"Now my other side hurts."

What counts as a compensable consequence

Overuse of the opposite side. A right shoulder injury means everything gets done left-handed. A leg injury means the other leg carries the load. This is predictable, it is documented in the medical literature, and it is compensable.

The joint above or below. A knee injury changes your gait and the hip and low back absorb it. An ankle injury does the same.

A fall caused by the injury. If your knee gives out and you fall and break a wrist, the wrist is industrial.

Complications of treatment. Infection, a failed surgery, hardware failure, nerve injury during a procedure, complex regional pain syndrome. Under Hikida v. WCAB, where industrial medical treatment causes disability, that disability is industrial — and not apportionable to the underlying condition. But Hikida was narrowed.* County of Santa Clara v. WCAB (Justice) *(2020) 49 Cal.App.5th 605 [85 Cal.Comp.Cases 467] holds that it "precludes apportionment only where the industrial medical treatment is the sole cause of the permanent disability." Where pre-existing pathology also contributes, §§ 4663 and 4664 apportionment still applies.

Medication side effects. Gastrointestinal injury from long-term anti-inflammatories. Dependence on prescribed opioids. Organ damage.

Sleep disorder, and psychiatric injury. Both are subject to § 4660.1(c)(1) for injuries after 2013 — which bars increasing the rating for sleep dysfunction, sexual dysfunction, or psychiatric disorder — unless the injury was catastrophic or you were the victim of a violent act. How that exception works.

And in an amputation case, the contralateral limb and the shoulders — from crutch and wheelchair use — are the classic example. Amputation claims.

Why it gets missed

Because nobody adds body parts to a claim on their own initiative.

The original claim form lists a body part. The treating physician treats that body part. The medical-legal evaluator is asked about that body part. The permanent and stationary report addresses that body part — and the rating covers that body part.

The second one, if nobody said anything, contributes nothing.

And the timing is unforgiving. Under § 5502(d)(3) discovery closes at the mandatory settlement conference, and evidence not disclosed there is generally inadmissible. A body part raised after the case is set for trial is usually too late.

What to do

Tell your treating doctor, at the next visit, and make sure it goes in the note. "Patient reports left shoulder pain from overuse since the right shoulder injury" is the sentence that starts this.

Report it to the claims administrator in writing. Dated, specific, kept.

Ask that it be addressed in the medical-legal report — the evaluator has to be asked about it, in the letter that goes to them, before the examination.

Do it early. Not at the settlement conference.