WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER: 20100100
OBJECTION BY: The Worker
EMPLOYER: Participating
ISSUE
The worker objects to the denial of initial entitlement for an injury of October 1, 2009 under claim XXXX8236 or on the alternative as a recurrence of claim XXXX2593.
HOW THE ISSUE ARISES
Claim XXXX8236:
On October 1, 2009, the worker, who is employed as a paramedic, sat in a truck for four hours and developed back pain which he felt when he exited the vehicle. He sought medical attention and claimed entitlement for the back however in a letter of October 8, 2009, entitlement was denied. The worker objected to the adverse decision and her file was referred to the Appeals Branch for consideration. Upon conducting my review at the appeal level, I noted that the worker was claiming that the low back problems were an exacerbation of a prior injury he had in March, 2009. Since this issue was not addressed, the file was referred back to the operating area to make a determination on the worker’s entitlement as a recurrence of prior claim XXXX2593.
Claim XXXX2593:
On March 11, 2009, the worker was carrying a 250 pound patient on a stretcher approximately 250 to 300 feet over rough and uneven terrain when he had an onset of low back pain. He sought medical attention and was diagnosed with a lumbosacral strain. The worker returned to work, performing modified duties on March 13, 2009 and continued until he resumed full-time duties on March 26, 2009. Entitlement was granted and benefits were paid in accordance with the medical evidence received.
Following the return from the Appeals Branch, the worker’s onset of symptoms of October 1, 2009 was considered as a recurrence of this claim however a recurrence was denied in a letter of May 13, 2010. The worker’s files were then returned to the Appeals Branch so that the worker’s objection could be dealt with.
AUTHORITY
15-03-01 - Recurrences
RESOLUTION METHOD & PROCESS
The worker submitted a 60-day option form, thus requesting a decision without a hearing based on the claim file documentation. The employer was not contacted as I did not receive a participant form from them.
ASSESSMENT OF THE EVIDENCE
I have considered all of the evidence pertaining to this case. In doing so, I would have to accept that the worker’s onset of symptoms on October 1, 2009 are a recurrence of the injuries sustained in the accident of March 11, 2009. The reasons are as follows:
Following the accident of March 11, 2009, the worker returned to work performing modified duties until March 26, 2009. He resumed full duties on that date however in the meantime, chiropractic treatment was commenced on March 25, 2009. As such, although the worker returned performing regular duties, it is clear that he remained symptomatic and the condition therefore did not easily resolve itself;
The worker continued with treatment up to and including July 23, 2009. In the meantime, he had two further incidents, one on April 23, 2009 and another on May 7, 2009. While there is medical reporting from April 24, 2009 indicating that the worker had a complete recovery, given the fact that he continued with treatment and had a further exacerbation after this, it is clear that his back was still a problem. These further incidents were minor in nature, involved the same area of the back and could just as easily have been accepted as recurrences of the March 11, 2009 incident given the fact that the worker continued with treatment at the time of these incidents;
The worker then had a subsequent incident on September 20, 2009 covered under claim XXXX5402. The area injured was again the low back. This was a no lost time claim and given the minor nature of the accident and noting the fact that the area of injury remained consistent, again, this claim also could just as easily have been accepted as a further recurrence of the March 11, 2009 incident. The medical information on file supports on September 23, 2009 that although the worker was cleared for regular work, he had pain, paresthesia, stiffness and swelling in the lower back area;
The worker then had a further exacerbation on October 1, 2009. As already indicated, the worker had had an accident on March 11, 2009 for which he received treatment at least into July, 2009 and the last accident he had before this last one was on September 20, 2009. He was still symptomatic at least one week before the October 1, 2009 incident and as such, it is not surprising that sitting in the ambulance for longer than he was used to in a confined space caused an exacerbation of an already vulnerable back. The area of injury has remained consistent since March, 2009;
The chiropractor, who has been treating this worker all along, assessed the worker and submitted a letter on October 27, 2009 wherein he expressed the opinion that the worker’s exacerbation on October 1, 2009 was a recurrence of the March 11, 2009 incident. In the absence of any other medical opinion and given the facts outlined above, I am accepting the medical opinion provided and accept the worker’s exacerbation of back problems on October 1, 2009 should be treated as a recurrence of claim XXXX2593.
CONCLUSION
Based on the evidence outlined in this decision, I am accepting the worker’s onset of low back symptoms on October 1, 2009 as a recurrence of prior claim XXXX2593. As a result, claim XXXX8236 is to be amalgamated into claim XXXX2593. It appears the worker returned to work on October 9, 2009 and the worker would be entitled to full Loss of Earnings benefits for this time period should this be the case however full lost time details are to be clarified by the operating area and benefits paid accordingly.
The worker’s objection is granted.
DATED August 3, 2010
S. Marangoni
Appeals Resolution Officer
Appeals Branch