WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
DECISION NUMBER: 20110012
OBJECTION BY: Worker
EMPLOYER: Not participating
REPRESENTATIVE: Worker Representative
ISSUE
The worker’s representative defined the issue as entitlement for bilateral carpal tunnel syndrome (CTS) as arising out of and in the course of employment.
HOW THE ISSUE ARISES
The claim was established for this then body shop repairman (DOB September 9, 1953) who maintains he developed bilateral Carpal Tunnel Syndrome related to the nature of his work activities. The employment record reveals he worked in this capacity from 1977 to 2002. A diagnosis of bilateral CTS was advanced in March 1998.
The Claim was not established until January 2010 upon receipt of the Worker’s Report of Injury.
The Adjudicator, following inquiries which included a field investigation, as delineated in the correspondence dated June 22, 2010 concluded the claimed condition was unrelated to the work exposure. This is the issue for determination.
AUTHORITY
Operational policy document 15-02-01 speaks to "Definition of an Accident."
Section 2(1) the Workplace Safety and Insurance Act,
Operational Policy Document 18-03-02 Payment of LOE
RESOLUTION METHOD & PROCESS
Decision based on the information contained in the claim record.
ASSESSMENT OF EVIDENCE
The Appeals Resolution Officer has considered the information on record.
On review of the evidence that is a situation of determining entitlement under the disablement provision of the Workplace Safety and Insurance Act, Section 2(1). Entitlement may be considered for disablement given that there is a causal relationship established between the impairment and nature of the work performed. The onset of the impairment need not be immediate but there must be more than a passing connection between work and injury.
Operational Policy Document 15-02-01 speaks to "Definition of an Accident."
Accident includes:
a wilful and intentional act, but not an act of the worker
a chance event resulting from a physical or natural cause
a disablement arising out of and in the course of employment.
A chance event is defined as an identifiable unintended event, which causes an injury. An injury itself is not a chance event.
Operational Policy Document 18-03-02 - addresses the subject of “Payment of Loss of Earnings (LOE) Benefits.” The policy indicates, a worker who experiences a LOE as a result of a work-related injury is entitled to LOE benefits provided proof of injury can be established.
It is the worker’s position, the nature of his work activities as a “body man/automotive technician”, exposed him to vibratory air tools including orbital sanders, grinders, air ratchet and impact wrenches and chisels. He noted that the activities involved forceful repetitive wrist movements. He worked in this capacity until October 2002, following which he worked as a body shop manager for 5 months. From 2004 to 2007 he worked for Revenue Canada 5-6 months per year as a GST Clerk. The worker views the activities of body man/automotive technician as a significant contributing factor to the development of the bilateral CTS.
The issue for determination on appeal is whether a causal relationship can be established between the worker’s employment and the development of the cumulative trauma disorder, CTS.
Carpal tunnel syndrome results when there is compression of the median nerve, which supplies sensory branches to the skin of the thumb, index, middle and, the adjacent side of the ring finger. CTS may result in numbness, tingling, weakness or muscle atrophy in the hand and fingers. The condition is common in individuals who perform repetitive motions of the hand and wrist (gripping and or forceful repetitive movements). Injury or trauma, including repetitive movement of the wrist can cause swelling of the tissues and CTS. Activities involving the use of hand tools or tools that vibrate are a known cause of CTS.
In this case, there is no dispute as to the nature of the worker’s work activities (employer confirmed the essential duties as a body man as described by the worker) which involves heavy/stressful use of the hands, requiring repetitive wrist and hand motion. Physical exertion was required with exposure to vibratory tools. The worker worked in this capacity for a period of 25 years.
In the Appeals Resolution officer’s opinion, the nature of the work activities are viewed as contributing to the development of the CTS with no other known cause.
In reviewing the medical documentation, the worker does not suffer from any peripheral neuritis and considering the job description which is not in dispute, he would appear to be an ideal candidate for developing carpal tunnel syndrome. Furthermore, there is no history of diabetes, hypothyroidism or trauma to the wrist area.
Medically, bilateral CTS was diagnosed in March 1998 while still performing duties of a “body man/automotive technician”, by way of EMG and nerve conduction, however, weakness at that point was no evident.
The Appeals Resolution Officer also notes the Surgeon’s report dated July 27, 1998 in which the following is documented:
“Of note, he’s also talking about possibly submitting a WCB claim. Given his job history, with heavy use of vibrating and impact tools, I would certainly support this claim.”
In disablement cases the onus is on the worker to show a causal relationship between disability and work performed. The condition for which the worker was treated is seen to be a reasonable sequelae of the nature of the work performed.
The preponderance of evidence supports the worker’s position of a causal relationship between impairment and work. The Appeals Resolution Officer concludes the worker did suffer disablement arising out of and in the course of employment by virtue of the nature of the work performed as risk factors for the development of the condition existed, with no other known causes for the CTS or evidence to dispute the worker’s account of the development of the claimed condition.
The worker, as documented in the Claims Investigator’s notes, dates the onset to 1990 when he began to experience tingling in the fingers, with symptoms recurring over the years. He advised he would simply “shake it off” in order to get feeling back in his hands.
Operational Policy Document 11-01-04 speaks to the subject of Determining Date of Accident. Essentially, the date of injury is the date the worker experiences a disabling physical or functional abnormality or loss as a result of a disablement, occupational disease or trauma.
Disablements are injuries, which develop gradually over time. As a result establishing a precise “accident date” can be difficult. The Board’s practice, for defining accident date in disablement cases is that the accident date should be considered to be the date from which the worker suffered disabling physical or functional loss or abnormality.
The Appeals Resolution Officer is of the view, the date of injury should be the date when the worker’s impairment was clearly diagnosed and the worker began to experience a disabling physical or functional loss or abnormality. In this case, it is reasonable to establish
March 25, 1998 as the accident date as this is when the condition was diagnosed, with a referral for a surgical consultation undertaken.
CONCLUSION
In the judgement of the Appeals Resolution Officer, the preponderance of evidence establishes a causal relationship between the work performed by the worker and the development of the bilateral CTS. Loss of Earnings benefits (LOE) are not warranted at this time, as based on the worker’s statement to the Claims Investigator, no lost time has been incurred as of March 10, 2010. If the worker proceeds to decompression surgery, LOE benefits would be in order from the date of surgery. Furthermore a Non Economic Loss assessment is directed pending clarification from the worker as to whether he wishes to pursue surgery.
Furthermore, it is directed that the accident date be amended to March 25, 1998.
The worker’s objection is therefore allowed.
DATED January 10, 2011
M. De Marco
Appeals Resolution Officer
Appeals Branch