Worker’s Comp Injuries
Injured Worker’s Services
STSC will provide medical services to any patient who has sustained a work related injury. Our physicians and staff members are well in the policies and guidelines established by the TWCC.
A Patient Plan Care is coordinated with employee case manager and the insurance carrier. Our physicians are qualified to perform the following services:
- Impairment ratings
- Independent medical exams
- Confirmatory consultations
- Required medical exam
- Designated doctor evaluations
Our staff will also assist the injured worker with:
- Communicating with authorized patient representatives
- Process all TWCC forms
- Patient disability statements
- Requests for Medical Records
- Assistance in benefit review information
Q. What is the natural history of low back pain (LBP)?.
A. 80% of adults will experience back pain severe enough to miss work of seek medical attention.
Regardless of treatment: 60% of patients with low back pain recover within 1 week, 90% recover within 3 months.
Q. When are plain x-rays indicated?
A. For adults, in the absence of serious trauma, known cancer, or a nuerologic deficit, after 6 weeks of low back pain. View: AP, lateral, spot lateral. For adolescents, x-ray after 3 weeks of low back pain and obtain oblique views (possible spondylolysis).
Q. When is an MRI indicated?
A. Abnormal neuro exam with signs of a radiculopathy. Persistent low back pain for more than 3 months.
Q. What percentage of “normal patients” (asymptomatic) have abnormal MRI’s?
A. 30% – about the same for CT, myelogram and MRI increases with age. Over age 50, virtually everyone has some degree of degenerative disc disease.
Q. What are significant disc findings on an MRI?
A. Herniated disc(HNP)-material beyond the confines of the annulus. Bulging disc material within the annualus, posterior to vertebral body. Degenerative or desiccated disc of the nucleus pulposes is a normal aging process seen as low nucleus signal T2 images, this is the mos frequent “normal” finding that increases with age and is frequently assocated with disc “bulging”. Annular tears sometimes are present within a degenerative or dessicated disc, and are a common cause of mechanical LBP, referred to as discogenic pain.
Q. What are the features of quality MRI?
A. T1 and T2 sagittal images. T1 axial images, sequetially, L3-S1 – not just at the disc levels. T2 axial images at all disc levels. Clean, crisp images, not grainy – a function of large magnets (1.5 Tesla) and good software. A precise radiolgoy report.
Q. When is a CT or myelogram indicated?
A. MRI ($1400) is the best study for soft tissue (discs, nerve roots, spinal cord). CT ($1000) is best for bone detail fractures. Myelogram/CT ($1700)combined is good for stenosis and patients who cannot have an MRI.
Q. Pain control and epidural steroids for treatment.
A. Use narcotics sparingly