Workplace Safety and Insurance Board
Appeals Resolution Officer Decision
Decision Number: 20150047
Decision Date: June 3, 2015
Objecting Party: Worker
Represented by: Worker Representative
Respondent: Employer (not participating)
Hearing: Hearing in Writing
Heard by: S. McKinnon, Appeals Resolution Officer
ISSUE
The worker is objecting to the March 18, 2015 decision denying entitlement to a permanent impairment determination for his low back injury.
BACKGROUND
The 31 year old worker was injured at work on September 1, 2006. He bent over to lift a box and injured his back. The original diagnosis was low back strain. He returned to modified duties going off work as of October 14, 2006. The claim was allowed for the health care benefits and after further review, lost time from work.
The worker was then diagnosed with a disc herniation and was referred to an orthopaedic specialist. This doctor directed the worker’s conservative treatment and eventually discharged him from care in May 2007. At that time he wrote that he was expecting the worker would return to full function. The worker returned to modified duties and hour March 26, 2007 gradually returning to regular work as of June 18, 2007.
In March 2015 the worker representative wrote requesting a permanent impairment determination. This request was denied. The objection was referred to the Appeals Services Division.
AUTHORITY
From Operational Policy documents
18-05-03 Determining the Degree of Permanent Impairment
ANALYSIS
Workers are entitled to compensation for their non-economic loss if a work-related injury results in a permanent impairment. After review of the file record, including the worker representative’s further medical evidence, and the applicable policies I do not find there is evidence to support the worker was left with an assessable permanent impairment from the September 1, 2006 injury.
In arriving at that decision I considered all of the available information, however found the following particularly relevant:
- The worker was 31 years of age at the time of the work accident. He received conservative treatment following the September 1, 2006 work injury including physiotherapy. The last therapy was in 2007, there is no evidence of any ongoing treatment beyond June 2007.
- He had a CT scan November 3, 2006 that indicated there was L5-S1 herniation with encroachment on S1 nerve. This was reviewed by an orthopaedic specialist who commented it was suggestive of a herniation.
- The orthopaedic specialist Dr. B saw the worker on December 1, 2006. He noted the neurological and vascular exam was normal. Surgery would be considered if the injury did not settle down. The ongoing reports indicated the injury did settle down.
- This specialist continued to see the worker regularly as he progressed in this therapy and later in his return to work program. Dr. B wrote January 17, 2007 that the worker was improving and would return to see him in 6 weeks. On March 7, 2007 the specialist wrote the worker straight leg raise exam was 75 degrees, no crossover pain. The doctor reported that there had been a dramatic improvement. The worker was then considered able to return to work in some fashion.
- On May 9, 2007 Dr. B’s report was that the worker reported daily leg pain on the left. On exam to straight leg raise is limited by tight hamstrings. It measures 80 degrees; there was no nerve root tension findings, and no crossover pain. He believed the worker would return to full function. This is the last report from the orthopaedic specialist.
- When the representative requested the permanent impairment he submitted additional medical evidence including a report from the physiotherapist June 29, 2007. The therapist outlined at the worker’s final examination on June 4, 2007 there was no paravertebral tenderness, no pain in the vertebra, and minimal tenderness in the left sacro-iliac joint, all trunk movements were pain free and full in ranges. There was a minimal sprain of the sacro-iliac joint.
- There was a MRI February 19, 2015 found minor degenerative disc disease with mainly neural foraminal narrowing at L5-S1.
- Chart notes were submitted starting April 5, 2006. Although they are somewhat challenging to read, there is a notation in April 2007 about the low back and then in November 2009 reference is made to low back pain without specific injury. In February 23, 2011 mention is made of recently was pulling hard and strained low back again. The January 2015 note mentioned sciatica in 2006, symptoms again without new injury. The visits from that date refer to ongoing back complaints.
The worker would be entitled to compensation for a non-economic loss determination if a work-related injury/disease resulted in a permanent impairment. In this case the worker was injured in September 1, 2006 was diagnosed with a possible disc herniation and was referred to a specialist. After a period of conservative treatment, recovery was evident. The physical findings at the May 4, 2007 specialist’s assessment and the June 4, 2007 physiotherapist’s assessment do not indicate the worker was left with a residual physically measurable impairment from the work accident. After June 2007 he did not seek ongoing medical attention; the chart notes do not support there was continuity of complaint or medical attention. I do not find the recent MRI indicative of a relationship to the injury of nine years previous, September 1, 2006.
For the reasons outlined above, I do not find the worker is entitled to a permanent impairment determination as in June 2007 there was no longer an assessable impairment from the September 1, 2006 work injury.
CONCLUSION
The worker’s objection is denied.
DATED June 3, 2015
S. McKinnon
Appeals Resolution Officer