WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
decision number:
20150029
DECISION DATE:
April 2, 2015
OBJECTING PARTY:
Worker
REPRESENTED by:
Self-Represented
RESPONDENT:
REPRESENTED by:
Employer
Self-Represented
HEARING:
Hearing in Writing
HEARD by:
S. Marangoni, Appeals Resolution Officer
ISSUES
The worker objects to:
- The denial of entitlement to a recurrence of April 23, 2013.
BACKGROUND
On October 18, 1986, this then 27 year old Production Assistant was attaching a pipe wrench. The screw auger jammed and the excess force caused the worker to sustain an injury to his left shoulder. Entitlement was granted and the worker went onto receive a 10% Permanent Disability (PD) award following an assessment of February 2, 1991.
The worker claimed a recurrence on April 23, 2013 which was denied in decisions dated
July 30, 2013 and October 30, 2013. The denial was confirmed upon reconsideration in a decision dated February 12, 2015.
AUTHORITY
15-03-01 - Recurrences
ANALYSIS
I am confirming the denial of entitlement for the recurrence of April 23, 2013 for the following reasons:
Policy 15-03-01 requires that for a recurrence to be accepted, it must be established that a worker’s ongoing problems are, on the balance of probabilities, attributed to the initial injuries sustained;
Following the injury of October 18, 1986, the worker had surgery on May 26, 1987. The post-operative diagnosis was traumatic chondromalacia of the AC joint and tear of the AC joint meniscus with Grade II instability. The surgery consisted of excision of the outer end left clavicle. Entitlement was granted for the surgery and it was accepted the worker was left with a 10% impairment. However, the surgery was successful for the most part and the worker was able to resume work. A report of November 30, 1987 noted the worker had pain and crepitus but he was able to work without restrictions;
In the meantime, the worker was assessed on September 9, 1987 and it was noted the worker had progressive degenerative changes of the meniscus of the AC joint. It was noted that only about 3% of AC joints preserve their meniscus into adult life. Based on this report, it was anticipated that degenerative issues would come into play, regardless, it appears, of the work-related injury;
Following the PD assessment in 1991, there is no medical reporting until April, 2013. A medical report dated November 20, 2013 noted the worker developed insidious pain in April, 2013. It was felt the worker had developed rotator cuff tendinitis and a partial thickness tear. The insidious onset would suggest a manifestation of the degenerative issues, unrelated to the initial injuries sustained;
The file was reviewed by a Physician Consultant on July 15, 2013 who indicated that the worker’s problems were attributed to degenerative, age-related changes and not to the effects of the initial injuries sustained;
The file was reviewed by a second Physician Consultant on October 21, 2013 who noted that a left shoulder MRI scan report of August 11, 2013 showed a moderate amount of fluid in the subdeltoid bursa with a trace amount of fluid in the subacromial bursa. There was also some subscapularis tendinopathy and a small partial thickness tear over the bursal side of the supraspinatus tendon. The Physician Consultant provided the opinion that these findings were not consistent with the workplace injury, but rather attributed to age-related wear and tear. Given the fact that the initial surgery appeared to be successful for the most part and noting the medical reporting in September, 1987 that suggested degenerative issues would play a part in this worker’s symptoms, I accept the Physician’s opinion;
The worker had surgery on June 17, 2014. The post-operative diagnosis was left shoulder subacromial impingement. At the time of surgery, there were no significant rotator cuff tears identified; however, there was minor bursal fraying. The fraying suggests degeneration and it appears this was the significant contributing factor leading to the worker’s symptoms in April, 2013. Even though the surgical report was not on file at the time of either of the Physician Consultant reviews, given the apparent degenerative nature of the worker’s condition, the medical opinions would still be valid;
There is a medical report dated October 30, 2014 supporting compatibility between the worker’s ongoing problems and the initial work incident. However, given the other findings listed previously, I accept the opinions of the Physician Consultants in this case. I am not satisfied that the worker’s problems at the time of his layoff on April 23, 2013 were more probably than not attributed to the initial injuries sustained in this case. The recurrence is therefore denied.
CONCLUSION
I am:
- Confirming the denial of entitlement for the recurrence of April 23, 2013.
The worker’s objection is denied
DATED April 2, 2015
S. Marangoni
Appeals Resolution Officer
Appeals Services Division