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  • Writer's pictureBrian Keit

The Knappsack: Motivation and Loss of Earning Power

Dr. Thomas Knapp, MD is an orthopedic surgeon at a sports medicine clinic in Southern California. He patented a medical device that he invented called the "Knappsack", which is basically an arm immobilization brace with new innovative features.

Steve Vai is a guitar virtuoso from Long Island, NY, famous and regarded by many as the most talented electric guitarist in terms of technical skill and innovation as well as creative ingenuity blurring the lines between musical genres and creating a unique sound.

In 2022, Steve Vai injured his shoulder while baking a pizza in his wood fire oven at his California residence. It was likely a rotator cuff tear or labrum tear and he underwent arthroscopic surgery with Dr. Knapp.

Shoulder injuries are the most common workers' compensation cases. This is because the shoulder (the most mobile joint in the body) is comprised of four relatively small or delicate rotator cuff muscles, tendons and ligaments. These structures are prone to tearing especially with heavy lifting at or above shoulder height. If the tear is a full tear, surgery is usually the only option and is usually undertaken by arthroscopy, where small instruments with cameras are inserted into joint and anchors are drilled into the bone and the torn muscle is reattached to the anchors. Recovery time post surgery is often long. Immediately following the surgery, the shoulder is usually placed in a shoulder immobilization brace for a number of weeks or longer before commencement of or in conjunction with physical therapy.

Following Steve Vai's surgery, Dr. Knapp placed him in (his patented) arm immobilization brace (the Knappsack) and gave him work restrictions of no use of the right arm for several weeks. With a doctor's order of no use of the right arm, most professional guitarists would not undertake the challenge of writing and recording a new song.

Steve Vai however, did just that. He found a way to play one handed, and to make his new song interesting and pleasant to the ear. He named the song, "Knappsack" in honor of Dr. Knapp and his patented arm immobilization brace with innovative features. The song was included on Steve Vai's latest album, a big success, and was also sold as a single.


In workers' compensation some injuries may be compensated based on a loss of earning capacity analysis, also called "industrial disability."

A workers' compensation judge looks at many factors when he or she decides your extent of industrial disability. Age, education, prior work history, skills and whether they are transferable to easier work, impairment ratings, work restrictions, actual effect on earnings, and motivation to return to work and mitigate your damages.

Motivation can increase or decrease your industrial disability award significantly. If in the months preceding your trial you have made no effort to return to work, you can expect to be attacked by the defense counsel on these grounds. The argument will be that you are not motivated, you have no desire to work anyway, so that is good evidence (they will say) that you have little or no industrial disability, regardless of how bad your injury is and regardless if your former employer terminated you because of your injury.

With one exception that I will discuss later, I always recommend that in the three months preceding the trial, my clients make a diligent job search and document it. Apply for good jobs that pay well and interest you, and it is a win win situation. Either you will get a good job, which is more valuable than any workers' comp case, or no one will hire you and now you can establish evidence of motivation. The judge might also infer that employers are not hiring you because of your disability. Another thing that is possible is that you are offered the job, and you try it, but you cannot tolerate it, and need to quit after a few days or weeks. That is still good evidence that you are motivated to return to work. It is far better than never trying to return to work.

Some injuries are catastrophic and a return to work effort is futile and the Court will understand this, so motivation is not an issue. However, this is very rare, and motivation is usually at play. For most cases, you will receive a big boost in your case value (and you will make a good impression on the judge) if you think like Steve Vai and try to make the best of a bad situation and pursue a return to productivity following maximum medical improvement from your work injury.


Brian F. Keit

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