SI Joint Injuries Part One- What Is An SI Joint Injury

Sacroiliac joint pain

What is Sacroiliac (SI) joint pain? SI injuries have gained a lot of attention in the last ten years as an underappreciated cause of back pain with some studies indicating it is responsible for 15% to 40% of low back pain. The increased attention is due to the increasing knowledge of the SI joints intimate role in pelvic stability. I hope more physicians consider SI joint pain in their differential after reading this article.

Pathophysiology

Work injuries involving the SI joint are due to instability of the SI joint. Experts believe that SI joint pain is a component of a larger problem of pelvic instability(1). Pelvic instability has traditionally been underappreciated as a cause of low back pain, buttock pain, groin pain, and leg pain. Physical therapists and doctors of osteopathic medicine have been teaching these concepts for years but only relatively recently has this dissemination of knowledge trended towards mainstream thinking among medical doctors.

The SI joint complex (the SI joint and its associated ligaments) is the major support structure of the pelvic ring and is the strongest ligament complex in the body. The complex consists of interosseous sacroiliac ligaments, iliolumbar ligaments, posterior sacroiliac ligaments, and the sacrotuberous and sacrospinous ligaments. The SI joints are two of the three joints involved in the stability of the pelvic ring. The pelvic ring is the meeting place of the force vectors from the upper body and the lower extremities. The third joint in the pelvic ring is the pubis symphysis. Pelvic instability causes pelvic rotation which can also cause twisting of the pubis symphysis. Coupling this with its anterior location appears to provide an explanation as to why patients with SI joint instability can also experience anterior groin pain. Anecdotal evidence for this is seen when patients undergo a successful SI joint intra-articular injection relieving all of their posterior back, buttock, and leg symptoms but the patient still has groin pain. Groin pain is almost never eliminated by SI joint injections unless pelvic symmetry is corrected.

If the SI joints are unstable, it can lead to significant pain and discomfort over the SI joints as well as numerous referred areas. If an individual affected by SI joint pain has pain only over his or her SI joint, he/she should be considered lucky. Most often SI joint instability causes unnatural strain on the entire low back and pelvic region causing a sometimes confusing clinical picture.

At Minnesota Disability & Atkinson Law Offices, P.A. we work to help injured workers obtain the benefits they deserve following a Minnesota Work Injury. We work to ensure our clients obtain the ANSWERS to their questions and EXPERT treatment with the top medical clinics in Minnesota. Contact attorney Thomas Atkinson today and learn how he can assist you with your workers compensation injury. 651-414-0678 or email me today at tom@mndisability.com

Also visit our website at www.mndisability.com for more information regarding Minnesota Workers Compensation Injuries.

Who Pays For My Medical Bills After A Workers Compensation Injury?

Under Minnesota's workers compensation laws, an employee sustaining a work related injury is entitled to reasonable and necessary medical treatment. Given this rule many injured workers assume that the Minnesota employer and workers’ compensation insurer will automatically pay for the injury and the related medical expenses. This is unfortunately often not the case.

Many injured workers then go without treatment which allows the same employer and workers compensation insurer to allege that the lack of treatment is an indication you were NOT injured or injured that bad. Given some cases can take anywhere from a few months or even up to a year before a judicial determination is made on the dispute, it is VERY important that you find some way to get the treatment you deserve and need.

If you have private health insurance and your workers compensation claim or treatment has been denied, Minnesota law requires the health insurer to provide coverage under their policy and seek reimbursement from the workers compensation insurer. Many of my clients have overlooked this right as nobody who works for the insurance company is willing to share this secret.

If, however, you are without health insurance you are not alone. Nearly 700,000 Minnesotans receive health care through the state’s three publicly funded basic health care programs — Medical Assistance (MA) — Minnesota’s Medicaid program, General Assistance Medical Care (GAMC) and MinnesotaCare. For more information click here. Even with these programs in place,over 453,000 Minnesotans go without health insurance according to the U.S Census Bureau.

The Minnesota Department of Human Services (DHS) administers these programs and pays all or part of enrollees’ medical bills for:

Medical Assistance (MA) (Minnesota’s Medicaid program) is the largest of the health care programs, providing health care coverage and prescription medication coverage for a monthly average of 507,000 low-income senior citizens, children and families, and people with disabilities in fiscal year (FY) 2007.

General Assistance Medical Care (GAMC) provides medical care for a monthly average of 33,000 (FY 2007) low-income Minnesotans who don’t qualify for MA or other state and federal programs — primarily low-income adults, ages 21 and 64, who do not have any dependent children.

MinnesotaCare is a publicly subsidized program for Minnesota residents who don’t have access to affordable health care coverage. In order to eligbile you must meet the following:

• Have a Social Security number or be willing to apply for one (unless you have religious objections);
• Live in Minnesota;
• If you are an adult and do not have children living with you, or if your children are over age 21, you must have lived in Minnesota for six months;
• Be a U.S. citizen or non-citizen lawfully residing in the U.S.;
• Not have other health insurance now or have had health insurance (including Medicare), for at least four months except for Medical Assistance enrollees whose health insurance premium was paid for by Medical Assistance; and
• Not be able to get health insurance through an employer who offers to pay at least half the monthly cost.

Assistance in applying can be found here.

The only way an injured worker can get back to work is to get the necessary medical treatment. If you find yourself without medical insurance and the workers’ compensation insurer refuses to pay for your medical treatment, look into contacting the state and/or county for assistance. MinnesotaHelp.info is another great resource for help.

If you have been injured at work, attorney Tom Atkinson is more than willing to discuss your claim. There is NO obligation and he is willing to review your case to ensure you are properly receiving all the benefits you have coming to you. Contact him directly at 651-324-9514 or visit his web site at www.mndisability.com

Wal-Mart Fired Me, Now What Do I Do Now?

News of more and more layoffs belies the harsh reality that our economy is not recovering quickly. The Pioneer Press recently reported that Maplewood, Minnesota-based 3M Company laid off 1,200 workers in the first three months of 2009, and 2,400 in the last three months of 2008. Executives said that more job cuts could be coming. Several hundred of these layoffs are from 3M locations within Minnesota.

Hopefully, the economy will start to recover, layoffs of Minnesotans will slow in the next few months and folks can start getting back to work.

While getting laid off is extremely difficult, it can be even more difficult for laid-off workers who have physical restrictions related to a work injury. Frequently, workers who are on light-duty or who have physical restrictions related to a work injury are the first to be laid off. These physical restrictions, such as lifting limitations, or limitations on the number of hours a person can work can make finding a new job incredibly difficult. Fortunately, in Minnesota, if a worker who has physical restrictions due to a work-related injury is laid off for economic reasons, that worker may be entitled to wage loss benefits and job search or retraining assistance through workers’ compensation.

One of the most important benefits is the assistance of a Qualified Rehabilitation Counsultant or QRC who can provide job placement services and/or retraining.

If you’re a laid off employee OR were possibly even terminated from your employer, but you have physical restrictions for a work-related injury, you may be entitled to workers’ compensation benefits. To schedule a free, no-obligation consultation with one of our workers’ compensation lawyers, call Minnesota Disability and Atkinson Law Office PA at 651-324-9514 or visit our web site at www.mndisability.com to send us an email. We can help you get the benefits you are entitled to NOW!

Your Claim Has Been Denied, Now What?

Hire an EXPERIENCED workers compensation attorney. The same fee is paid to every attorney under Minnesota law so why would you hire someone who only does some work comp defense or has only been out of law school for a few years? It makes no sense!

At Atkinson Law Office and Minnesota Disability Attorney Tom Atkinson will personally oversee your claim, puncutually returning your calls! When your claim is denied the ONLY way to get benefits paid is to initiate a claim by filing a Claim Petition.

A Claim Petition is a standard form that sets forth basic information about the employee’s claim for workers’ compensation benefits. The Claim Petition contains information about the employee, including his or her name, address, Social Security Number, date of birth, and date(s) of injury. It also lists the name of the employer(s) and insurer(s). The Claim Petition also sets forth the nature of the injury and the average weekly wage at the time of the injury. Finally, the Claim Petition lists the types of claims alleged, including Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Total Disability (PTD), Permanent Partial Disability (PPD), Rehabilitation Benefits, and/or medical benefits.

The Claim Petition is filed with the Department of Labor and Industry, and copies of the Claim Petition are served on the employee, the employer, the insurer, and any third-party payors, such as major medical insurers. Notice to Potential Intervenors are often served along with the Claim Petition to any medical providers and any third-party payors.

A Claim Petition is generally filed when the employer and/or insurer is denying primary liability, meaning that they admit no responsibility for the injury. A Claim Petition is also filed when there is a claim for monetary benefits, such as Temporary Total Disability (TTD), Temporary Partial Disability (TPD), and/or Permanent Partial Disaiblity (PTD), even if the insurer admits primary liability. If an injured worker has settled his or her case on a full, final complete basis, leaving open future medical benefits, a Claim Petition may be used in some instances where there is a dispute over medical expenses.

Once your Claim Petition has been filed, the employer and/or insurer is generally required to file an Answer to the Claim Petition within 20 days. The employer and/or insurer is required to serve specific responses to the allegations in the claim petition. If an answer is not filed in a timely matter and/or an extension of time to answer is not requested, the employee may request that the matter be scheduled for an expedited hearing.

Typically, after the Claim Petition has been filed, the matter is scheduled for a Settlement Conference at the Office of Administrative Hearings. Prior to the Settlement Conference, if appropriate, the employee’s attorney will often submit a settlement demand to the attorney for the employer and insurer. The purpose of the Settlement Conference is to attempt to discuss the possibility of settlement. Some cases settle at the Settlement Conference, and some do not. If it appears that the parties have reached an impasse, and that further negotiations will not facilitate a settlement, the case may be referred to the Office of Administrative Hearings for the scheduling of a hearing. If either side needs additional information, if the case is not ripe for settlement discussions, or if the sides need additional time to negotiate, the Compensation Judge may also reset a Settlement Conference for a month or two in the future.

If the parties are unable to reach a settlement, the case will proceed toward a Hearing. In Minnesota workers’ compensation, a Hearing is the equivalent of a trial. At the Hearing, both sides will present evidence in support of their respective positions, and the employee will generally provide testimony. After all evidence has been heard, the Compensation Judge issues a decision, which is final and binding on the parties.

The entire process from the filing of the Claim Petition through a Hearing can take anywhere from six months to a year or more. In some instances your case can be expedited due to financial hardship. Let an attorney like Tom Atkinson personally assist you in determining whether your case could possibly qualify. You may reach him directly at 651-324-9514 or email at tom@mndisability. Also be sure to check our the Minnesota Disability and Atkinson Law Office web site at www.mndisability.com

Wal-Mart Employees Have Right To Decide Whether to Unionize AND They Have Right To Workers Compensation Benefits

by Madeleine Baran, Minnesota Public Radio

June 26, 2009

St. Paul, Minn. — A union has filed charges against a St. Paul Wal-Mart store for alleged intimidation of pro-union workers, as organizing efforts at several Twin Cities locations intensifies.

The charges, filed with the National Labor Relations Board yesterday, claim that supervisors at the University Ave. store required workers to attend anti-union meetings and threatened to fire union supporters.

According to Doug Mork, organizing director for the United Food and Commercial Workers Local 789, the mega-retailer sent a team of corporate representatives to the Twin Cities in June to stifle organizing efforts. The company then allegedly told workers that they could easily obtain a list of workers who signed union cards and "that union supporters would not continue to be employed by Wal-Mart," according to the charges.

The UFCW claims that assistant store managers also asked workers if they had signed union cards and "interrogated" workers regarding their union support.

Daphne Moore, a Wal-Mart spokesperson, said the company is reviewing the charges and does not have an immediate response to the filing. "I can tell you that we make sure that we take steps to educate our managers on labor law and make sure that our associates know their rights as well," Moore said.

The union plans to file a petition with the NLRB for a union election at the University Ave. store, but Mork declined to provide a timetable, citing concerns about worker intimidation. If the union drive is successful, the University Ave. store would be the only unionized Wal-Mart in the country.

The National Labor Relations Board will conduct an investigation to determine whether the employer violated labor laws, said Marlin Osthus, the NLRB's regional director, Osthus expects a ruling on the case by mid-August.

If the investigation concludes that Wal-Mart violated labor laws, the company would be required to post a notice that states that workers have a right to organize and that the company will not interfere in union efforts. The NLRB does not have the authority to impose a fine or other penalties in the case, Osthus said.

Wal-Mart has aggressively fought similar unionization efforts. When Wal-Mart meat packers in Jacksonville, Texas vote to form a union nine years ago, the retailer closed its meat packing departments and switched to selling pre-packaged meats. The company claims the changes had been planned in advance and were unrelated to unionizing efforts.

The retailer also closed a store in Jonquiere, Quebec four years ago, after workers voted to make it the first unionized Wal-Mart in North America.

Union Members Rally At St Paul Minneapolis Wal-Mart

By Paul Demko 6/5/09 1:13 PM

Wal-Mart is the most notoriously anti-union corporation in the world. In the last two decades, the company has gone to extraordinary lengths to keep organized labor out of its stores. Most recently it shuttered a store in Canada after workers voted to organize. Wal-Mart’s anti-union tactics have been so successful that for roughly five years United Food and Commercial Workers — the country’s largest union representing retail workers — didn’t even bother with a concerted organizing campaign.

But galavanized by a more labor-friendly administration in Washington, the UFCW is once again looking to bring the company’s 1.4 million U.S. workers into the fold. The union is focusing on roughly 100 Wal-Mart stores in 17 states, including Minnesota. Yesterday UFCW Local 789 held a rally at the Wal-Mart store in St. Paul’s Midway neighborhood:

I Received A Notice Of Intent To Discontinue My Benefits, Now What Do I Do?

Attorney Thomas Atkinson has authored numerous articles on the subject of the receipt of Notices of Intent to Discontinue (NOID) Workers Compensation benefits by injured workers in articles published in my blog and national publications such as The American Bar Association Journal and US Law Blog.

At Minnesota Disability and Atkinson Law Offices we believe that your receipt of a NOID signals the single most important time for injured workers to contact an attorney. You will NEVER be charged a fee for merely discussing this document. If you are an injured Walmart employee currently receiving wage loss benefits YOU WILL RECEIVE a NOID in your mailbox within the next few months guaranteed! When you receive the NOID you have very little time to act to preserve your right to receive ongoing wage loss benefits. These documents usual follow an “independent medical examination” or return to work slip obtained by pressuring a treating physician to return you work.

Remember that release you signed allowing the insurer to contact your health care providers, well the “nurse case manager” employed by the insurance company earns his/her job by getting you released finished with treatment and returned to work as fast as they can. You should NEVER allow a nurse case manager to assist with your file. They have no right to interfere with your doctor/patient relationship.

As soon as the Notice of Intent to Discontinue Benefits arrives in your mailbox you need to contact an experienced workers compensation attorney who limits their practice to workers compensation matters. Tom Atkinson has the number of the Minnesota Department of Labor employee who sets conferences to contest NOIDs on the speed dial of his phone! Tom will arrange for an expedited conference to your discontinuance action immediately. Contact Tom Atkinson at 651-324-9514 or email me at tom@mndisability.com Feel free to visit my website at www.mndisability.com