That’s very interesting Tracy . A difficult case. I am in concordance with Sharons ’ thoughts. Anxiety is known to exasperate pain and lower thresholds. CBT maybe useful. .

The pain and movement sounds similar to cupsulitis (frozen shoulder) which may also benefit from physio. We have individuals’ who work with similar injuries with adjustments.

An interesting case though. OHP may be useful however as Sharon said you appear to have gone through his case well.

Good luck

Ruth

The simple answer is that it seems to me that you have addressed the clinical issues and have answered the questions that you have been asked. The harsh truth is that if the company decide to terminate his contract and this upsets him, and indeed if he sues them for personal injury it quite simply is between them
 
However - it would be useful to know what he actually is meant to do at work, and what restrictions are available and over what duration of time. These types of injuries are painful and can be slow to resolve but have to say that I have people working (with restrictions) with significent shoulder problems - might be a ontroversial point but a lot depends on how motivated the individual is
 
On another tack chronic pain and its associated psychological responses can be very debilitataing, particularly if the focus of his anxieties is work (and he is carrying on singing). I work with lots of people who are more debilitataed by the fear of pain than the pain itself, and thus limit their activity. There are talking therapies that are very good at limiting the impcat of chronic pain and increasing activities (eg CBT) and it may the worth the company considering funding this , it may just work and in any event will mitigate when it comes to compensation
 
With regards to OHP referral - that rather depends on what the employers normal practices/procedures are
 
> Date: Sun, 22 May 2011 09:03:23 +0100
> From: [log in to unmask]
> Subject: [OCC-HEALTH] Adice re long turn sickness please
> To: [log in to unmask]
>
> Good Morning
>
> Please can I have any advice.
> I have a gentleman - an inherited long term absence aged 50. Fell at work 2 years ago. Rotary cuff injury - required surgery when did not improve. Three attenps back to work in a light duty role all episodes short lived. and 6 weeks ago returned again following cortizone injection into joint. GP has adivsed tooo soon for another injection. The role did not require him to use his left arm at all. Three weeks later he went off sick stating that the pain in his shoulder was too bad to work. The GP reportedly feels that the effects of the injection has worn off. Recent MRI scan shows tear to the bicep tendon and spurs in the joint - further surgery may be required to resolve this. Specialist assessment pending.
> This gentleman manages ADLS but reportedly in his own time - very slow and rests frequently. However he also is a semi professional singer and continues with his shows as says his wife carries the equipment and he does not require the shoulder to sing! On examination keeps arm close to him in a guarded way - dificulty putting coat on and off - very limited movement.
>
> Work are now considering ending his contract. In my last report I have said that given his history he is unlikely to be fit to return to work unles future treatment is sucessful i.e surgery and therefore he is likely to remain off for several months. I do not have a OHP and when considering referral on an ad hoc basis I am not sure how much more information the Busienss will be furnished with. Do you think OHP referral should be sought as it is likely this gentleman is going to lose his job. A report from his specilaist states that his treatment is ongoing and therefore no further information can be given. The specilaist appologised in the letter for the lack of information he could give appart from diagnosis and that further surgery may be required and that shoudler surgery is known to take along recovery .It was the smallest report i have ever seen althought the standard questions were asked. The employee strongly believes that the Busienss is at fault and the fall has made him half the man he was - He is claiming significant costs. He says he wants to come back to work and that he will be upset if the Business end his contract. Sick pay has not run out. He has a further one month sickness. Any comments would be appreciated.
>
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