Workplace Safety and Insurance Board
Appeals Resolution Officer Decision
DECISION NUMBER: 20100041
OBJECTION BY: Worker
EMPLOYER: Participating
REPRESENTATIVE: Worker
ISSUE
The worker is objecting to the January 29, 2008 decision denying a secondary condition to the left wrist which was as being the result of the work related disability to the right shoulder.
HOW THE ISSUE AROSE
On November 7, 2007 the worker contacted the claims adjudicator and advised that she had suffered a secondary condition to her left wrist on October 23, 2007. At this time the worker reported she was taking a shower on October 23, 2007 when her right shoulder came out of joint. In an attempt to put it back in, the worker indicated that she bent over and used her left hand to wiggle around. As a result, she ended up slipping in the shower and breaking her left wrist.
The claims adjudicator reviewed the details of the secondary condition and determined that the worker had delayed in seeking medical attention until November 5, 2007 and furthermore, she was unable to establish that the worker’s compensable right shoulder impairment was the cause of the worker’s left wrist injury. As a result, the claims adjudicator denied entitlement to the secondary condition resulting from the work related disability. This was outlined in a claims decision dated January 29, 2008.
The worker is now objecting to this decision.
AUTHORITY
Please note the following:
Workplace Safety and Insurance Act (the Act) Operational Policy Manual (OPM) Document(s):
15-05-01 – Secondary Condition Resulting from Work Related Disability
18-03-02 – Payment of Loss of Earnings (LOE) Benefits
RESOLUTION METHOD AND PROCESS
It was agreed that this objection be resolved by means of a decision without hearing. No submissions were received by either party.
ASSESSMENT OF THE EVIDENCE AND SUBMISSIONS
In reviewing the objection, I have had regard for the claim file information, legislation and policy, and for the arguments presented.
On January 1, 2006 this then 54 year old cleaner was holding a fire door open while pulling on a maid cart weighing greater than 20 pounds with her right arm. As a result of this action, the worker suffered an injury to her right shoulder where she was then diagnosed with having a re-injury of a previous right shoulder rotator cuff problem.
In 2003 under a prior claim, this worker had injured her non-dominant left shoulder. She had apparently continued with symptoms on the left side where it was expected this worker would have ongoing left shoulder problems given her type of work especially after the worker’s right shoulder problems would be addressed under this claim.
With regard to the worker’s dominant right shoulder injury under this claim it should be noted that this worker had already had a right shoulder acromioplasty and rotator cuff repair in February 2004 for non-compensable reasons. This occurred after the worker’s 2003 claim for her left shoulder.
This claim was referred to the Workplace Safety and Insurance Board’s (WSIB) medical consultant where on April 7, 2006 (Memo 5) it was confirmed that the present right shoulder claim and accident history of January 1, 2006 clearly aggravated the worker’s pre-existing right shoulder problems for which she had already had surgery as she sustained further tearing of the already repaired rotator cuff as documented in Dr. Kaczmareki’s medical reports on file. This was further confirmed in the worker’s magnetic resonance imaging (MRI) scan report of January 29, 2006 for the right shoulder only.
On June 22, 2007 this worker then underwent a second right rotator cuff repair surgery. Subsequent to this, the worker underwent physiotherapy for post operative treatment of her right shoulder.
In an October 15, 2007 report from the physiotherapist, it is noted that on September 12, 2007 while this worker was completing her exercise program using the finger wall for active assisted abduction of the right shoulder, she suddenly had severe pain and the shoulder had popped out of place. At this time, she was encouraged to see her physician and subsequently exercises were restricted to below 90 degrees. Since the incident, the worker had remained on this restriction due to pain and clicking of the right shoulder. Furthermore, it is also noted in this report that the worker was concerned that her right shoulder had not improved but in fact appeared to be getting progressively worse over time.
Just over one month after the finger wall incident with the physiotherapist the worker reported that on October 23, 2007 her shoulder came out of the joint while she was taking a shower and washing her hair. At this time, she indicated that in an attempt to put her right shoulder back into the joint, she bent over and wiggled around using her left hand/arm where she then slipped in the shower subsequently breaking her left wrist. As she initially thought that she had simply sprained her left wrist she explained that she delayed in seeking medical attention until November 5, 2007. At this time she was referred for an x-ray which was conducted on November 8, 2007 which then confirmed an obligue fracture of the distal left ulnar diaphysis with slight anterior and medial displacement of the distal fragment.
In reviewing this claim for an October 23, 2007 recurrence, it is important to note that the worker’s right shoulder appears to have come out of joint again while she was washing her hair. As this had previously occurred during a physiotherapy session of September 12, 2007 (just over one month prior), I accept that this incident is quite probable. As a result of her right shoulder coming out of joint, the worker explained that she then felt she had to shake herself while in a bent position in an attempt to get her right shoulder to pop back into joint. As a result of trying to pop her right shoulder back into joint by shaking herself in the shower, she then slipped catching herself on a rail, however, breaking her left wrist at the same time.
Had it not been for this worker’s accepted right shoulder disability under this claim and the fact that she had popped her right shoulder out of joint during physiotherapy treatment related to this injury, her arm would not have come out of the joint and the worker would not have had to shake herself in an attempt to pop it back in. I therefore accept that had it not been for the work related disability she would have not been put in this position to slip in the shower subsequently breaking her left wrist.
The evidence, therefore, suggests and I conclude that the worker’s secondary condition to her left wrist was a direct result of the worker’s accepted right shoulder disability under this claim.
CONCLUSION
The worker’s objection to the denial of entitlement for the left wrist as a secondary condition resulting from the right shoulder work related disability is allowed. Finally, I leave it to the operating area to determine any benefits that may flow from this decision.
Dated: April 21, 2010.
S. Godin
Appeals Resolution Officer
Appeals Branch