WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER: 20100126
OBJECTION BY: Employer
PARTICIPANTS: Employer, Worker
HEARING DATE: N/A
ISSUE
The employer is objecting to the allowance of initial entitlement.
HOW THE ISSUE ARISES
The worker was born in September 1966. He began working for the employer, a construction company, as a crane operation on July 10, 2000. On August 3, 2007 he was changing into his work clothing when he was bit by some type of insect. He worked the entire day, even though his arm was swelling and he was not feeling well. Over the long weekend his arm continued to swell. He reported for work on the Tuesday, and his arm was double in size, he left work after a few hours and went to the hospital.
He was treated at the hospital and given a prescription. His condition worsened, he lost consciousness, and was rushed back to the hospital on August 8, 2007 and admitted to intensive care. The worker had gone into septic shock, underwent surgery, and was hospitalized for 7 weeks. He returned to his regular duties on September 25, 2007.
Inquiries were conducted with the worker and employer. The employer advised that the incident was not reported to them until the Tuesday after the long weekend. The worker stated that on August 3, 2007 he arrived on the job site prior to everyone else, as he is a crane operator. They were building a parking garage close to a wooded area. While changing into his work clothes like he always does, he felt something bite him. He thought it was a mosquito or some other insect. He thought nothing of it, and so did not mention it to anyone. His arm gradually became swollen, and he reported it when he returned to work on Tuesday. His condition worsened, and he became very ill and was taken to the hospital.
The medical information confirmed that the worker was treated at York Central Hospital on August 7, 2007, prescribed anti-biotics and released. He was rushed to Credit Valley Hospital on August 8, 2007, with findings of septic shock, hypertension, and celllulitis. He underwent incision and drainage of the right forearm and debridement of the fasciitis on August 8, 2007, and further surgery on August 14, 2007. The pathology confirmed group A streptococcal infection. As a result of the septic shock, the worker also suffered respiratory failure, a myocardial infarction, acute renal failure, and left lower lobe pneumonia.
The medical information was reviewed by the WSIB internal medicine consultant as outlined in memo #18. He noted that it is reasonable to conclude that the portal of entry for the Streptococcus A was the abrasion on the right elbow, and it is not unreasonable to conclude that this was caused by an insect bite.
The adjudicator accepted entitlement as outlined in memo #19, and loss of earnings (LOE) benefits were paid from August 7 to September 25, 2007. The decision is outlined in the letter dated December 21, 2007. A permanent impairment was accepted for the disfigurement of the arm, and a non-economic loss (NEL) assessment was arranged. However, the worker did not attend the appointment, and no further action has been taken.
The employer objected to the allowance of the claim as outlined in their letter dated November 14, 2008. The employer also requested Second Injury and Enhancement Fund (SIEF) cost relief. This request was denied as there was no evidence of a pre-existing condition to warrant SIEF cost relief. This decision is outlined in the March 1, 2010 letter. The employer elected to proceed with the objection to initial entitlement and completed an objection form. The claim was referred to the Appeals Branch.
METHOD OF RESOLUTION
I contacted the employer to discuss the appeal issue. The employer confirmed that they had no additional information to submit, and outlined their position in our conversation. We agreed that I would proceed to a decision based on the information in the claim file record.
AUTHORITY REFERENCE
Operational Policies:
11-01-01 Adjudicative Process
11-01-02 Decision Making
11-01-13 Benefit of Doubt
15-02-02 Accident in the Course of Employment
ASSESSMENT OF THE EVIDENCE
In reviewing the issue before me, I have considered all of the information in the claim file record, the employer’s position, and the relevant policies. I conclude that the balance of evidence supports that the insect bite which led to the infection did occur in the course of the worker’s employment, and the allowance of initial entitlement is confirmed.
The employer outlined their position to the adjudicator and in my conversation with him. He noted that the worker did not report the incident until after the long weekend, and they are not sure whether he was bitten on the job site. He confirmed that the worker does have to change his clothes as a crane operation, but questioned why he did not seek medical attention sooner. The worker is a good crane operator and continues to work for them to date.
I have considered this position, but conclude that the benefit of doubt should be afforded to the worker. I appreciate the employer’s concerns that the incident was not reported immediately. However, I accept the worker’s statement that he felt being bit by an insect was a minor incident and he thought nothing of it. It is logical that he did not report this minor event to this employer. It has also been confirmed that the worker does change his clothes prior to beginning work, and that the job site was close to a wooded area.
I also agree with the employer that it is likely the worker should have sought medical attention sooner. However, as he felt it was a minor insect bite, it is reasonable that he did not feel medical attention was necessary. When the symptoms persisted and he did seek medical attention on August 7, 2007, he was given anti-biotics and sent home. Unfortunately, his condition deteriorated rapidly and he was rushed back to hospital the following day.
The worker’s description of what occurred has remained consistent. He provided the same history of an insect bite to his employer, the physicians at the hospital, and the WSIB. The treating physicians at Credit Valley Hospital attributed the cellulitis to the insect bite. The WSIB internal medicine specialist also confirmed that it is reasonable to assume the port of entry of the infection was the right arm abrasion compatible with an insect bite.
CONCLUSION
After careful consideration, I conclude that proof of work accident has been established, and the allowance of initial entitlement is confirmed.
The employer’s objection is denied.
DATED August 30, 2010
D. McParland
Appeals Resolution Officer
Appeals Branch