WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
Decision number: 20100097
OBJECTION BY: Employer
HEARING DATE: N/A
ISSUE
The employer objects to the Eligibility Adjudicator’s (EA’s) decision dated October 23, 2009 in which a new claim was established for the worker’s right wrist impairment. The employer requests the amalgamation of claim “B”, with a date of accident of August 28, 2008, to be amalgamated into claim “A” with the accident August 13, 2008.
HOW THE ISSUE ARISES
Claim “A” was established following an incident of August 13, 2008. The worker reported a sudden onset of sharp pain in the right wrist while twisting her wrist in an effort to pull a piece of luggage from a box. Entitlement was allowed for health care benefits, as the worker did not require any time off work following the accident. While the worker continued to seek medical attention through a specialist, the worker did not seek any further benefits through the Workplace Safety and Insurance Board until September 28, 2009 when she requested authorization for payment of a wrist splint.
The case manager noted that, while the current diagnosis of carpal tunnel syndrome (CTS) was not compatible with the original accident of August 13, 2008, the repetitive nature of the worker’s job activities likely contributed to the development of the worker’s impairment. Thus, the EA determined that entitlement for the carpal tunnel impairment would be established in a separate claim, claim “B” with an accident date of August 28, 2008. The entitlement in claim “B” was extended to include the left wrist, which subsequently became affected as a result of increased reliance on the left arm in an effort to avoid further injury to the right. The employer’s representative objects to the establishment of a new claim and seeks an amalgamation of claim “B” into claim “A”.
AUTHORITY
15-03-01 - Recurrences
RESOLUTION METHOD AND PROCESS
The employer’s representative has agreed to a written decision within 60 days. No new submissions have been received.
ASSESSMENT OF THE EVIDENCE
The issue before me pertains to the necessity for the establishment of a new claim for the CTS, diagnosed on August 28, 2008. Policy 15-03-01 states:
A recurrence may result from an insignificant new accident, or may arise when there is no new accident. To identify a recurrence, the WSIB must confirm that there is clinical compatibility between the original injury or disease and the current condition, or a combination of clinical compatibility and continuity. If a significant new work-related accident occurs, the WSIB establishes a new claim.
Following the work accident of August 13, 2008, the worker sought medical attention through the family physician on August 14, 2008. While the physician did not submit an initial report to the claim, the chart notes confirmed symptoms related to right wrist pain and numbness over the last three digits of the right hand. The family physician provided a diagnosis of CTS. The worker was referred to a neurologist who provided regular assessment and treatment for this condition since August 28, 2008.
Although the worker has since reported additional areas (elbow, shoulder), she has consistently identified symptoms related to CTS since the time of the accident. I note that the entitlement to the condition of carpal tunnel syndrome is not at issue. The diagnosis has remained consistent throughout. Given the fact that the condition is usually one of a gradual onset, one could presume that if the condition was evident on August 28, 2008, it was likely also present on August 13. Noting the nature of the sudden onset of symptoms, the EA’s trepidations to grant entitlement under the same claim are reasonable, as the worker clearly reported that she experienced sudden wrist pain as a result of a specific incident.
However, it is also probable that the worker’s carpal tunnel syndrome had been progressing prior to August 13, and the specific incident acted as a catalyst causing the condition to become acute. It is clear that the August 13 accident initiated the worker’s right wrist pain and that her symptoms have remained consistent since then. Moreover, there is no different diagnosis following the family doctor’s assessment of August 14, 2008 to suggest that a separate and distinct injury to the wrist had occurred. Consequently, the medical evidence suggests that the worker’s right wrist symptoms on August 28, 2008 were in keeping with the symptoms she initially reported after the accident of August 13, 2008.
CONCLUSION
The employer’s objection is allowed. Claim “B” (accident date August 28, 2008) is to be amalgamated into claim “A” (accident date August 13, 2008), and all benefits granted to date are to be transferred to claim “A”.
DATED October 4, 2010
R. Calvert
Appeals Resolution Officer