Why Restrictions Matter More Than Your Diagnosis-Permanent Restrictions

Why Restrictions Matter More Than Your Diagnosis-Permanent Restrictions

One of the biggest misconceptions we encounter is that the diagnosis determines the outcome of an Alabama workers’ compensation claim or Social Security Disability case.  It often does not.

Imagine two workers.  Both suffer identical rotator cuff tears.  Both undergo the same surgery.  Both have identical MRI findings.  One recovers completely and returns to unrestricted work.  The other develops chronic pain and permanent restrictions against overhead reaching, repetitive lifting, and lifting more than twenty pounds.

Same diagnosis-Completely different vocational consequences.

The diagnosis explains what happened medically-your restrictions explain what you can still do vocationally.

That distinction often determines the outcome of both workers’ compensation and Social Security Disability claims.

Common Permanent Work Restrictions

Lifting Restrictions

One of the most common permanent restrictions limits how much weight a worker can safely lift.

Examples include:

• Sedentary lifting
• Light lifting
• Medium lifting
• Heavy lifting

For someone whose career has involved construction, manufacturing, healthcare, warehouse work, or trucking, permanent lifting restrictions may effectively prevent a return to their former occupation.

Standing and Walking Restrictions

Some of the most important restrictions involve standing and walking.

These frequently result from:

• foot injuries;
• ankle injuries;
• knee injuries;
• hip injuries;
• back injuries; or
• chronic pain.

Many people do not realize that under Social Security’s vocational rules, light work generally requires standing or walking for a substantial portion of the workday.

Someone permanently limited to standing only brief periods may be unable to perform many occupations classified as light work.  An altered gait can also place additional stress on the knees, hips, and lower back, creating problems far beyond the original injury.

Recommended Reading: Can a Foot Injury Lead to Workers’ Compensation and Social Security Disability Benefits?

Can a Knee Injury Lead to Workers’ Compensation and Social Security Disability Benefits?

Can a Hip Injury Lead to Workers’ Compensation and Social Security Disability Benefits?

Understanding Pain in Alabama Workers’ Compensation and Social Security Disability Claims.

Reaching Restrictions

Shoulder injuries frequently result in restrictions involving:

• overhead reaching;
• repetitive reaching;
• lifting away from the body; and
• pushing or pulling.

These restrictions may eliminate many occupations involving construction, electrical work, plumbing, warehouse work, healthcare, and manufacturing.

Recommended Reading: Can a Shoulder Injury Lead to Workers’ Compensation and Social Security Disability Benefits?

Hand Restrictions

Many jobs require constant use of both hands.  Permanent restrictions involving:

• gripping;
• handling;
• fingering;
• feeling;
• fine manipulation; or
• repetitive hand use

can have tremendous vocational consequences.

This is especially true for workers with:

• carpal tunnel syndrome;
• nerve injuries;
• tendon injuries;
• crush injuries; or
• severe arthritis.

Social Security has long recognized that many sedentary jobs require frequent bilateral manual dexterity.

Recommended Reading: Why Your Grip Strength Matters in Workers’ Compensation and Social Security Disability Claims

Can a Hand or Wrist Injury Lead to Both Workers’ Compensation and Social Security Disability Benefits?

Postural Restrictions

Doctors frequently restrict activities such as:

• climbing;
• kneeling;
• crouching;
• crawling;
• balancing; and
• working at unprotected heights.

For many workers, these limitations are every bit as significant as lifting restrictions.

Recommended Readings: Why Postural Restrictions Matter in Workers’ Compensation and Social Security Disability Cases

Restrictions Determine Work Classifications

Physicians often describe a worker as capable of performing:

• Sedentary work
• Light work
• Medium work
• Heavy work
• Very heavy work

These are not simply descriptive terms.  They are vocational classifications used by:

• physicians;
• Functional Capacity Evaluators;
• vocational experts;
• employers; and
• Social Security.

A worker who spent thirty years performing heavy construction work but is permanently restricted to sedentary work has experienced a dramatic vocational change.

Recommended Readings: What is the Role of a Vocational Expert?

Why Restrictions Matter in Alabama Workers’ Compensation Cases

In workers’ compensation, restrictions affect much more than medical treatment.

They may influence:

• whether you can return to your previous employer;
• whether your employer has work available within your restrictions;
• vocational disability;
• loss of earning capacity;
• settlement value; and
• whether permanent total disability becomes an issue.

Restrictions often become the foundation upon which vocational experts build their opinions.

Scheduled vs. Non-Scheduled Injuries

Restrictions also play an important role in determining how certain injuries are evaluated.

Many injuries involving:

• hands;
• arms;
• feet; and
• legs

are generally treated as scheduled injuries under Alabama law.

Other injuries involving:

• shoulders;
• hips;
• the spine;
• chronic pain; or
• conditions affecting the body as a whole

are evaluated differently.

Sometimes a scheduled injury produces consequences far beyond the injured body part.

For example, chronic pain or Complex Regional Pain Syndrome (CRPS) may affect the efficient functioning of the body as a whole.

When that occurs, the legal analysis may become far more complicated than simply looking at the injured body part.

Recommended Reading: Can a Scheduled Injury Become a Whole-Body Injury Under Alabama Workers’ Compensation Law?

How Complex Regional Pain Syndrome (CRPS) Affects a claim for Alabama Workers’ Compensation Benefits and a claim for Social Security Disability Benefits.

Social Security Looks at Restrictions Differently

Social Security asks a different question than workers’ compensation.

Instead of focusing primarily on the work injury itself, Social Security asks:

What can this person still do on a regular and continuing basis?

The Administration evaluates limitations involving:

• lifting;
• standing;
• walking;
• sitting;
• reaching;
• handling;
• fingering;
• balancing;
• concentration;
• persistence; and
• pace.

The emphasis is on functional capacity, not merely the medical diagnosis.

Recommended Reading: How Postural Limitations affect a claim for disability benefits

Age Can Completely Change the Analysis

Restrictions do not affect every worker the same way.

Consider two workers with identical permanent restrictions.

One is 32 years old.

The other is 61.

Although their medical conditions are identical, Social Security recognizes that advancing age often makes changing occupations significantly more difficult.

The Medical-Vocational Guidelines—commonly called the Grid Rules—may therefore produce very different outcomes.

Recommended Reading: How Does Age Affect My Social Security Disability Claim?   What are the Grid Rules?

Past Relevant Work Matters

Restrictions also interact with the type of work a person has performed throughout their career.

Imagine two people who are permanently restricted to sedentary work.  One spent thirty years as a construction worker.  The other spent thirty years as an accountant.

Those identical restrictions may have dramatically different vocational consequences because their work histories are completely different.

Social Security carefully evaluates past relevant work when determining disability.

Recommended Reading: What Is Past Relevant Work in a Social Security Disability Case?

Transferable Skills Can Be Critical

Social Security also considers whether skills learned during previous employment transfer to less physically demanding work.  A master electrician may possess supervisory or estimating skills, while a laborer who has spent an entire career performing heavy manual labor may have far fewer transferable vocational skills.

These issues become increasingly important as workers grow older.

Recommended Reading: Transferability of Acquired Work Skills

Functional Capacity Evaluations (FCEs)

Many permanent restrictions are based, at least in part, on a Functional Capacity Evaluation (FCE).

These evaluations measure:

• lifting;
• carrying;
• pushing;
• pulling;
• standing tolerance;
• walking tolerance;
• grip strength;
• pinch strength;
• endurance; and
• repetitive activity.

Although an FCE provides useful information, it represents only one piece of the overall medical and vocational picture.

Recommended Reading: What Is a Functional Capacity Evaluation (FCE)?

Pain Often Determines Restrictions

Sometimes imaging studies look relatively mild, but the restrictions are not.  Why?

Because pain is itself functionally limiting.

A worker may technically be capable of lifting twenty pounds once.  Doing so repeatedly throughout an eight-hour workday may be impossible because of:

• chronic pain;
• fatigue;
• muscle spasms;
• medication side effects; or
• reduced endurance.

That is why physicians, vocational experts, and courts often focus on functional ability, not simply imaging studies.

Recommended Reading: How Can Chronic Pain Affect My Workers’ Compensation and Social Security Disability Claims?

Medication Side Effects Matter Too

Restrictions are not always caused by the injury itself; sometimes they result from the treatment.

Pain medications may impair:

• concentration;
• reaction time;
• balance;
• alertness; or
• the ability to safely operate machinery or commercial vehicles.

Those limitations may be every bit as important as lifting or standing restrictions.

Recommended Reading: Can the Side Effects of My Medication Help My Social Security Disability Claim?

Every serious injury eventually leads to one fundamental question: What can this person still safely and reliably do?  That question is answered not by an MRI alone, nor by a diagnosis, but by permanent work restrictions.

Whether those restrictions involve lifting, standing, walking, reaching, gripping, balancing, or chronic pain, they often determine whether an injured worker can return to work, whether vocational experts believe competitive employment remains available, and whether benefits are owed under Alabama Workers’ Compensation law or the Social Security Disability Act.

At Powell & Denny, we have spent more than 30 years representing injured and disabled workers throughout Alabama. We understand that successful claims are rarely decided by a diagnosis alone. They are decided by how an injury changes a person’s ability to earn a living.

If you have questions about an Alabama Workers’ Compensation claim, or a claim for Social Security Disability benefits, don’t hesitate to contact the experienced attorneys at Powell and Denny today a free consultation; remember. Virtual appointments are available through Zoom so you can meet with one of the attorneys of Powell and Denny from wherever you live, and remember-there is no fee unless you win.

Powell & Denny: We Work When You Can’t.

Offices in Huntsville, Alabama and Birmingham, AL