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This is the medical report. My solicitor is suggesting put forwards £7500, with acceptance over £5000.
He's pushing me to instruct him to settle, even though I've just provided a witness to strengthen the claim.
"This report has been provided for The Court with information contained in the solicitor’s letter of instruction, brief Occupational Health records and G P records from June 2016. Identity was confirmed by passport and driving licence.
PAST HISTORY
Mr lives with his partner. He has four children, three of whom live at home. He works on assembly for _________, where he has worked for seven years. His interests include boxing and attending a gym.
Review of medical records confirms that his health in the past has been good although he has psoriasis and he has long term anxiety due to problems at work. He was involved in a motorcycling accident in 2012 but all injuries settled completely. He has keratoconus of his left eye which has resulted in a degree of visual disturbance.
There is an entry in his occupational health records which states that he had right shoulder pain in October 2015. He was seen at ******* Hospital and an ultrasound scan was performed. I have not seen the report on this scan but I assume that there was no major problem since no significant action was taken. Further details may be available should relevant records be reviewed in the future.
HISTORY OF PROBLEM
Mr ****** states that he started work for ******** in January 2012. He performed various jobs but he had no problem for about four years.
In January 2016 he was changed to a job where he had to use an overhead crane on rollers to move differentials and then position them in vehicles. This involved considerable pulling and twisting, the process being repeated about 300 times each shift.
At first he was aware of considerable strain on his shoulders and back but he coped for several weeks without discomfort.
PROGRESS
Soon after starting the job the rollers became worn and defective and he had to use much more effort to move the differentials. He very quickly began to develop discomfort and stiffness in his shoulders and in the central part of his back. He reported the problem but although help was promised no immediate action was taken.
He continued to work over the next two weeks during which time he had increasing pain and stiffness in his shoulders and in his back. He went to his occupational health department where physiotherapy was arranged but he was not informed of the subsequent appointment and therefore he received no treatment. He saw his G P and he was prescribed Naproxen but this is not recorded in his medical records.
About two weeks after reporting the problem the rollers were fixed and he continued to perform the job with the usual degree of physical strain. Symptoms continued but he then had physiotherapy on his shoulders with some improvement. He took Paracetamol and Ibuprofen.
The situation remained unchanged over the next few months but at the end of 2016 he had to take nine months off work due to work related stress. In spite of this prolonged period of rest he continued to have pain and stiffness in both shoulders and variable discomfort in the central part of his back.
He returned to work in August 2017 following which he coped with light work for about six months. He still had shoulder and back pain but there had been some improvement.
In October 2017 he had a detailed assessment of his shoulders by a physiotherapist. It was stated that he had previously had an MRI scan in 2016 which confirmed bilateral shoulder impingement. He was found to have good movement of both shoulders although he still had pain at the limits of movement and on strain.
Aggravating factors were overhead activity, attempting to hold his arms at head level for prolonged periods of time and carrying his youngest child. It was suggested that he might see an orthopaedic specialist.
Unfortunately he continued to have work related stress and he has been unable to work since April 2018 although he now feels that he would be able to return.
He still has pain in the front and the upper aspects of both shoulders on strain with some aching at rest. In spite of this he can cope with all routine activity but he avoids strenuous activity. He has aching in the central part of his back which is increased by strain and he feels that all symptoms have been unchanged for a prolonged period of time. No further treatment is contemplated.
EFFECTS ON LIFESTYLE
Following the onset of pain in his shoulders and back Mr ****** continued to work and he took only one week off work in 2016 as a result of shoulder pain. Two prolonged periods of time off work have been due to stress. He now feels that he would be fit to return to work if suitable work was to be offered.
Activity at home has been restricted by ongoing symptoms and he has returned to boxing or to his gym. He has been less involved with his children when symptoms have been particularly troublesome.
EXAMINATION
Mr ******* presents as a healthy man who is right handed. He gives a clear account of his problem although some details may be vague due to the passage of time.
Examination of his shoulders reveals no abnormality. In particular there is no tenderness around either joint and all shoulder movements are full and pain free.
Examination of his thoracic and lumbar spines reveals no abnormality. In particular spinal contours are normal, there is no tenderness over the spinous processes or associated musculature and all back movements are full and painfree.
There is no other relevant abnormality on general examination.
OPINION
Mr ******* suffered pain and stiffness in both shoulders and in the central part of his back following repetitive strain at work in March 2016. Even though the major cause of the strain was eventually removed symptoms have continued.
Examination of his shoulders excludes major damage and MRI scans have revealed impingement. This is consistent with the repeated strain as described. It seems that the situation, after expert assessment, is not considered sufficient to require surgery. He has had physiotherapy and performed exercises, and had prolonged rest during time off work due to stress.
The present situation is that he continues to complain of discomfort in certain circumstances but he has good movement and he can cope with all routine activity. Shoulder problems often run a very prolonged course but it is likely, if he able to avoid excessive strain, that his shoulder problems will eventually settle but this could take five years from the time of onset of symptoms. No further treatment is indicated as long as the situation does not deteriorate.
He has continued to have pain an stiffness in the central part of his beck although this no longer prevents normal activity. Examination excludes major damage and symptoms are due to soft tissue injury. It is difficult to understand why progress has been so slow but it is likely that his physical symptoms have been exacerbated by ongoing stress and frustration.
It is very difficult to predict the outcome of long term back symptoms but I feel that there is a good chance of his back returning to normal in the next year or two as long as he avoids excessive or repetitive strain.
In the last three years Mr ****** has suffered considerable stress due to problems at work and I feel that he has been in a vicious circle where physical and psychological problems have each exacerbated the other. He feels that his level of stress is now much reduced and it would be very much to his advantage, from all points of view, to return to work"
He's pushing me to instruct him to settle, even though I've just provided a witness to strengthen the claim.
"This report has been provided for The Court with information contained in the solicitor’s letter of instruction, brief Occupational Health records and G P records from June 2016. Identity was confirmed by passport and driving licence.
PAST HISTORY
Mr lives with his partner. He has four children, three of whom live at home. He works on assembly for _________, where he has worked for seven years. His interests include boxing and attending a gym.
Review of medical records confirms that his health in the past has been good although he has psoriasis and he has long term anxiety due to problems at work. He was involved in a motorcycling accident in 2012 but all injuries settled completely. He has keratoconus of his left eye which has resulted in a degree of visual disturbance.
There is an entry in his occupational health records which states that he had right shoulder pain in October 2015. He was seen at ******* Hospital and an ultrasound scan was performed. I have not seen the report on this scan but I assume that there was no major problem since no significant action was taken. Further details may be available should relevant records be reviewed in the future.
HISTORY OF PROBLEM
Mr ****** states that he started work for ******** in January 2012. He performed various jobs but he had no problem for about four years.
In January 2016 he was changed to a job where he had to use an overhead crane on rollers to move differentials and then position them in vehicles. This involved considerable pulling and twisting, the process being repeated about 300 times each shift.
At first he was aware of considerable strain on his shoulders and back but he coped for several weeks without discomfort.
PROGRESS
Soon after starting the job the rollers became worn and defective and he had to use much more effort to move the differentials. He very quickly began to develop discomfort and stiffness in his shoulders and in the central part of his back. He reported the problem but although help was promised no immediate action was taken.
He continued to work over the next two weeks during which time he had increasing pain and stiffness in his shoulders and in his back. He went to his occupational health department where physiotherapy was arranged but he was not informed of the subsequent appointment and therefore he received no treatment. He saw his G P and he was prescribed Naproxen but this is not recorded in his medical records.
About two weeks after reporting the problem the rollers were fixed and he continued to perform the job with the usual degree of physical strain. Symptoms continued but he then had physiotherapy on his shoulders with some improvement. He took Paracetamol and Ibuprofen.
The situation remained unchanged over the next few months but at the end of 2016 he had to take nine months off work due to work related stress. In spite of this prolonged period of rest he continued to have pain and stiffness in both shoulders and variable discomfort in the central part of his back.
He returned to work in August 2017 following which he coped with light work for about six months. He still had shoulder and back pain but there had been some improvement.
In October 2017 he had a detailed assessment of his shoulders by a physiotherapist. It was stated that he had previously had an MRI scan in 2016 which confirmed bilateral shoulder impingement. He was found to have good movement of both shoulders although he still had pain at the limits of movement and on strain.
Aggravating factors were overhead activity, attempting to hold his arms at head level for prolonged periods of time and carrying his youngest child. It was suggested that he might see an orthopaedic specialist.
Unfortunately he continued to have work related stress and he has been unable to work since April 2018 although he now feels that he would be able to return.
He still has pain in the front and the upper aspects of both shoulders on strain with some aching at rest. In spite of this he can cope with all routine activity but he avoids strenuous activity. He has aching in the central part of his back which is increased by strain and he feels that all symptoms have been unchanged for a prolonged period of time. No further treatment is contemplated.
EFFECTS ON LIFESTYLE
Following the onset of pain in his shoulders and back Mr ****** continued to work and he took only one week off work in 2016 as a result of shoulder pain. Two prolonged periods of time off work have been due to stress. He now feels that he would be fit to return to work if suitable work was to be offered.
Activity at home has been restricted by ongoing symptoms and he has returned to boxing or to his gym. He has been less involved with his children when symptoms have been particularly troublesome.
EXAMINATION
Mr ******* presents as a healthy man who is right handed. He gives a clear account of his problem although some details may be vague due to the passage of time.
Examination of his shoulders reveals no abnormality. In particular there is no tenderness around either joint and all shoulder movements are full and pain free.
Examination of his thoracic and lumbar spines reveals no abnormality. In particular spinal contours are normal, there is no tenderness over the spinous processes or associated musculature and all back movements are full and painfree.
There is no other relevant abnormality on general examination.
OPINION
Mr ******* suffered pain and stiffness in both shoulders and in the central part of his back following repetitive strain at work in March 2016. Even though the major cause of the strain was eventually removed symptoms have continued.
Examination of his shoulders excludes major damage and MRI scans have revealed impingement. This is consistent with the repeated strain as described. It seems that the situation, after expert assessment, is not considered sufficient to require surgery. He has had physiotherapy and performed exercises, and had prolonged rest during time off work due to stress.
The present situation is that he continues to complain of discomfort in certain circumstances but he has good movement and he can cope with all routine activity. Shoulder problems often run a very prolonged course but it is likely, if he able to avoid excessive strain, that his shoulder problems will eventually settle but this could take five years from the time of onset of symptoms. No further treatment is indicated as long as the situation does not deteriorate.
He has continued to have pain an stiffness in the central part of his beck although this no longer prevents normal activity. Examination excludes major damage and symptoms are due to soft tissue injury. It is difficult to understand why progress has been so slow but it is likely that his physical symptoms have been exacerbated by ongoing stress and frustration.
It is very difficult to predict the outcome of long term back symptoms but I feel that there is a good chance of his back returning to normal in the next year or two as long as he avoids excessive or repetitive strain.
In the last three years Mr ****** has suffered considerable stress due to problems at work and I feel that he has been in a vicious circle where physical and psychological problems have each exacerbated the other. He feels that his level of stress is now much reduced and it would be very much to his advantage, from all points of view, to return to work"
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