Workplace Safety and Insurance Board
Appeals Resolution Officer Decision
DECISION NUMBER: 20090021
OBJECTION BY: Employer
WORKER: Participating
REPRESENTATIVES: Employer, Worker
HEARING DATE: N/A
ISSUE
The employer has appealed the Case Manager’s (CM) decision dated December 11, 2008. The CM has concluded that the onset of the worker’s bilateral upper arm condition has been caused by the nature of the worker’s employment in general.
HOW THE ISSUE ARISES
On September 22, 2008 this 52 year old letter carrier reported on onset of left bicep pain and related it to his work in general as a letter carrier.
The worker eventually reported an additional onset of similar symptoms in the right arm. The worker has been diagnosed with bilateral upper arm tendinopathy, specifically a torn long head of the biceps brachii on the left side and tendonitis of the long head of the biceps brachii on the right.
A MRI of both shoulders was completed January 11, 2009 revealed that the worker was presenting with osteoarthritis of the acromio-clavicular (AC joint) joint bilaterally. In addition, tendinopathy of the Supra and Infraspinatus bilaterally was also identified.
The CM contacted the worker who reported that he is exposed to repetitive motions of both arms while sorting mail for up to two and a half hours at a time without a break. He further indicated that the pain occurred gradually over time and recalls there was a heavy load of flyers. The worker also confirmed that he is not involved in any other or outside repetitive hobbies nor does he take part in any sporting activities.
The CM concluded that the onset of the worker’s bilateral upper arm difficulties were related to the repetitive nature of the worker’s job duties.
The employer has appeal this decision and this issue is now before the appeals resolution officer (ARO) for further consideration.
AUTHORITY
The ARO will consider the employers appeal in light of operational policy document(s);
- 11-01-01 – Adjudicative Process
- 11-01-02 – Decision-Making
- 11-01-03 – Merits and Justice
RESOLUTION METHOD AND PROCESS
The employer has submitted a 60 day decision option. By completing the option form, the employer indicates their understanding that the ARO will provide the final decision of the Workplace Safety and Insurance Board (WSIB) based on the information on record and any additional information submitted with the objection form.
ASSESSMENT OF THE EVIDENCE
The employer submits in support of their appeal that results of the clinical investigations suggest that the cause of the worker’s bilateral upper arm condition is a result of idiopathic condition and not due to the worker’s employment duties.
They note that the MRI shows AC joint osteoarthritis bilaterally which “…will flare up form time to time…” Additionally, they suggest that the worker recovered from the documented flare up of symptoms by February 2, 2009.
The worker presents with bilateral upper arm difficulties and has claimed that the onset of difficulties are due to the nature of his work as a letter carrier. The CM noted that the worker is required to sort mail using repetitive actions of the arms to place mail in pigeon holes while sorting up to 2.5 hours at a time.
There are risk factors present inherent in the actions descried by the worker. The worker would be required to repetitively extend his arms at or above shoulder level while sorting mail. This would be done at a fast pace over a period of 2.5 hours in order to have the mail ready for the trucks at 10 AM.
Clearly the worker does present with an underlying and pre-existing condition which may predispose the worker to an onset of difficulties. There is no evidence to suggest that the worker would be engaged in any external activities or events outside the scope of his work that could be suggested as a cause of the onset of difficulties.
The repetitive nature of the worker’s duties would, based on the balance of probability lead to the onset of the condition as described by the worker. I would support the employer’s contention that initial entitlement be granted with the provision that it be extended on an aggravation basis only.
The available clinical evidence is in my view, non conclusive as to whether any aggravation has indeed ceased. Any limitation of entitlement based on the available evidence would be somewhat premature. If additional clinical evidence is submitted to the claim file record operations is required to provide a decision on the extent of the compensable aggravation of the pre-existing condition.
CONCLUSION
Having studied the available evidence, and considered the submissions made it is the judgement of the ARO that;
There is sufficient evidence to support the granting of initial entitlement based on the balance of probability.
Initial entitlement is granted on an aggravation basis of a pre-existing condition further, the clinical evidence is non conclusive to properly comment on whether the compensable aggravation has ceased.
If additional clinical information is provided to the claim file record Operations is instructed to rule on the extent of the aggravation and communicate the results of their review to the workplace parties.
The employer’s objection is denied.
DATED July 17, 2009
N.J. Shruiff
Appeals Resolution Officer
Appeals Branch