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Some orthopaedic conditions are painful due to inflammation of the tissues or joint. This includes osteoarthritis of the knee, frozen shoulder, rotator cuff tendonitis and subacromial bursitis. Successful recovery from orthopaedic surgery requires a structured progressive rehabilitation program. However, it is possible to have too much of a good thing. It certainly looks good on a progress report to have …

Why am I being singled out?

Dr David Colvin workers compensation

13/06/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

To the insurance company, a workers’ compensation claim is just another insurance claim, no different to a car accident.  By its very nature, any insurance system is somewhat adversarial.  Insurance companies always ask questions about the validity of a claim.  I myself can clearly recall a rather unpleasant conversation with a motor vehicle damage assessor that occurred over twenty years …

What is a common law claim?

Dr David Colvin workers compensation

30/05/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

About six months after you have lodged a workers’ compensation claim, you may receive a letter from your employer or insurer indicating that your termination date is about another six months away. The letter will state that if you wish to pursue a common law claim you must notify of your intention prior to that date. Unfortunately this letter usually …

The graduated return to work program

Dr David Colvin workers compensation

16/05/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

One of the commonest things I hear from patients who are on a return to work program is that they feel that their colleagues think they are “bludging”.  There is no way to change what other people are thinking but rest assured your work restrictions have been put in place by your treating doctors for good reasons.  It is not …

Rotator cuff repair: return to work

Dr David Colvin workers compensation

02/05/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

The results of rotator cuff repair surgery in young people are generally very good and most people return to their previous occupation.  That is not to say that everybody makes a full recovery, most people still have some slight reduction in their range of movement.  The normal recovery after rotator cuff repair surgery requires a sling for four to six …

My doctor has suggested a pain specialist

Dr David Colvin workers compensation

04/04/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Successful pain management is critical to the recovery from any injury. Some patients struggle with pain management and are referred to pain specialists.  This can be invaluable, but if we are needing their services, we are already facing an uphill battle.  We should plan not to need their help. The workers’ compensation scheme places a heavy emphasis on early return …

Maximum Medical Improvement (MMI): What is It? When is It?

Dr David Colvin workers compensation

21/03/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Your workers’ compensation claim cannot be finalized until you have reached maximum medical improvement.  That does not mean that you are fully recovered.  Rather it means that you have made as good a recovery as you are going to make, and there is no prospect of further improvements over time or improvement with further treatment.  Generally you are likely to …

Knee replacement for a work injury

Dr David Colvin workers compensation

14/03/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

Although it is not common, I occasionally see patients who have had a work related injury to their knee where the underlying arthritic changes are so severe that the only appropriate treatment would be a knee replacement.  The question then arises as to whether the workers’ compensation insurer is liable for the cost of a knee replacement.  The first issue …

How long after surgery until I’m 100%?

Dr David Colvin workers compensation

14/03/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

This is a question I am asked frequently.  Unfortunately if a work injury is severe enough to require surgical treatment, then it is highly unlikely that we will ever reach that gold standard 100% recovery.  One of the problems we face in orthopaedics is that some human tissues have limited or no regenerative capacity.  Muscles have very good blood supply …

Don’t let the flare ups floor you

Dr David Colvin workers compensation

14/02/2018 Dr. David Colvin, trained in orthopaedic surgery in Perth. David's specialty is knee and shoulder surgery and sports injuries.

The recovery from major reconstructive surgery is never a straightforward path. There are inevitable ups and downs and occasionally minor aggravations or re-injuries. These flare ups can occur anytime within the first twelve months after surgery and often come completely out of the blue. Sometimes it can be as simple as a change in the weather, or the way you …