Blast Injuries and Workers’ Compensation

A blast injury is a physical trauma caused by an explosion that directly or indirectly affects an individual. Blast injuries can damage many parts of the body. They can cause a traumatic brain injury, a traumatic amputation, burns, internal organ damage, lung damage, broken bones, hearing loss, and vision loss. If you experienced a blast injury on the job, talk to the workers’ compensation attorneys at Silverman, McDonald, & Friedman in Newark, Wilmington, and Seaford today.

Blast injuries aren’t only confined to the battlefield. Delaware workers who deal with any type of explosives, such as those used to destroy old buildings, to clear land, or in construction or manufacturing. Defective or malfunctioning equipment and machinery can also cause explosions.

How are blast injuries classified?

The US Department of Defense (DOD), which is concerned about blast injuries in combat, has its own five classifications of blast injuries.

• Primary blast injuries. These injuries result from high pressure created by explosions. Blast overpressure can crush the body. Blast overpressure is essentially the pressure due to the shockwaves of the explosion. Overpressure refers to forces above normal atmospheric pressures. Per the DOD, “Primary blast injuries are the only category of blast injuries that are unique to the blast or high pressures that occur and include:”

• “Blast lung (pulmonary barotrauma)
• Tympanic Membrane rupture and middle ear damage
• Abdominal hemorrhage and perforation
• Globe (eye) rupture
• Concussion (mild traumatic brain injury (mTBI) without physical signs of head injury”

• Secondary blast injuries. These injuries result when “strong blast winds behind the pressure front propel fragments and debris against the body and cause blunt force and penetrating injuries.” Secondary blast injuries include:
  • Penetrating ballistic (fragmentation or blunt injuries)
  • Penetration of the eye
  • Brain injuries – closed or open
• Tertiary blast injuries. Strong winds from the blast and pressure gradients can “accelerate the body” and cause the same types of force injuries that happen in car accidents, falls, and building These injuries include:
  • Fractures/broken bones
  • Traumatic amputations/loss of limbs
  • Crush injuries
  • Traumatic brain injuries
  • Blunt injuries
• Quaternary blast injuries. These blast injuries are due to heat, light, and exposure to toxic substances (from metals, gases, and fuels). These injuries include:
  • Burn injuries
  • Breathing disorders from inhaling toxic fumes, smoke, or dust
• Quinary blast injuries. These blast injuries “refer to the clinical consequences of post-detonation environmental contaminants, including chemical (e.g., sarin), biological (e.g., anthrax), and radiological (e.g., dirty bombs) substances.” These injuries include:
  • Chemical burns
  • Radiation exposure
  • Bacterial or viral infections

These five classifications for blast injuries are also used by the US Centers for Disease Control and Prevention.

The CDC discusses some of the more common types of blast injuries as follows:

• Lung injuries. Blast lung is “a direct consequence of the HE over-pressurization wave.” This injury can be fatal. Symptoms include chest pain, dyspnea, hemoptysis, and cough. They are often diagnosed through the use of a chest X-ray.
• Ear injuries. The severity of this injury depends on the relationship of the ear to the blast. The most common blast ear injury is TM perforation of the middle ear. Symptoms include loss of hearing, vertigo, bleeding from the external canal, tinnitus, and otalgia. The diagnosis includes an otologic assessment and audiometry.
• Abdominal injuries. This type of injury can cause bowel perforation, hemorrhages, “mesenteric shear injuries, solid organ lacerations, and testicular rupture.” Symptoms include vomiting, nausea, rectal pain, and testicular pain.
• Brain injuries. Primary blast waves can cause a mild TBI or a concussion without a direct blow to the head. The symptoms include fatigue, headaches, insomnia, anxiety, poor concentration, and depression.

Blast ear injuries

Blast injuries that cause ear damage typically affect the inner ear. Some blast injuries do resolve with time. Normally, ear blast injuries do not worsen with time. Per Hear.com,

Initial treatment options (as with sudden deafness) are hemorheologic infusion therapy with HAES (hydroxyethyl starch) and Procaine. Thereafter, cortisone can be administered. If both these treatments fail, hyperbaric oxygen therapy is another alternative.

In any event, early initiation of treatment is critical for a good prognosis. The earlier treatment is started, the lower the risk of permanent damage. Surgery is only recommended if one or both inner ear windows are damaged, or if a perilymphatic fistula has developed.

Many blast injuries of the ear heal within six weeks. If a Delaware employee is still experiencing hearing loss after six weeks, the prognosis for further improvement is low. Workers with blast injury-caused hearing loss can often benefit from hearing aids, which are often effective for hearing loss in the high-frequency range.

What are the treatments for blast injuries?

Any worker who is lucky enough to survive an explosion will likely need immediate medical help. Many blast injury victims require surgery, and most will require long-term rehabilitative care to learn to live with their injury. Most blast injuries cause permanent damage.

The concerns and treatments vary depending on the type of injury, according to the CDC:

• Blast lung develops shortly after exposure. It’s the most dangerous blast injury because it’s often fatal.
• The clinical signs of a blast-related abdominal injury may be silent until acute signs or sepsis develops.
• Concussions and auditory injuries can easily be overlooked.
• Mild TBI symptoms and PTSD symptoms may be identical.
• A traumatic amputation “is a marker for multi-system injuries.”
• “Air embolism is common, and can present as stroke, MI, acute abdomen, blindness, deafness, spinal cord injury, or claudication. Hyperbaric oxygen therapy may be effective in some cases.”

What benefits are workers entitled to after a blast injury?

Workers’ compensation benefits for employees who suffer blast injuries on the job include:

• Payment of all your medical bills, for as long as the medical care is either improving your health or helping you manage your health. Many blast injury victims require a lifetime of medical care.
• Temporary wage benefits. Employees are generally entitled to 2/3 of their wages for as long as medical care is improving their health.
• Permanent wage benefits. Once your health stabilizes, an evaluation is made of the type of injury you have and the severity of the injury. Many blast injury victims are entitled to additional permanent disability benefits – for either a specific number of weeks or years – or for as long as they are disabled.

Some employees may be entitled to vocational benefits to be trained for a new position or career if they are no longer able to perform their current job.

At Silverman, McDonald, & Friedman, our Delaware workers’ compensation lawyers are strong advocates from the moment of your injury through the claims process, negotiations with the insurance company, and any hearings or appeals. We are skilled at presenting your claim and anticipating the arguments employers make to try to deny or limit your claim. To discuss your right to compensation after a blast injury, call us at 302-888-2900 or complete our contact form to schedule a free consultation. We have offices in Wilmington, Seaford, and Newark.