WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER: 20100143
OBJECTION BY: Worker
EMPLOYER: Participating
REPRESENTATIVES: Worker Representative, Employer Representative
ISSUES
The worker objects to the decision of July 21, 2008, denying the low back as an area of injury and ongoing entitlement for a right knee injury.
The worker seeks initial entitlement for the low back and ongoing entitlement for his right knee.
HOW THE ISSUES AROSE
On November 29, 2005, this then 55 year old Truck Driver was unloading tube rounds from the back of a flat bed truck and was walking to the front of the truck when the load rolled off the flat bed and struck the worker in the right leg. The worker was seen by his chiropractor and diagnosed with a valgus strain of the right knee and bruising on the right lateral leg.
The worker’s chiropractor recommended modified duties with limitations for standing, kneeling and climbing. The worker did not lose time from work.
In May 2008, the worker contacted his Workplace Safety and Insurance Board (WSIB) Case Manager and reported ongoing problems with his knee and back. Updated records were requested from the worker’s chiropractor.
The worker’s file was subsequently reviewed by the WSIB Medical Consultant, who was of the opinion there was no medical continuity or compatibility, relating the worker’s current low back or right knee problems to his injury of November 29, 2005.
In a decision dated July 21, 2008, the WSIB Case Manager denied ongoing entitlement for the worker’s right knee condition, as well as the low back as an area of entitlement.
The worker objected to the above noted decision. The operating area upheld their decision and the worker’s file was forwarded to the Appeals Branch for further consideration.
AUTHORITY
Operational Policy Manual (OPM) documents:
11-01-01 Adjudicative Process
11-01-05 Determining Maximum Medical Recovery (MMR)
15-03-01 Recurrences
RESOLUTION METHOD AND PROCESS
The worker submitted a 60 day expedited decision option which was received by the Appeals Branch on August 20, 2010. This election requires the Appeals Branch to make an expedited decision (within 60 days) based on the information on file. The 60 day time frame in this case expires October 18, 2010.
ASSESSMENT OF THE EVIDENCE
The Employer’s Report of Injury/Disease (Form 7) dated December 6, 2005, records the worker was struck on the right leg resulting in contusions to his right thigh and right forearm.
In the Worker’s Report of Injury/Disease (Form 6) dated January 1, 2006, the worker reported he was struck on the right leg. There is no mention of an injury involving the back at that time.
The Worker’s Continuity Report (Form REO6) dated May 5, 2008, reported:
It has continued to be sore off and on, but being retired, I didn’t realize it would still be cov[er]ed. When I started doing some heavy yard projects I had to go to [the] chiropractor, who informed me it was [the] original injury and should be covered….
If I walk to[o] much, sit too much or stand to[o] long it hurts, burning feeling, sometimes numb. Just a nagging problem.
The Health Professional Continuity Report (Form REO8) dated March 19, 2008 recorded the worker’s present complaints as lower back pain and right leg numbness.
The employer’s Occupational Injury Report of First Treatment report dated November 29, 2005, recorded the worker was struck on the right leg when a load rolled off a flat bed truck, striking the worker in the right leg. The examination revealed pain/contusion to the right thigh and right forearm with good mobility and strength noted.
The bulk of the medical evidence originates in a letter dated June 6, 2008, from the worker’s chiropractor. The worker’s initial visit was on November 30, 2005 and the worker informed his chiropractor that a 24 foot long shaft weighing approximately two tons struck the right lateral aspect of his knee. The chiropractor stated the worker was treated specifically for the right knee, which was diagnosed at the time as a valgus strain of the right knee with bruising on the right lateral leg, from November 30, 2005 to February 10, 2006. On December 19, 2005, the worker informed his chiropractor his knee was improving however he reported his right trochanteric area was getting sore. On January 3, 2006, the worker reported his knee was improving and stairs were “getting easier”. On January 5, 2006, the worker reported to his chiropractor that “his lower back is getting progressively worse”. The worker related the worsening low back symptoms to the fact he could not squat and had to bend at the waist. The worker was treated for the right knee and low back from January 9, 2006 to February 10, 2006, at which time the chiropractic treatment was complete and the worker was recorded to be “feeling relatively well”.
On June 15, 2006, the worker informed his chiropractor he had left low back pain “which was what he had following the knee injury”. On his next visit to the chiropractor, being
June 30, 2006, the worker mentioned his right knee was still sore. The worker’s next visit was on July 12, 2006 and he reported soreness in his entire spine, being the cervical, thoracic and lower back as well as an “achy” right leg following a car ride. On November 15, 2006, the worker reported his right leg was “going numb” and on July 4, 2007 that his right leg was “falling asleep”. On March 18, 2008 the again reported the right leg was “falling asleep” and that walking aggravates his low back, right leg and lateral knee.
Analysis and findings:
I will first address the issue of ongoing entitlement for the right knee and then the issue of the low back as an area of entitlement in relation to the injury of November 29, 2005.
Right knee:
OPM document 15-03-01 “Recurrences” states:
A worker is entitled to benefits for a recurrence of a work-related injury or disease. 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.
The worker’s Form 6 indicates the worker sought medical treatment from the emergency department at the local hospital however this report is not on file. The worker was subsequently treated by his chiropractor and no further medical investigative procedures or referrals to a physician or specialist are on record.
The worker was treated by his chiropractor for a valgus strain of the right knee with bruising on the right lateral leg, from November 30, 2005. The worker’s right knee pain appeared to be improving in January 2006. The worker reported low back symptoms with an “achy” right knee in June/July 2006 and that the right leg was numb in November 2006 and July 2007.
There is no record of medical attention between July 11, 2007 and March 18, 2008. The worker reported on the REO6 that he had retired and did not realize chiropractic treatment would be paid for otherwise he stated he would have continued. In the attachment to the worker’s REO6, the worker stated his right leg has hurt “off and on” since the original injury and it is interfering with the worker’s “large yard project & golf”. In March 2008, the worker reported to his chiropractor that the right leg was “falling asleep” and that walking aggravates his low back, right leg and lateral knee.
The WSIB Medical Consultant reviewed the worker’s claim in Memo 3 and noted there appeared to by a full recovery to the “valgus strain of the right knee and bruising on the lateral aspect of the right knee”, with no permanent impairment, by about January 30, 2006. The WSIB Medical Consultant did not find that the worker’s low back condition was related to the work injury and that the right leg pain from June 30, 2006 “may be related to low back condition
(? Sciatica)”.
The REO8 on file dated March 19, 2008 states “lower back pain & rt [right] leg numbness”.
I find the worker’s original diagnosis of valgus strain of the right knee and bruising on the right lateral leg at the time of injury is not medically compatible with the March 2008 diagnosis of low back pain and right leg numbness. I am persuaded the worker recovered from his original injury on November 29, 2005 and his more recent problems right leg problems appear to be related to his low back and possible sciatica. This view is supported by the Medical Consultant’s comments in Memo 3.
Low Back:
Both the Form 6 and Form 7 report an injury to the right leg however there is no mention by the worker or the employer of an injury to the low back.
The first documentation of a low back issue in noted by the worker’s chiropractor on
January 5, 2006, at which time the worker reported that “his lower back is getting progressively worse”. The worker related the worsening low back symptoms to the fact he could not squat and had to bend at the waist. The worker was subsequently treated for the right knee and low back from January 9, 2006 to February 10, 2006, at which time the chiropractic treatment was complete and the worker the worker was recorded to be “feeling relatively well”.
The worker’s chiropractor indicated the worker did not have right knee problems prior to his injury however he made no comment regarding the any prior treatment for the worker’s low back.
I do not find the worker injured his low back on the date of injury. This view is supported by the fact the worker did not report a back injury on November 29, 2005 to his employer; the worker did not complain of a low back injury to his chiropractor while in active treatment in the month following the injury; and the worker did not report an injury to the low back when he completed the Form 6 on January 4, 2006.
CONCLUSION
In reaching my conclusion, I considered all the documentation in the worker’s claim file, the relevant sections of the WSIB Act and operational policy.
The worker’s objection is denied.
The worker is not entitled to ongoing benefits for a right knee condition.
The worker is not entitled to the low back as an area of injury.
DATED September 23, 2010
M. Barbeau
Appeals Resolution Officer
Appeals Branch