Return to Work in the Setting of Upper Extremity Illness

Abstract

HE PATIENT ary is a 44-year-old woman who sustained a simple ong finger extensor tendon laceration at the midetacarpal level at work 5 months ago. Surgical repair as straightforward. She had difficulty getting to hand herapy due to family issues, but she did participate in a -month program and regained full motion. Her theraist noted disproportionate complaints of pain, particuarly when discussing return to work (RTW). Three years before the injury she was disabled for 1 ear due to upper extremity pain that she describes as eing due to repetitive trauma. She states that she did ot feel normal even when she returned to work. Mary has confided that she has a stressful relaionship with her supervisor at work. Presently, here are no findings on examination or diagnostic tudies that explain Mary’s pain complaints. She oes not feel that she can return to her job, and she eports that her employer does not want her back nless she can return without restrictions. She decribes her job as fast paced and requiring frequent eavy lifting. Mary has not been in contact with ny of her co-workers since the accident. She xpressed hope that you will not make her return to ork. Her attorney is pursuing litigation against er employer and is requesting a letter from you egarding permanent disability. Her worker’s comensation carrier wants to know whether she is leared for duty and indicates that they can accomodate any restrictions.