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Causes of Injury in the Hands And Arms and Possible Impairments

Causes of Injury:

Contact Trauma With Work Surfaces or Tools
Forceful or Prolonged gripping of tools, products, materials or working in a cold environment without proper protection for the hands.
Repetitive finger or arm motions with wrist deviations

Disorders:

De Quervain's Syndrome
Stuck Finger
Sore Hands
Guyon's Tunnel Syndrome
Digital Neuritis
Finger Click
Tendenitis
Tenosynovitis
Trigger Finger or Thumb
Carpel Tunnel Syndrome
Stenosing Tenosynovitis
Medial Epicondylitis
Lateral Epicondylitis
Golfer’s Elbow
Tennis Elbow
Sore Elbow
Swollen Hand or Elbow
Tingling Fingers
Ganglion Cyst
Radial Tunnel Syndrome
Cubital Tunnel Syndrome
Pronator Syndrome
Ulnar Nerve Entrapment
Strain or Sprain

Back / Neck / Attorney

Free Back, Neck Hand Arm Disorder Consultation

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Injured Person Information:

Date of Birth / Age: (ex. mm/dd/yyyy or 54)
Were you injured?	Yes No
If not, who are you inquiring on behalf of?

If you are NOT inquiring on your own behalf,
what is your relationship to the injured person?

Is the person deceased?

Yes No

If deceased, what is the cause of death
as stated on the death certificate:

Date of Death: (ex. mm/dd/yyyy)
Was an autopsy performed?	Yes No
If not deceased, does the injury prevent you or the victim from working?	Yes No

If yes, when did you/victim stop working?
What is the approximate lost wages due to the injury?

Accident / Injury Information:

Date of Injury:	*
City where injury occured:	*
State where injury occured:	*

Please briefly explain the incident that caused the spine/neck/back injury:
Who do you believe was at fault in causing the injury, and what do you believe they did wrong?
Describe the injuries in detail:

Do you believe the injuries are permanent?

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Case Description*
Please explain exactly what happened, trying to state
as thoroughly as possible who you believe was responsible
and why you believe that person was negligent:

Please explain the full extent of the victims injuries:

Comments / Additional Information
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