NYS Workers\' Compensation: The Falling and The Recent Symptoms

【The following file was given by me to some physicians, including Dr. Robert S. April on my Nov. 08, 2019 visit. A very similar file was given to a treating physician, Dr. Mehrdad Golzad. An earlier version was provided to NYS Workers' Compensation Board and the WC insurance adjuster Ms. Lisa White in June 2019. Almost nobody cares. Medical readers can understand why the deniers want to wipe Neck off the established list of established injury sites, because the Neck was seriously injured during the Jan. 16, 2018 workplace fall and its trauma contributes to the tetraplegia.】

 

Patient’s Own Statements on the Falling and on the Recent Symptoms

Limin Wang (Injured Worker and Patient)

August 7, 2019

 

How and When the Falling Happened

I had been working for the direct employer B.Q. Wide Auto Body Parts Supply, Inc. (109-35 178th Street, Jamaica, NY 11433) consecutively for two years and five months. My job there was basically the entry-level hard-laborer almost always hurrying in moving auto body parts, as far as routinely bending for the ground-level deep pockets to reaching for the top-shelf close to the ceiling, which I estimate to be ~ 20 ft, across the big (>200 ft x 250 ft) warehouse. That job put a very high demand to my whole musculoskeletal system and my nervous system. Since Jan. 15, 2018, I was switched to a different job at the

same warehouse, and such a switch is a routine management operation there for entry level hard-laborers. Jan. 15, 2018, I found that the 8-ft Louisville aluminum stepladder (i.e., it opens to form a standing in-depth A shape) involved in the next day’s fall incident was already strangely broken at least with its right metal bracelet disconnected from the front rail. That broken stepladder put at there was supposed to be used exclusively by me on my new task, and I used it several times since. On the date of accident, Jan. 16,

2018, ~11:05 a.m., I had to use that broken 8-ft stepladder to stock a fender to a height of 11 ft 8 in (which I measured at a later day) onto a shelf and a pile of fenders already there. When my feet were at a top metal step (absolutely not the very top plastic space, and I say “a top”, not “the top”), the ladder started to tilt to its right. I then reached my left hand to grab the shelf to the left. I am not sure of which level of the shelf, but it should never

be an overhead level. My body was falling and my right hand was still holding the fender which was about 10 lbs. My body was spinning for a 180-degree rotation to avoid my face being ruined by the shelves and stocked parts, including the automobile hoods stocked on the ground level. When my left arm was stretched to its limit, the body falling was suddenly stopped, and I felt my head and neck had a hyperflexion, toward the end of which I had a split second of total loss of consciousness. When the consciousness came back, I sensed my head and neck was still in the process of hyperextension. During the falling, I made a loud distress scream and then heard a loud metal-banging sound. My left hand lost grip and I then fell further with my feet onto the ground and my back against the auto hoods on the ground level. I lost the holding to the fender during falling, which includes motions of vertical acceleration-deceleration compression, sideway jerking, whiplash, and rotation, particularly to my head, neck, up and low back. My glasses were picked up from the ground, with small cracks on both lenses then. I felt very dazed in the immediate afterward. Minutes later, I reported the falling to the warehouse manager Mr. Benny Fang. Mr. Fang was simply eager to urge me to get rid of the broken stepladder. I didn’t follow it to remove the evidence. Mr. Fang soon left early from work for the day and later answered that he didn’t know how to deal with work injury or the workers’ compensation path. To my understanding, Mr. Fang is a years-long manager and the employer is a decades-old business. I left early on the Date Of Injury (DOI, Jan. 16, 2018) to find out what is the right venue of medical evaluation and treatment for my soon exacerbated symptoms.  On Jan. 20, 2018, Saturday, I submitted the written report of this falling incident to the store manager Simon Y. (I forget Simon’s full last name.) It was in his surveillance room, and I expressed my needs for the workers’ compensation. Simon then and there agreed to go the workers’ compensation proceeding.

 

 

My Symptoms of Recent Months

The traumatic sequelae have deteriorated and expanded. To my own current understanding, the central nervous system (CNS, head and spine) controls the whole body, and the trauma to the CNS leads to the direct/primary sequelae on it and the indirect/secondary sequelae on other body sites and systems. A living human being is a dynamic metabolic system. What’s unfortunate to me is that my health has not recovered as expected, instead, has deteriorated. To my very limited knowledge of medicine and my old scans data, the deterioration could have been well specified and explained. I need the follow-up proper diagnosis, recovery, and compensation, please.

 

My symptoms of the recent months are presented in three large categories: 1) physiological, 2) cognitive, 3) emotional and behavioral.

 

1) Physiological Symptoms

1a) Head/Brain

The headache is constant, has long become all over the head, many times goes with some sense of dumbness/numbness, and varies from at a moderate to severe degree. There have been tens of times of severe headaches each of which last a day or two, and during which I had little appetite, intense nausea, and great difficulty in falling asleep. The headache manifests in a variety of forms. The constant headache may be described as dull, tightening, numb and dumb. The episodic headache which can vary from moments to days presents sometimes as warm acute pain, sometimes as throbbing pain, and sometimes as ring-rippling around the head, etc. Also, there is constant faintness/dizziness varying from mild to severe degree. Up to a daily basis, there are episodes of drowsiness which can happen irregularly any time of the day. The sleeping pattern has become irregular too. Unpredictable episodes of extra headache at local areas or all over the head happen almost all the time. The local area can be around the frontal, parietal, temporal, occipital lobes, cerebellum, brain stem, or craniovertebral junction area. These extra headaches usually come to one or two local areas and it may not be symmetrical. Also, pulses of extra faintness (syncope) can happen any time, during walking, standing, or even lying down awake.

 

1b) Senses on the Head

The scalp sometimes feels painful, and more often some kind of numbness. The whole face has become numb, particularly when the facial muscles actively move around, and particularly around my mouth. The whole set of teeth have long since had some mixed sensation of numbness, tingling and pain. The teeth crunching motion makes such sensation more obvious. Additionally, there are bouts of acute pain on the whole set of teeth and around the temporomandibular joints. 

The eyes always feel tired or some kind of pain, and sometimes have blurred vision, or have the sense that the walking ground is gently rippling, or see brown floating patches. Quite often, I find out that my eyes have accommodation difficulty, e.g., they can not quickly adjust the focusing as usual when the view is switched from the TV to the phone or vice versa. The eyes have also become hypersensitive to the sudden change of light intensity, e.g., when I come from indoor to sunlight bright outdoor or vice versa. Such momentary hypersensitivity also brings extra momentary intense dizziness. During the May 03, 2019, Friday cognitive evaluation at New York City Medical & Neurological Offices, P.C. (91-31 Queens Blvd, Suite 611, Elmhurst, NY 11373. Tel: [phone]), my eyes experienced minutes of pain with tears and vision difficulty. The black background and the quick flashing of intense white or bright colors on the computer screen exposed part of the eyes problem. I mentioned it to Dr. Chiyoko Kobayashi Frank who was giving me the neuropsychological evaluation. At other occasions, there appear some moments of partial vision opaqueness in part of either one or both eyes’ view field. Such partial vision opaqueness is found more often at getting-up and afterwards for some time. One time at night, one side of my head-back had pulses of acute ache, and one eye meanwhile resonated with pulses of such opaqueness.

The acuity of my hearing and smelling (olfaction) has diminished. Quite often, I need to ask for a volume raise, and I do not easily sense the supposedly intense foul smell. Nonetheless, I become more sensitive to sensed noise and smell (real or hallucinated). Sometimes, family members answer me that they do not sense such. Also, momentary ear ringing (tinnitus) has happened several times since DOI. My tongue tip has begun to constantly feel somewhat numb and tingling (paresthesia), and occasionally the whole tongue has paresthesia. 

 

1c) Spine (Cervical, Thoracic, Lumbar, Sacral, Coccygeal) 

The cervical spine later has more frequent episodes of up to moderate or even severe level of neck pain and stiffness, beyond the constant mild to moderate pain. Such episodes have developed to daily frequency and each appears to start suddenly and lasts for as long as most of the awake time, ranging from the posterior to the two laterals. The neck pain and stiffness usually do not show up on all subareas all at one time. The moderate to severe pain and stiffness  on the left lateral aspect of neck happens a lot oftener and each stays a lot longer, and stretches from the left frontal-parietal-occipital head area down to the left shoulder-top, and horizontally to the left posterior of the neck and the neck-torso junction. At quietness, gently rotating my head left or right generates dull clicking/friction noise audible to my ears. Some circumstances, such audible noise from neck rotation is more obvious. Also, when I make empty swallow motion, I feel something slightly swollen at the back of the upper throat. The left-side shoulder top has presented the constant moderate to severe pain, while the right-side counterpart has pain but of less severity and frequency.

The low back (lumbar spine and its broad bilateral area) has often shown moderate to severe symmetric pain, which usually lasts from getting-up to lying-down and may not always be alleviated by lying-down. Sometimes, the pain on the broad lumbar back is so severe that it bothers me from falling asleep or getting up on bed. The thoracic, sacral, and coccygeal spine segments and adjacent areas occasionally have mild to moderate ache, which can be sharp or dull, broad or spotty, on the spine or off, bilateral or unilateral, long-lasting or temporary. The sacral and coccygeal area often some kind of tingling sensation.

 

1d) Torso’s Front and Inside

The whole chest’s front wall has developed constant pain, which has become severer and is probably described properly as burning-like. The breathing has often gone with hyperventilation even at rest before and during the manifest. While my daily routine activity has taken the slow, gentle, and light mode, it easily exacerbates the hyperventilation. The respiration also goes with mild to moderate pain, and the pain stays when I momentarily hold my breath.

Since DOI, the heart has almost daily shown situations, sometimes so severe that I am so frightened that I may die suddenly. I have to stress here that I did NOT have heart health situation before the DOI of Jan. 16, 2018. The heart situation varies from violent tearing or searing ache, sharp ache, dull ache, palpitation, pulsation, tightness, arrhythmia, etc, and was aggravated by the medications prescribed in this case, and stays after I initiated and decided myself to stop continuing the medications. However, the measured blood pressure and heart rate were often shown normal, but the headache and faintness absolutely existed at those measurement moments, and sometimes while the heart had the acute ache. 

The appetite is generally not affected too much, but it does diminish somewhat over the time, and especially obvious when the headache gets severe. At such episodes, the nausea is strong, but without vomiting. There are periods I have diarrhea-like situation. Other periods of weeks, I feel wet at my penis opening which is actually not leaking. Since DOI, the penis erection difficulty has started and become more as a “norm”. The nuts-bag (scrotum) has the constant paresthesia of some numbness.

 

1e) Extremities (Upper and Lower Limbs)

Since DOI, the upper and lower extremities of the left-side have not really got better. On the contrary, the health problem has extended to more sites on the left side and expanded to the right side. All four limbs have shown daily fluctuation from as-if normal health to severe symptoms, on sites of upper arms, elbows, forearms, wrists, hands (all ten digits, the handbacks, and thenars, hypothenars, and palms), butt, thighs, knees, lower legs, ankles, and feet. The ache on the extremities usually does not all show up at the same time, or with the mirror symmetry between the left and right sides about the location, duration and severity. For example, the left hand has constant ache and paresthesia since DOI and gets worse, but the right hand has later developed and reached the mirror symptoms. The right wrist and right ankle currently have severer, longer, and more frequent ache than the left counterparts. The left upper arm, left elbow, left forearm, and left knee show the opposite comparison to their right counterparts. The soles, particularly the balls and around, have the constant paresthesia, some mix of numbness and tingling, which occasionally goes to sharp pain and seriously bothers the walking. The heals show sudden and momentary sharp piercing ache occasionally.

 

1f) Whole Body Together

Ache is not the only obvious symptom of the affected musculoskeletal system. Accompanying symptoms include joints stiffness, muscle tightness, muscle fatigue, muscle trembling, loss of fine coordination, loss of steadiness, and loss of balance. Sometimes, the whole body simply has the extreme fatigue, while the leg muscles even feel trembling while standing, breathing is heavy, fast, hot, and dry, heart tightens up or palpitates, and the mind is in a kind of trance state. Sometimes, the sporadic drowsiness comes, and I have to lie down like a half-dying person. Sometimes, the heart-attack-like goes so violent or sharp that I am frightened of sudden death. Still other times, severe headache goes together with whole body ache, loss of appetite, sense of nausea, hyperventilation, and difficulty in falling asleep. Some postures and activities such as momentarily bending low and forward or squatting or continuously having light-duty physical (such as grocery shopping) or moderate-duty mental activities (such as a session of cognitive therapy or evaluation) directly exasperate the symptoms like headache, faintness, drowsiness, and bodyache. The aches on the four limbs have gradually expanded from the distal over to the proximal ends.

 

2) Cognitive Symptoms

The traumatic brain injury has caused quite significant degeneration of my cognitive function. Before the DOI, I was excellent at book learning and creative in scientific research. After the Jan. 16, 2018 injury, I have gradually found that many things previously routine or easy have become so disturbingly challenging to me. It now becomes often difficult for me to understand complex new things, even to comprehend some complex sentences in common words (such as some law sentences) or to remember a new procedure of multiple steps. Quite often, my mind can not settle down, concentrate, and proceed. In other words, the mental process either does not start or often gets stalled. The attention lapses involuntarily happen. Sometimes, even my mind keeps warning myself to pay attention, but the signals are only signals not being processed into understood information. At home, a simple word spoken by my teenage children may require them to repeat multiple times for me to finally match a word in my mind and to turn it into some (mis)understanding. The relatively usual events in my everyday life leave very little, blurry, and light memory with me, if any. For example, when, where I did what very recently, if recallable, may take me a long processing time and many helping clues to recall. Some examples of memory loss here: 1) I may be so confused of whether I already added ingredient like salt to the food preparation a short moment ago; 2) I may forget the item for which I shuffled my feet from the other room to here just seconds ago; 3) for a previously routine and easy errand outside, I may remember suddenly that I have forgotten to bring this or that, so sometimes I need to go back and forth to get ready. Beyond the mental process difficulty and memory loss, the capacity of planning and execution is found impaired too. So many things appear to be too difficult for me to cope with now, such as this injury case which I know are important and to which I don’t intend to add any extra difficulty from my side, or such as keeping my own personal items organized.

 

3) Emotional and Behavioral Symptoms

My health deterioration and this case’s complexities are the main causes of my current emotional and behavioral disorders. These secondary symptoms include restlessness, anxiety, depression, impulsiveness, fury, hysteria, recklessness, mood swing, etc. Many important or enjoyable things I have well-tended before the injury are pretty much off my reach now. To my understanding of some evidence and experiences, my sustained injuries were caused by a premeditated murder attempt veiled as a work accident on my life. The workers’ compensation system claims to be a no-fault system and stops short of finding out the underlying real cause, but I think many other parties in this injury case have been somewhat and somehow delaying or denying the justice and recovery owed to me by “finding” various “faults” on me. Since the Jan. 16, 2018 injury, and the subsequent treatments, my health has actually deteriorated, but so many parties want to say and do the disservice. While I actively seek for recovery and truth, many other parties’ purposes and behaviors are to put the blames on me, cover things up, twist things up, wrap this case up, and let me die off before their burial of the truth.