WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION WITHOUT A HEARING
DECISION NUMBER: 20100110
OBJECTION BY: Employer
WORKER: Not Participating
REPRESENTATIVES: Employer Representative
ISSUE
Entitlement to cost relief under the Second Injury and Enhancement Fund (SIEF).
HOW THE ISSUE ARISES
This claim was established on the basis of an Employer’s Report of Injury/Disease (Form 7) advising that the worker had sustained a right-wrist injury when lifting large heavy boxes at work. Neither the Form 7 nor the Worker’s Report of Injury/Disease (Form 6) endorsed prior problems. The Form 6 established the date of injury as of June 17, 2006 and that the worker worked as a salesperson for the employer for three months before hurting her wrist.
The emergency room report of June 17, 2006 supported the incident history as provided by the employer and provided a diagnosis of tendonitis.
The Health Professional’s Report (Form 8) for treatment on July 26, 2006 diagnosed a right‑forearm strain and provided precautions for two weeks.
The balance of the medical record confirmed that the worker continued to suffer from a soft-tissue injury (STI) but that recovery, despite physiotherapy, was prolonged. The worker was referred to a pain clinic in November 2006, where a diagnosis of Complex Regional Pain Syndrome (CRPS) secondary to a repetitive strain was provided. It was further noted that the worker had a history of migraines.
In a letter dated April 7, 2009, the employer representative, acknowledging the length period of lost time and the documentation of depression as being a factor in her lost time, requested that cost relief under the SIEF be extended in the claim.
After a review of the claim-file, including the medical documentation, the Operating Area wrote on July 29, 2009, in respect of the employer representative’s claim. The decision-maker advised that the medical record offered no support for the presence of a pre-existing condition that had prolonged or enhanced the work-related injury. The development of psychological problems after the accident was not considered by the case manager (CM) to have impacted the compensable injury as it did not pre-exist the incident history date in the claim.
The employer continued to object to the denial of cost relief under the SIEF and the matter was referred to the SIEF case manager (CM), who wrote on March 5, 2010 that the documented incident history of lifting a box of garbage, weighing approximately 40 pounds into a bin, which resulted in the diagnosis of right-wrist tendonitis, could be expected to cause a disabling injury and was therefore considered moderate. With respect to the medical record, the evidence, including the worker’s assessment at the pain clinic which identified non-occupational depression, was acknowledged but it was not agreed that there was any impact on the work-related soft-tissue injury. Accordingly, in the absence of a pre-existing condition that either prolonged or enhanced the work-related condition, cost relief under the SIEF was denied.
The employer has objected to the decision and the issue is now before the Appeals Branch (AB).
AUTHORITY
Workplace Safety and Insurance Board Operational Policy Manual Document (OPM):
- 14-05-03 – Second Injury and Enhancement Fund (SIEF)
METHOD OF RESOLUTION
The employer representative sought and was approve to receive a decision without a hearing following final written submissions. These have been received and have been considered in light of the evidence supplied to the claim file.
ASSESSMENT OF THE EVIDENCE AND SUBMISSIONS
In her Objection Form of November 5, 2009, the employer representative comments on the existence of a pre-existing condition, but makes no submission with respect to the significance of the incident history other than to simply say that it was moderate in significance. Subsequently, in her submission of June 17, 2010 to the AB, no comment is made with respect to the significance of the incident history.
From my review of the documentation of this matter, the Form 7 offers that on June 17, 2006 the worker and a co-worker were responsible for removing garbage to a collection area. In doing so, the duo carried six to seven heavy boxes together. These boxes were filled with other boxes. Lifting the filled boxes up 1½ metres to her co-worker, the worker states that she felt pain in her right wrist. It is not indicated in the report the precise weight of the boxes but it is not accepted, on the basis of the evidence before me, that one would anticipate a disabling injury resulting from the activities in which the worker engaged. I therefore find that the incident history was minor in significance.
It is acknowledged that the worker had a repetitive strain injury and that the condition diagnosed in June 2006 continued to impact the worker in November 2006. The headache and pain management clinic report provided a diagnosis of Complex Regional Pain Syndrome (CRPS) for which ongoing treatment was being considered. It is accepted, therefore, that the worker’s work-related condition was prolonged beyond the usual healing time.
In examining the medical record for evidence of a pre-existing condition which may have prolonged or enhanced the work-related condition, I acknowledge the employer representative’s concern with respect to the findings that the worker had a pre-existing depression which is evident by way of the history taken at the pain clinic. It is also noted that the worker had acknowledged suffering from depression when she spoke to the incident employer in October 2006.
The employer representative submits that, as the worker is said to have had depression prior to the work-related injury, and was suffering from depression after the work-related injury, and that this depression is documented in the pain clinic report of November 22, 2006, was the most significant factor in the worker’s medical profile according to the assessing doctor, it should be considered to be an enhancing factor or the worker’s work-related injury.
In considering this notion, I find that there is an absence of evidence that would connect the worker’s pre-existing episodes of depression with the post-injury documentation of the condition but for the work-related injury. The employer representative submits in her claim for cost relief under the SIEF, that the depression aggravated the work-related condition, yet no clear evidence has been elicited by the employer representative of how the depression prolonged the worker’s recovery from her soft-tissue wrist injury. It is only argued that the worker continued to suffer from depression following or coincidentally to the work-related impairment. Such a confluence of medical evidence does not establish, for the purposes of cost relief under the SIEF entitlement, the enhancement of a work-related condition by a pre-existing condition. Consequently, I am unable to accept that the criteria for the extension of cost relief under the SIEF, of a pre-existing condition which enhances or prolongs a work-related condition, has been met.
CONCLUSION
There is no entitlement to cost relief under the SIEF.
The employer’s objection is denied.
DATED July 14, 2010
(Mr.) B. J. Martlin
Appeals Resolution Officer
Appeals Branch
/882797/ppg