Private industry employers reported approximately 2.5 million nonfatal workplace injuries and illnesses in 2024, according to the U.S. Bureau of Labor Statistics (BLS). This number is a 3.1% decrease from 2023.
Workers who have on-the-job shoulder injuries are forced to keep away from their jobs for extended periods. And these injuries resulted in a median of 26 days away from work in 2023-2024, according to the National Safety Council’s analysis of federal data. In fact, these are injuries that can take longer to recover from because the shoulder plays an important role in lifting, reaching, and moving the arm.
Most workers’ compensation claims for shoulder injuries focus on what caused the damage. Very little debate goes into whether there is an injury to the shoulder. An MRI or similar imaging study generally establishes the presence of a shoulder injury early in the claim process. Once that is settled, the focus of the workers’ compensation claim for a shoulder injury is on determining what percentage of the shoulder injury is work-related.
Other questions that need to be dealt with include what portion of the injury was not work-related and what the worker’s residual functional capacity is after the injury.
Why the Shoulder Is Built for Disputes
The shoulder gains flexibility at the cost of stability. This configuration seats the ball mostly outside a shallow socket and leaves four rotator cuff tendons to do the work that bone does in other joints. It allows people to reach behind the back more easily. As a result, soft tissue absorbs loads that a hip would transfer through the skeleton.
A shoulder scan may show both a recent injury and signs of wear from aging. In a workers’ compensation claim, the dispute often centers on whether the workplace accident caused or worsened the condition. The insurer may argue that the damage existed before the accident. On the other hand, the worker may point to new pain or difficulty lifting their arm afterward. Both sides may use the same scan to support their arguments.
Two Ways a Shoulder Gets Hurt at Work
Acute injuries tend to be simpler to document than chronic conditions because they come with a clear date and event.
This isn’t to say that single incidents aren’t complex. For the National Institute for Occupational Safety and Health (NIOSH), musculoskeletal disorders can be tied to a combination of forces, repetitions, and postures. Overhead work is one of the physical risk factors named. The risk depends on how intense, frequent, and long-lasting the work tasks are. For example, a drywaller with 9 years of overhead work cannot point to a single date to record on an injury form.
What the Claim Actually Fights About
With apportionment comes money, particularly when there are several permanent injuries in the mix. Once that is settled, the focus in some states shifts to determining what percentage of the shoulder injury is work-related. This factor lowers the awarded value, and the percentage assignments in the medical records have the greatest influence on the result. State regulations of this type vary dramatically. In other words, results vary based on where the claim was filed.
Delays in reporting and filing feed the same fight. A worker who mentions shoulder pain to a supervisor in March but does not file until September gives the carrier six months of alternative explanations, and none of them involve the job.
Notice and filing deadlines also vary by state. California residents facing that kind of dispute may enlist the assistance of a Glendale industrial accident lawyer to gather evidence and manage the insurance company’s response to a workers’ compensation claim.
Ratings and Restrictions
The measurement of permanent impairment is a rating of the extent of loss of function. Most states use rating guides to establish consistency in determining a percentage rating. Ratings of shoulders are often based on loss of motion and muscle strength as recorded by an evaluator.
Because shoulder ratings depend on documented measurements, the ratings process can matter as much as the earlier surgical procedure. Two physicians measuring the same shoulder a month apart can reach noticeably different ratings and awards.
Return to work is the other lever. When someone is permanently unable to perform overhead lifting, they may no longer be able to do their old job but are able to do other work. States have different rules for this gap. Some allow for loss of wages beyond an impairment rating, while others stop at the impairment rating.
In shoulder claims, documentation is most useful when it begins early. The worker’s description of how the injury happened, the date of that description, the motion involved, and the body part reported all belong in the record. Whether the report names the shoulder, the arm, or the neck can appear insignificant, but a claims carrier may use any inconsistency to argue against the claim. Small details recorded early can carry weight much later in the process.
Marissa is a Pediatric Occupational Therapist turned stay-at-home mom who loves sharing her tips, tricks, and ideas for navigating motherhood. Her days are filled starting tickle wars and dance parties with three energetic toddlers and wondering how long she can leave the house a mess until her husband notices. When she doesn’t have her hands full of children, she enjoys a glass (or 3) of wine, reality tv, and country music. In addition to blogging about all things motherhood, she sells printables on Etsy and has another website, teachinglittles.com, for kid’s activity ideas.
