WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFER DECISION
Decision number: 20150008
DECISION DATE: March 31, 2015
OBJECTING PARTY: Worker
REPRESENTED by: Worker Representative
RESPONDENT: Employer
REPRESENTED by: Employer Representative
HEARING: Hearing in Writing
HEARD by: M. St-Hilaire, Appeals Resolution Officer
ISSUE(S)
The worker requests initial entitlement to right carpal tunnel syndrome.
BACKGROUND
On February 3, 2014, this worker was aged 51 and employed as a painter. He attended a Regional Evaluation Centre (REC) assessment for a right elbow injury in a prior claim. The REC assessor indicated the worker had right carpal tunnel syndrome.
The worker reported the condition to the employer and related it to his work in general as a painter. An EMG test conducted on March 3, 2014 confirmed the diagnoses of moderate carpal tunnel syndrome. The worker is left hand dominant.
Eligibility Adjudicator’s Decision:
The eligibility adjudicator reviewed the worker’s non-work-related factors and the job description and determined there was no causal relationship between the work performed and the right carpal tunnel syndrome. This decision was outlined in the letter dated April 7, 2014 and the reconsideration dated May 5, 2014.
Worker’s Representative’s Position:
The worker’s representative has submitted that the worker’s job as a painter was a significant factor in the development of right carpal tunnel syndrome due to the awkward positions and weight loads his right hand needed to maintain when performing his regular duties.
He has worked with this employer since 2007 as a painter. While performing his job, he used his right hand 80 to 90% of the time; holding and carrying ladders, standing, wiping paint off, holding the paint roller handle (which weighed approximately 10 to 20 lbs.) for long periods of time and holding paint cans weighing approximately 10 lbs. He also set up and removed scaffolding.
AUTHORITY
Operational Policy#15-02-01, Definition of an Accident
Operational Policy#15-02-02, Accident in the Course of Employment
ANALYSIS
Operational Policy #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.
The definition of an accident as a disablement arising out of and in the course of employment is,
"a condition which emerges gradually over time." However, it must have a causal relationship with the work being performed.
I do not find that the worker’s job entailed sufficient employment risk factors for the development of carpal tunnel syndrome in his non-dominant, right wrist. I do not find that the potential contribution of the work was a significant factor in the worker’s development of right carpal tunnel syndrome.
In weighing the evidence and determining the potential contribution of the work, it is important to ensure the details concerning any pre-existing or co-existing conditions are considered. Should a worker have a pre-existing condition that renders them more susceptible to injury, it is important to then consider if the work activity may be a significant factor in triggering the impairment.
The discussion paper prepared by Dr. Brent Graham, MD, FRCSC (May 2001) for the Workplace Safety and Insurance Appeals Tribunal (May 2002) was reviewed as a reference document. This paper provides the following information and states, in part:
“Carpal tunnel syndrome is widely held to be a very common clinical condition. Most physicians would agree that, among the compressive nerve lesions that may affect the upper extremity, carpal tunnel syndrome is, by substantial margin, the most commonly diagnosed.”
Repetitive strain injury (RSI) and cumulative trauma disorders such as carpal tunnel syndrome are terms used to refer to several discrete conditions that can be associated with repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained/awkward positions.
Repetitive tasks are made up of a sequence of upper limb actions, of fairly short duration, which are repeated over and over again, and are almost always the same. These tasks are sustained tasks with little or no rest periods between activities.
The worker is left hand dominant. His tasks as a painter included painting with the left hand, painting trim using a paint brush using the left hand. He used rollers on a stick and would have his right hand on the top and the left hand on the bottom.
He applied pressure to the roller with his right hand and controlled the direction of the roller with his left hand. When prepping the painting surface, he would fill holes with putty and did a little bit of sanding with the left hand. He would hold the paint can with his right hand when there was only about one to two inches of paint in the can.
A detailed job description was provided to the claim file by the worker and the employer. As well, the prior claim also had a job description outlined. I reviewed all of the information relating to the job description.
The following are known employment risk factors for carpal tunnel syndrome:
forceful exertions
awkward postures
repetitive movements
pressure at the base of the hand
exposure to vibration
exposure to low temperatures
I am not persuaded on the facts of this case that there is a probable relationship. I am not satisfied that the preponderance of evidence showed the worker’s job involved forceful exertions of the right hand, awkward postures, repetitive movements, pressure at the base of the hand and exposure to vibration and low temperatures.
The non-employment risk factors for carpal tunnel syndrome include:
diabetes
rheumatoid arthritis, osteoarthritis, gout
obesity
hypothyroidism
pregnancy
The worker has Type II Diabetes, Gout, Hypertension, Obstructive Sleep Apnea, dyslipidemia, and obesity. I find that the worker’s non-work-related risk factors appear to be a more significant factor in triggering the impairment. As such, entitlement to right wrist carpal tunnel syndrome is denied.
CONCLUSION
Initial entitlement to right wrist carpal tunnel syndrome is denied.
The worker’s objection is denied.
DATED March 31, 2015
M.St-Hilaire
M.St-Hilaire
Appeals Resolution Officer
Appeals Services Division