From Injury Back to Work Again Part III - The Light at the end of the tunnel.

From Injury Back to Work Again Part III
Retraining and all.

In this article we will examine the process and timeline from surgery back to work again. We will chronicle the days, weeks and months from surgery to a return to work if not a return to 100% health.

This part of the journey began at St. Jospeh's Health Care Centre in London, Ontario. After many trips to the hospital over the last nine months, the time had finally come for surgery. After coming out from under the general anesthetic I would not be allowed to drive so I needed an escort to take me to London. My friend John Helmers accompanied me to the hospital. Before I was admitted to pre-op, a nurse went over the expectations for the day and what would happen, and John's role in looking after me after the surgery and on the return trip from London to Waterloo. After that we parted ways, and they began to prepare me for surgery.
As I do not recall the surgery I cannot comment on that part of the day's events. But they went in through my neck and did a nerve block, freezing the nerve for my arm in the neck rather than local on the shoulder. This was combined with the general anesthetic. After my surgery, they discovered that the nerve block must have hit the diaphragm also, because every time they tried to take me off oxygen my blood oxygen level would drop too low and I would have to be put back under the mask. I was expected to be discharged from the hospital around 1pm and it was after 5 before we were finally able to leave. What they did during the surgery was to go in and cut out the scar tissue from around the tear in the supraspinatus tendon. The surgeon also shaved bone from both the Acrommion and the Humerus to give more room for the tendon to swell when it gets inflamed.

After the surgery there were a few follow-up meetings with the surgeon. After the first 10 weeks, physiotherapy began again. This time it was only three days a week. For the first 12 weeks I did not even have doctor approval for driving so had to make arrangements for rides to and from appointments and treatment. So I was back and forth to Kinetex Rebab frequently. Then a determination was made between the surgeon and physiotherapist that the shoulder was as good as it was going to get; treatment would continue but with my employer being unable or unwilling to take me back with modified duties it was time to look at other long-term options. Permanent restrictions were put on my working. No repetitive or sustained work at shoulder height or above, no lifting above shoulder height of 10lbs or at shoulder height of 15 lbs. These were now permanent restrictions - something I will have to abide by the rest of my working life. If I choose to work and ignore these restrictions then WSIB will not cover any future problems. If I have abided by these rules and down the road the injury reoccurs, WSIB purchased a home TENS unit for me. A Transcutaneous Electrical Nerve Stimulation (TENS) is a non invasive, drug-free, pain management modality, used for short-term acute pain or long-term chronic pain management. I can use it daily at home to help manage the discomfort and pain on an as-needed basis.

Since returning to my previous job was not possible and I now had permanent work restrictions, WSIB sent me to a subcontractor for a Labour Market Re-entry Assessment or Plan (LMR). The first time I met with my assessor I was more than a little disappointed. I went with copies of my high school and university transcripts, copies and samples of different resumes and cover letters that I had used. My worker's response was: "I don't know what to do with you; most of my clients have never finished high school, and I have to send them for aptitude testing before even looking at creating a plan and what type of schooling a client can do." At that time I was 4 credits short of graduating at the University of Waterloo. But because I was injured working construction, my worker would not even submit a plan to have me finish my university degree. So she created two plans and submitted them to my WSIB adjudicator for approval.

Unfortunately the plan that was decided upon was not well-planned or well-researched. It was created to get me in and out of school in the quickest way possible - to get me back in the work force. I began at triOS College to work on Microsoft Office Certification. I trained on two of the applications in the office suite and then moved to Laurel College, for the other three. Unfortunately triOS does not offer the certification exams for the courses done there and Laurel taught and offers exams on a different version of Office. Fortunately Laurel College allowed me to work at my own pace and I did the coursework, practice exam and certifications in Word, Excel, Access, Powerpoint and Outlook in 21 days - what is normally 12 to 15 weeks of private instruction. Then I had a week off and after that went back to trios. It had now been over 2 years since my original injury. Again my worker who planned the LMR did not realize that she had me in a part of a course that did not include the exam certificates allowing me to write the certification exams for all of the courses done in class. We had to go back to WSIB with a modification of the LMR to request the exam vouchers for the courses being worked on, and add courses to complete certain certification requirements.

There had been both good and bad along the road to recovery. For the first 17 Months I had the same adjudicator from WSIB. We developed a rapport and relationship. Then over the next 12 months I had at least 8 adjudicators, some of whom never returned or called before I was informed that I had a new one. The two years off work had been a mix of good and bad. Some of the instructors and staff at both triOS and Laurel College were great to work with. I was also able to be home the first year of my daughter's life, an opportunity many fathers do not get to have. On a down side, my wife had to return to work shortly after the birth because we could not afford for both of us to be on reduced income. I was also able to focus on developing my writing and spend more time at Imprint volunteering. It was a struggle being on reduced income and there were emotional trials of being off work for such a long period, and it caused some stress in the family. During my entire time off work I looked for a job that would not contradict my restrictions. I applied for many jobs and never heard a thing. Just as I was returning to triOS for my second stint there, a headhunter from Spherion Staffing contacted me because they had found my resume on Workopolis and thought I would be perfect for one of their clients. I did a couple of interviews but did not get the job. Then late in November they called again to see if I might be interested in interviewing for a different client. It was a hard decision; my schooling had been extended into February. Should I take a contract job and leave school and continue studying on my own?

I took the risk and accepted a contract position, through the headhunters, at Crawford. I had been hired to do IT support, which was what I was training for at triOS. I negotiated with the company managing my LMR and was able to transfer my unused tuition from leaving school early to extra book and exam vouchers to write more certification exams on my own. After my contract expired at Crawford I was hired on full time. My first day back to work as a fulltime employee was Monday March 10th 2008, almost 30 months to the day from the injury. I was now employed full time again.

My advice, since having gone through the system and meeting many at triOS who were doing the same, is to learn what you are entitled to, and fight for it. Find out about all your options and don't sign anything you do not agree with. Seek the advice of others who are going through the process and from professionals (Lawyers, Medical Staff etc.) and organizations or associations set up to help injured employees. Yet first and foremost protect yourself at work. Do not do something just because you are told to, if you think it is unsafe. If you have questions or doubts check it out before proceeding and hopefully you will never have to go through this kind of experience yourself.

(First published in Imprint 2008-06-13 as The Road to Recovery Part 3: The final installment of McEvoy's journey from injury to recovery. He undergoes surgery, explores his career options, and finally finds an employer who understands.)

(You can read Part1 and Part 2 by following the links. You can also follow my progress by checking here.)

From Injury back to Work Again Part II

From Injury back to Work Again Part II The first year

In the summer of 2005 I was working as a foreman for a landscaping company. One Monday morning my boss told me he had told the crew not to meet me at the current job site until he called them, and that we had a side job to do. We drove our trucks and trailers out from Kitchener to Ayr to pull some conduit for an electrician. When we arrived in Ayr, the electrician did not have any conduit. He wanted to run pipe under ground from the house to a shed/garage at the back of the property to run wire through. Most of the PVC pipe we had on my truck was one inch diameter for residential irrigation. The Electrician wanted a wider pipe to run a few wires through. So we unrolled an old partial role of one and a half inch pipe that was in my trailer to see if it would reach from house to shed. It did but just barely. So we rolled the pipe back up and began to pull it under ground with a ditchwitch.

My injury occurred because of many factors. First we went to do a job without being prepared or knowing the details of what we were doing or what was expected. So there I was standing in the center of a loose role of pipe that was now taller then I am, trying to keep it spinning so it would feed into the ground without kinking. The electrician saw me struggling and helped from time to time. But I was standing in a roll of pipe with both arms extended full above my head, one leg kicking the roll backwards as it fed, and I did something to my shoulder. I felt the pain right away, but worked through and got the pipe pulled. Then when I went to dig up the other end of the pipe, I could not drive my shovel into the ground from the pain. I drove back into Waterloo to meet my crew at the Open Text building on North Campus, to get to work for the day. By the time I met them I could not even lift my arm, and was having shooting pain down my whole arm.

I called my boss to tell him I was going to seek medical attention. He gave me a hard time, saying I just wanted the day off, or I hurt it on the weekend, and was scamming him. Yet I insisted and had one of my crew drive me to a clinic. After being examined by the doctor I was told I probably had a strain or sprain in the shoulder and they prescribed an anti-inflammatory and 2 weeks of light duty. Those modified duties included no heavy lifting, and no repetitive movements at or above shoulder height. I called my boss and he went ballistic, yelling and screaming at me on the phone. He decided he would not pay me to just be the supervisor and in his words "Stand around doing nothing" so he ended up paying much more through WSIB for me to be off and at home. He said I had to get someone to pick me up and take me to the office to fill out the WSIB paperwork. I spent the next 2 weeks taking it easy and with my arm in a sling. On the Sunday evening before I was to return to work, I called to find out if I was to go to a job site or pick up the rig at the shop. He asked if I had medical clearance and I said no. He insisted I see a doctor before he would allow me to return to work. Fortunate for me he insisted so. Even though I felt much better, my shoulder was, in reality, not better. When I went back to the doctor she did a series of tests for range of motion, mobility and functionality of the shoulder. She was not happy with these results and referred me for physiotherapy and eight more weeks off work.

So two days later I found myself at Kinetex Rehab on Columbia. I had an extensive intake interview and series of tests with a specialist. Then I began a physiotherapy routine, for more than a year from the day I went to physiotherapy, five days a week most weeks. It was a mix of treatments, of ultrasound therapy, acupuncture, electrical stimulation as well as manual stimulation, combined with home exercises with elastics and a ball and light weights. A few days after I began treatment, I had an ultrasound scan of the shoulder done. That scan revealed a tear in the supraspinatus tendon, which I later learned is the most often-injured part of the rotator cuff muscles. During one of my first visits I was told that shoulders often take a year to heal, and I laughed out loud. I had cut off casts in the past and returned to work or sports from other injuries - what was so special about shoulders? One of the benefits of having treatment at Kinetex was seeing many Kynselogy students from UW doing placements, and talking with them as my process went on and on.

My life changed drastically. I went from being a very active and fit university student, to someone who read, worked on the computer and went for physiotherapy. I started to gain weight, and as the weeks dragged into months, it started having a psychological effect also. I even looked at returning to former jobs. I went and talked with previous managers at Starbucks and Chapters yet neither would hire me back with the restrictions. After four months off work, WSIB required that I visit with a surgeon and consider that option. So off I traveled to St. Joseph's Hospital in London, Ontario to the WSIB Upper body clinic. Fortunately this surgeon was not eager to cut. He extended treatment times from January 2006 again and again until August 2006 when the decision was made to go ahead with surgery, as the shoulder was not showing marked improvement or recovery. And I was then put on the waiting list for surgery. Over this period of a year I did almost 100 job applications hoping for work that would meet my limitations, yet never even received an interview.

That sums up the narrative part of the journey, but what about the WSIB and my boss and all the issues surrounding that? My first adjudicator with WSIB was excellent; he worked my case from the injuring in 2005 until January 2007. My boss was very difficult to deal with; every time I was assessed and treatment was extended he would get mad and flip out on the phone. In December when he laid off the rest of the crew, he got mad and screamed at my adjudicator on the phone because he could not grasp that because I was injured and could not find work that met my limitations he would have to pay me over the winter even though he closes the company during this period. My boss was not the wisest man; he said at the beginning that he did not want me on site with modified or light duties. WSIB would have charged him much less if he had tried to have me back to work but he was unwilling to do so. When we talked he would berate me and accuse me of faking again. I told my adjudicator that I had spent the whole evening before the injury with friends over playing cards and had witnesses that I was not injured on Sunday. When I ran into my boss around Christmas at Future Shop he called me fatso because of the weight I had started putting on and yelled across the store calling me a faker. I shared this information with my adjudicator and the boss was rebuked for inappropriate behavior.

In September of 2006 I got a call telling me my surgery date had been set. I would need an escort to take me to London for the surgery and would be in a sling for 8-12 weeks after. When I received this call, I had a four week old baby at home. Now I was going to be out of commission for helping with the baby and helping around the house. Therefore surgery was not really eagerly anticipated. Yet a whole new phase in the journey of recovery, the journey back to work, was about to begin.

Next time I will chronicle the process from the day of the surgery, through a Labour Market Reentry (LMR) Plan, to being employed again. In that piece I will examine: changes in my WSIB case management, outside contractors to WSIB who actually performed the LMR, to starting a new job in a different field.

(First Published in Imprint 2008-05-30.) 

Part I. Part II. Part III.

From Injury back to Work Again Part I

The Road to Recovery
Part I The WSIB and the Workplace, part one of three: Safety, insurance, and tips for protecting yourself

Often it is said that when you are young you think you are invincible and thus attempt and do things you should not. Workplace safety is one of those areas where youth need to learn to take fewer risks. May 4th-10th 2008 marked North American Occupational Health and Safety (NAOHS) week. Every year together Canada, the United States and Mexico join forces to help to focus attention on the importance of preventing injury and illness in the workplace. As someone who was injured at work and subsequently off work for 2 years, I know first-hand the stress and pain that can be caused by a workplace injury. As such, this is the first in a three part series about The Workplace Safety and Insurance Board (WSIB) here in Ontario. In these articles I will try to chronicle for the reader, some of what a worker in Ontario needs to know about workplace safety, and the process from injury to being back to work again. So come follow me on a journey that was more than two years in the making.

The WSIB has a youth site aimed at high school and university aged students www.youngworker.ca. It states that on average 42 young workers are injured or killed on the job every day in Ontario. It also declares that workplace accidents can happen at any job and can cause serious injuries. The WSIB declares that "By law, you have basic rights, including:
1. The Right to Know about what hazards there are in your workplace and to know what to do to prevent injuries from them.
2. The Right to Participate in health and safety activities in your workplace without fear of discipline.
3. The Right to Refuse work that you reasonably believe can be dangerous to yourself or others.
However, you also have responsibilities including:
1. Work Safely: use all machinery and equipment the way you were trained to.
2. Report Hazards: if you know that Ontario's health and safety laws are not being followed, you must report the circumstances to your supervisor or employer as soon as possible.
3. Use or wear Protective Devices: don't remove a guard or device designed to protect you. "Wear your safety gear--it's the law." As such you are protected by the law but also have responsibilities. In Ontario all companies that hire full time or part-time employees must register with the WSIB within 10 days of hiring the first employee.

The WSIB has a long history of trying to protect employee rights and safety in Ontario. In 1884 it all began with the passing of the Ontario Factories Act, a system of inspection and enforcement of health and safety standards for all factories in Ontario. The immediate precursor to the WSIB was the WCB Workers Compensation Board, which was created by the Workers Compensation Act in 1914. In 1965 the WCB established the Safety Education Department to coordinate resources and programs from different industry associations and labour associations. Then in 1998 the WCB became the WSIB for Ontario. What does all that history mean? It means that this organization has over 100 years of history or working to protect and educate Ontario workers. In 2006 the WSIB reports:

There are three types of claims that the WSIB tracks. They are: 1. Allowed lost time 2. Allowed no lost time and 3. Allowed traumatic deaths. Looking at the statistics can be a little staggering. Comparing 2002 to 2006 will give us a sample of some of the recent data collected. (Click on chart to see larger version.)

As can be seen from these numbers, even with all the advertising campaigns and awareness the WSIB is trying to generate, the number of claims is remaining consistent. Roughly 10 student employees each year are dying on the job because of a workplace injury or accident. Therefore it can only be concluded that all students and all employees must be active in educating themselves and protecting themselves and others in the workplace.

The WSIB is an organization that has developed over time. As working conditions and the labour market have changed, it has also changed to meet the new conditions and requirements. It is there to educate and to help if you happen to fall victim to an accident or injury in the workplace. If you are injured at work you have a responsibility to report it as soon as possible. If your employer tries to dissuade you from seeking medical attention be insistent. In the summer of 2005 I was working for a landscaping company and prior to my injury 2 other employees were injured on the job. One burned his hands on the muffler of a machine, and another hurt his shoulder. Both did not seek medical attention because they were told that 'They would not have a job when they returned.' Both worked with their injuries for months and if they have problems in the future they have no recourse. An employer cannot do this. Even if they offer to cover your wages do not do it. Follow the system and protect yourself for the long term. Your employer cannot threaten to fire you or fire you for seeking medical attention. It is against the law for them to do so. Get the medical attention you need, when you need it. Even if you lose no time from the job, at least the injury is documented. Educate yourself and know your rights.

Yet even with all of that knowledge fluke accidents can still happen. And in September 2005 it did happen to me. I was working as a foreman for a landscaping company. My boss and I went out to do a side job, pulling some conduit for an electrician. Neither my boss nor I had the right equipment in our trucks, or the right information from the electrician. So while we attempted to solve his problem we created a huge one for me, and for my employer. But that is a story for another time. In the next installment in this series I will chronicle the journey from the injury to just over a year later and the surgery to repair my rotator cuff.

[FYI:
According to the Canadian Centre for Occupational Health and Safety (CCOHS), the accident investigation process involves the following steps:

1. Report the accident occurrence to a designated person within the organization.
2. Provide first aid and medical care to injured person(s) and prevent further injuries of damage.
3. Investigate the accident.
4. Identify the causes.
5. Report the findings.
6. Develop a plan for corrective action.
7. Implement the plan.
8. Evaluate the effectiveness of the corrective action.
9. Make changes for continuous improvement.

While work injuries sites say they are for employees it is best that one get representation to insure their rights are being met. Protect yourself because although places like WSIB helps employees the organization has also been accused of functioning to favour employers. Also, WSIB has come under scrutiny for issuing rebates to companies found and prosecuted of safety violations that lead to death and/or serious injuries: found here.

At the CIWA (Canadian Injured Workers Alliance) discussion board workers can use posts about injuries as a place to seek assistance, found here.]

(Note: All data in this article taken from here.)
(First published in Imprint 2008-05-15 as 'The Road to Recovery'.)

Part I. Part II. Part III.