2 min read
Dr. Berg Answers a Claims Adjuster's Questions:
Question:
For a claimed condition of plantar fasciitis, how do you assess causation; specifically in a work environment that requires prolonged standing and/or walking? For example, how do you differentiate a pre-existing condition such as flat feet versus an occupational disease or workplace injury?
Answer:
Scott Berg, M.D., FACFAS
Podiatrist
It can be difficult to assess a condition like this. I see plantar fasciitis in my regular clinic 2-3 times per day. Most causes have to do with increased activity, weight gain, or changes in shoe gear. Pre-existing conditions can contribute to this as well, including a person's foot type, and sometimes there is no reason why people get plantar fasciitis.
It is very multifactorial, considering work activities, out-of-work activities, habits, and previous injuries. Also, a delay in treatment, or inappropriate treatment, can cause this condition to worsen.
Question:
How do other conditions factor into your treatment plan, such as diabetes, bone spurs, and other comorbidities?
Answer:
I try to look at as much of the picture as I can. This includes BMI, smoking, past injuries, current hobbies, activities outside of work, and patient age. All of those factors can contribute to the treatment plan.
Question:
What injuries of the foot and ankle do you evaluate the most?
Answer:
I see a wide variety of pathologies from sports medicine, fracture care (both conservative and surgical) of the foot and ankle, ankle sprains, tendon tears, plantar fasciitis, osteoarthritic conditions, congenital anomalies, pes planus, pes cavus, diabetes, infections, amputations, plastic surgery skin flaps and graft surgery, bunions, hammertoes, and ingrown toenails. I'll see pretty much anything from the mid-tibia down to the toes.
Question:
Finally, what is the etiology of a stress fracture?
Answer:
Typically from repetitive use, and sometimes it can come from trauma. The majority of the time it is from repetitive use.
Dr. Scott Berg, M.D., has held an active practice in Salem, OR since 2014, offering conservative and surgical treatment for the foot and ankle. Dr. Berg obtained his doctorate from Scholls College of Podiatry in Chicago.
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A Previous "Ask the Doctor" Response
In our previous "Ask the Doctor" blog, Dr. Mangum discusses the impact that diabetes can have on a worker’s injury treatment and recovery.