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A lot of our maritime cases come from major accidents and traumatic circumstances. A person may have washed overboard, machinery collapses, an inexperienced operator swings the crane and strikes a crabber with a pot. However, not all Jones Act and unseaworthiness cases arise from this kind of made for TV drama. Many, and in fact probably most, injuries are the result of repetitive injuries.

The causal link between the cumulative trauma caused by vibratory tools and repetitive-motion work tasks has been well-recognized for decades. Most repetitive injury cases involve railroad workers. Interestingly, the law that governs claims by railroad workers (FELA) also applies to claims by fishermen.

Injured workers have recovered for a litany of different types of repetitive injuries. But the most frequent is Carpal Tunnel Syndrome (resulting of repetitive intensive hand work).

Just like any other case, it’s necessary to establish causation. When a fisherman gets hit in the head by an unsecured crab pot and suffers a fractured skull, causation is pretty straightforward. But in repetitive injury cases the evidence isn’t so palpable. Causation is typically established through a "differential diagnosis." A differential diagnosis is one where a physician considers all relevant potential causes of the symptoms and then eliminates alternative causes.

In order to prevail in carpal tunnel syndrome cases the injured seamen typically must come forward with a history of jobs involving one or more of the following activities before the development of symptoms:

1. Frequent repetitive use of the same or similar movements of the hand or wrist.

2. Regular tasks requiring the generation of high force by the hand.

3. Regular or sustained tasks requiring awkward hand positions.

4. Regular use of vibrating hand held tools.

5. Frequent or prolonged pressure over the wrist or base of the palm.

These risk factors are widely accepted by professional ergonomists, industrial hygienists and other occupational professionals. The greater the numbers of factors that are present in a task, the greater the risk of developing CTS (and the stronger the case against the maritime employer).

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