WORKPLACE SAFETY AND INSURANCE BOARD (WSIB)
APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER: 20100175
OBJECTION BY: Worker
EMPLOYER: Not Participating
PARTICIPANTS: Worker, Worker Representative
ISSUE
The worker requests an increase in the non-economic loss (NEL) award.
HOW THE ISSUE ARISES
This 45 year old farm worker injured his left ring finger on September 30, 2009, comprising of an amputation over the base of the tuft of the distal phalanx. Revision was carried out on the accident date and it was later determined that he achieved maximum medical recovery (MMR) on December 23, 2009.
Based on medical information submitted to the claim, the worker was allowed a 2 per cent NEL award in March 2010. His objection to the level of the award was reviewed by the NEL clinical specialist, who confirmed the level of the award on August 6, 2010.
AUTHORITY REFERENCE
Operational Policy Manual Documents:
11-01-03 – Merits and Justice;
11-01-05 – Determining MMR;
18-05-03 – Assessing Permanent Impairment.
RESOLUTION METHOD AND PROCESS
The worker and his representative requested a 60 day expedited decision.
ASSESSMENT OF THE EVIDENCE AND SUBMISSIONS
In arriving at my decision I have considered the information in the claim file, the relevant sections of the Workplace Safety and Insurance Act (the Act) and the appropriate Operational Policies.
I find, on balance the evidence does not support the worker’s objection, and the following is a summary of my assessment/observations.
According to WSIB policy;
“When the worker reaches MMR the WSIB attempts to determine the degree of the worker’s permanent impairment by considering all relevant health care information in the claim file.
The prescribed rating schedule is The American Medical Association Guides to the Evaluation of Permanent Impairment, 3rd Edition (Revised), (the AMA Guides).”
The worker’s objection is based on the medical report of December 23, 2009, which again indicated the worker had been doing desensitizing exercises as per the doctor’s instructions. It was reported that the worker was pain free, with a grade five grip in his left hand.
“I have now assessed him as being at a point of maximum medical improvement with a permanent physical disability with 9 per cent of the left hand which converts to 8 per cent of the upper extremity which converts to 5 per cent of the whole person.”
According to the previous reports, the worker had an amputation over the base of the tuft of the distal phalanx. By November 23, 2009 it was reported that he had a healed tender scar over the distal aspect of the left ring finger.
According to the NEL data extraction sheet the noted diagnosis was the amputation of the left distal phalanx and surgical revision. The referenced medical reports were noted by the NEL clinical specialist. According to the impairment calculation summary of the NEL evaluation, a 3 per cent award was allowed for the left arm, which reduced to a 2 per cent whole person impairment. The specific details for the left arm impairment are noted in the calculation summary.
In comparing the medical information to this type of injury in the AMA Guides I concur with the findings of the NEL clinical specialist and do not see evidence that the worker’s permanent functional impairment is greater than the level recognized by the 2 per cent NEL award.
CONCLUSION
The worker is not entitled to an increase to the 2 per cent NEL award.
The objection is denied.
DATED December 16, 2010
B. J. Romano
Appeals Resolution Officer
Appeals Branch