WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
decision number: 20150034
DECISION DATE: April 17, 2015
OBJECTING PARTY: Worker
REPRESENTED by: Self-Represented
RESPONDENT: Employer
REPRESENTED by: Self-Represented
HEARING: Hearing in Writing
HEARD by: S. Marangoni, Appeals Resolution Officer
ISSUES
The worker objects to:
- The denial of initial entitlement for a left meniscal tear.
BACKGROUND
On December 6, 2012, this then 38 year old Heavy Equipment Mechanic twisted his left knee while climbing onto a road grader. He sought medical attention in October, 2013 and was diagnosed with a left knee medial meniscal tear. Entitlement was denied in a decision dated March 25, 2014.
AUTHORITY
11-01-01 – Adjudicative Process
15-02-01 – Definition of Accident
15-02-02 – Accident in the Course of Employment
ANALYSIS
I am accepting entitlement for a left knee medial meniscus tear for the following reasons:
- Proof of accident is established with immediate onset of pain, immediate reporting, immediate layoff from work and immediate medical attention. There also has to be medical compatibility established between the accident history and the diagnosed condition. If there are any delays, there must be a reasonable explanation for the delays;
- In this case, the worker reported the incident immediately on December 6, 2012 and he felt immediate pain on this day. Immediate reporting and onset of pain is therefore evident;
- The worker did delay until October 31, 2013 to seek medical attention. This is a lengthy delay. However, information was obtained from the president of the company who indicated he was aware of the worker’s initial injury and ongoing complaints. He also noticed the worker limping following the injury. He noted that this is a conscientious and hard-working individual who thought the injury would heal on its own;
- The worker was never contacted prior to the denial of the claim however he did provide a statement following the denial wherein he indicated that he is not the type to run to the doctor. The pain was intermittent and he thought the injury would heal on its own. Furthermore, although he continued working, he was able to modify as necessary and he also did not operate the grader following the injury as he was unable to do so. Given the fact that he was able to continue working even with the intermittent pain, considering the obvious character of this worker, it is reasonable to accept that he would have delayed the length of time he did until he sought medical attention;
- To further speak to his character, the worker continued to work even after being diagnosed with a meniscal tear and was able to continue to do so until his surgery. Furthermore, he returned to modified work the day after his surgery of February 24, 2014. It is clear he is a hard-working individual with a strong work ethic and his ability to continue to work after his initial injury should not preclude entitlement. The delay in laying off work is therefore also reasonable;
- The worker had an MRI on December 12, 2013 and a small tear of the undersurface of the posterior horn of the medial meniscus suggestive of meniscoscapular injury/separation was identified. Even though chondromalacia was also identified, the meniscal tear is consistent with the twisting type injury the worker reported on December 6, 2012; There is no evidence of any other injury to the knee;
- Given the immediate onset of pain, immediate reporting, continuity of complaint, compatibility of the diagnosed condition with the mechanics of accident, even though the delays in medical attention and layoff were lengthy, I find them reasonable and am concluding that proof of accident has been established.
CONCLUSION
I am:
- Accepting initial entitlement for a left knee medial meniscal tear.
The worker’s objection is granted.
DATED April 17, 2015
S. Marangoni
Appeals Resolution Officer
Appeals Services Division