WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER: 20100128
OBJECTION BY: Worker
REPRESENTATIVE: Worker
EMPLOYER: Not Participating
HEARING DATE: N/A
ISSUE
The worker is objecting to the Claims Adjudicator’s (CA) decisions dated February 1, 2005 and July 31, 2006 which concluded the worker did not injure his low back, hip or leg due to his work duties and denied entitlement to benefits under the Workplace Safety and Insurance Act.
HOW THE ISSUE ARISES
The worker, then 31 years old, with the employer since October 17, 2000 was working as a Meter Reader at the time of his injury. The worker claimed to have developed pain in his lower back, right hip and right leg due to the nature of his work as a meter reader.
The employer completed an Employer’s Report of Injury on October 7, 2004 advising the worker had reported a work related injuries on October 6, 2004. The employer also advised the worker had received treatment for these injuries the previous year.
The worker spoke with the CA on October 24, 2004 as per memo # 1 and claimed to have sustained injuries to his right leg, right hip and low back due to the nature of his work duties. The worker related the onset of his condition to the repetitive movements of walking and driving while performing his job duties as a Meter Reader.
The doctor completed a Form 8, Health Professional’s Report confirming the worker had been assessed on October 20, 2004. The worker provided the doctor with a history of intermittent right buttock-right leg pain for three or four years. The worker advised the doctor he had increased walking and getting in and out of the car over the past three months. The worker was diagnosed as suffering from right sciatica.
The CA obtained the opinion of a WSIB medical consultant and in her decision dated February 1, 2005 concluded the worker’s injury was not related to the work duties. The worker’s representative, on behalf of the worker, objected to this decision and provided further information to support their objection.
The CA reviewed the worker representative’s submissions and obtained a second opinion from, a WSIB medical consultant. The CA confirmed the previous decision to deny entitlement. The worker representative on behalf of the worker objected to the decision.
AUTHORITY
Operational Policy Manual Documents
Policy 11-01-01 Adjudicative Process
Policy 11-01-02 Decision-Making
RESOLUTION METHOD AND PROCESS
The worker representative agreed to a decision based on the claim file record and her submission dated March 24, 2010. The employer did not return the Employer Participant Form.
ASSESSMENT OF THE EVIDENCE
In reaching my conclusion I considered the claim file record, the worker representative’s submission, and the relevant policy and legislation.
Analysis
Claim XXXXXXXXX was established when the WSIB received the Employer’s Report of Injury dated October 7, 2004 and a copy of a medical note from the family doctor advising the worker was suffering from right sciatica.
The worker completed the Worker’s Report of Injury, Form 6 on October 14, 2004 relating the onset of right hip, leg and back pain to the nature of his work duties. The worker reported he walked from house to house to read the hydro meters and would also drive from location to location. The worker advised he had been employed as a Meter Reader since October 17, 2000 and confirmed there had not been any changes in job duties since he was hired.
The family doctor provided a copy of the clinical notes confirming the history of treatment of the worker starting May 14, 1999. The doctor confirmed the worker was seen on June 13, 2003 complaining of right hamstring pain for approximately two weeks. There was no history of injury provided. The worker was next seen complaining of low back pain for approximately three weeks and the doctor questioned whether the worker was suffering from right sciatica versus a right hamstring strain. The worker, when assessed on February 27, 2004, provided the doctor with a history of right sciatica pain for three or four years. The doctor recommended physiotherapy treatment.
The worker next saw his family doctor on March 30, 2004 complaining of right sciatica pain and the doctor recommended the worker continue with physiotherapy. The worker saw his doctor on October 6, 2004 complaining of increased pain while working, walking and frequently getting in and out of his car.
The claim file was referred to the WSIB medical consultant and reviewed as per memo # 8 dated December 10, 2004. The consultant opined there was no accident to account for the worker’s symptoms.
The worker underwent x-rays of the lumbar spine on October 20, 2004, the results of which demonstrated minimal dorsal lumbar spondylotic change. The worker was diagnosed as suffering from right sciatica. When assessed on October 25, 2004 the worker was attending physiotherapy two to three times per week.
The worker was seen on several occasions by the family doctor subsequent to October 25, 2004 for ongoing symptoms of low back pain and right hamstring pain. The worker continued to have pain and was referred to a specialist for further assessment. The specialist assessed the worker on January 31, 2005 and diagnosed the worker as suffering from mechanical low back pain with referred pain into the hip. The worker was referred for further physiotherapy treatment and was assessed by the physiotherapist on February 10, 2005. The worker provided a history of suffering many slips and falls at work and that he had stopped playing hockey, and golf but that he wanted to get back to these sports.
The claims adjudicator spoke with the worker on July 18, 2006 as per memo # 12. The worker stated most days he would park his car and walk his route to read the meters. The worker advised on occasion he would get in and out of his car to drive to different locations to complete his work.
The worker subsequently underwent a MRI which demonstrated a disc herniation and degenerative changes at the L5-S1 level.
The worker representative provided a submission dated March 24, 2010 in support of the worker’s objection. Attached was a copy of several medical reports. The specialist report confirmed the worker underwent arthroscopic hip debridement for a labral tear.
The worker was assessed at the Chronic Pain Clinic on June 9, 2009 and provided a history of spinal pain for approximately ten years. The worker noted he had suffered several incidents including a car accident and various sports injuries.
The claim file was reviewed by a WSIB medical consultant as per memo # 27 dated April 19, 2009. The consultant opined the following:
“The job itself is not particularly strenuous and while being on the job may have caused the symptoms to become a little worse, they certainly were not a part of the cause of the problems or cause of the back pathology or the hip pathology. These appear to have been due to wear and tear over the years and there really is nothing about the job that would make one suspicious that this would be a major contributor.”
The worker representative, in her letter dated July 19, 2007, submitted the worker’s paystubs to demonstrate the activity at work for the week of June 4 and June 11, 2004 to demonstrate the worker volume of work. The worker representative, in her letter dated September 4, 2009, submitted the worker had suffered several incidents at work including an incident where he fell down the stairs of a customer’s house.
I appreciate the worker representative’s view on the events in this case. With respect to the several incidents that the worker may have sustained at work these were never reported to the employer nor was there medical attention sought. I find there is insufficient evidence to support the worker suffered specific accidents at work to account for the low back and right hip pain.
I also note the history the worker provided during the Chronic Pain Clinic assessment interview which provided various histories of injury. The worker referenced several sports injuries to account for the chronic pain.
The worker has been complaining of back pain dating back to a time prior to the start of the work as a Meter Reader. I note the medical opinion expressed as per memo # 27 in which the doctor opined the work duties were not a major contributor. I also note the worker’s description of the work duties as per memo # 12 which does not support the contention that the work is highly repetitive. While the worker does have to walk and get in and out of his car to perform his duties I find insufficient evidence to support that the work activities caused or accelerated the development of the worker’s current low back and hip condition.
CONCLUSION
I conclude there is insufficient proof of an accident at work and insufficient evidence to support the worker’s injuries were caused by the work duties performed. I further conclude there is insufficient evidence to support the nature of the work accelerated the development of the worker’s low back and hip injuries.
The worker’s objection is denied.
DATED April 20, 2010
D. Duguay
Appeals Resolution Officer
Appeals Branch