WORKPLACE SAFETY AND INSURANCE BOARD
APPEALS RESOLUTION OFFICER DECISION
decision number:
20150077
DECISION DATE:
March 23, 2015
OBJECTING PARTY:
Worker
REPRESENTED by:
Worker Representative
RESPONDENT:
REPRESENTED by:
Employer
Employer Representative
HEARING:
Hearing in Writing
HEARD by:
M. Kimevski, Appeals Resolution Officer
ISSUES
The worker objects to:
The denial of entitlement for left thumb osteoarthritis.
The determination that the left wrist tenosynovitis resolved.
BACKGROUND
The claim was established with an accident date of March 3, 2014 for this then 39 year old automotive production worker for a left hand/thumb injury. The worker attributed her injury to her job duties; she is right hand dominant but was required to use her left hand due to the direction of the line and the requirements of the work; there was a confirmed change in the physical demands due to a new car model.
Several diagnoses were provided in a medical report dated March 5, 2014. A decision letter dated March 31, 2014 advised that the diagnosis of left wrist tendonitis/tenosynovitis was accepted as related to the physical demands of the job and entitlement was allowed for health care benefits for this diagnosis only. There was no entitlement for the diagnosis of osteoarthritis. Further, the letter indicated that the diagnosis of carpal tunnel syndrome (CTS) was pre-existing and ongoing entitlement was under review under a prior claim.
In a further letter dated May 9, 2014 the worker was advised that the diagnosis of left wrist/tenosynovitis had resolved and ongoing symptoms and functional limitations for the left thumb were a result of pre-existing arthritis, which was not within the entitlement in the claim.
The worker objected and the decision was reconsidered. In a letter dated July 9, 2014 it was outlined that the left thumb joint osteoarthritis was generally age-related and pre-dated the claim. The worker’s thumb arthritis was diagnosed in 2012 under prior Claim 26372198 and therefore the diagnosis could not be considered as a new injury and the denial of osteoarthritis for the left thumb was upheld.
The case was referred to the Appeals Services Division for further consideration. The worker’s representative requested a hearing in writing to resolve the appeal; therefore, the decision was completed based on the information contained in the claim file as well as additional submissions from the representatives.
AUTHORITY
Operational Policies
11-01-01 Adjudicative Process
11-01-02 Decision Making
11-01-05 Determining MMR
ANALYSIS
In this case, the worker’s representative provided submissions including various documents, which were opined to support that osteoarthritis can be caused by repetitive use of the joint. It was submitted that the repetitiveness of the occupation must be considered as a significant contributing factor and while it is not disputed that the worker’s osteoarthritis was revealed in 2012, the worker continuously performed repetitive tasks since the start of her employment with the employer in 2009. This repetitive work pre-dated the 2012 osteoarthritis diagnosis and caused the osteoarthritis. It is opined that to refer to the osteoarthritis as a non-work related, pre-existing condition is unreasonable and narrow in view. Further, it is submitted that the wrist tenosynovitis continues to be problematic in overuse.
The employer’s representative submitted that following the examination at Altum Health the worker’s ongoing symptoms and functional limitations were the result of pre-existing arthritis. There was no mention of tendonitis/tenosynovitis and it was submitted that arguments not dealing with tendonitis/tenosynovitis are not relevant to this appeal and are related to the worker’s prior claim.
In reaching my conclusion I considered all of the available information in the context of the relevant operational policy and legislation. I acknowledge the arguments and evidence submitted by the representatives and I cannot support the position offered by the worker’s representative and I have outlined my findings and observations.
I note as mentioned in the claim file the worker has prior claims, which were not pursued or referred in conjunction with the current claim. While I make no findings pertaining to the worker’s prior claims; it is important based on the position presented by the worker’s representative to note the previous entitlements and decisions for purposes of context.
In Claim “A” there is a decision letter dated July 25, 2012 advising that entitlement was allowed for a strain to the left hand/thumb, but arthritis of the first metacarpal joint (thumb) was not work related and entitlement was denied for the condition.
In Claim “B” there is a decision letter dated May 14, 2013 advising that the diagnosis of a repetitive strain injury of the hands and fingers is compatible with the job duties, but the diagnosis of osteoarthritis is not considered to be caused by the job duties and entitlement was limited to a repetitive strain injury only. A permanent impairment was later recognized for bilateral CTS and the worker was granted a 7 per cent non-economic loss (NEL) benefit in August 2014.
Therefore, I do not concur with the worker’s representative’s generalization that the thumb osteoarthritis was caused by repetitive work pre-dating 2012 as this is not the context in which the current claim was established, and as outlined, the worker has been provided with decisions in two prior claims as to the denial of the condition being work-related.
Based on the scope of this appeal and the context of the current claim, which was established for a new onset with a date of accident of March 3, 2014, I must proceed on the basis that the worker’s osteoarthritis was a pre-existing condition for which previous entitlement was denied.
I note that from the outset of the claim, as documented in a conversation on March 31, 2014, the worker indicated that her issues were with the left wrist. The worker indicated, as also confirmed by the medical information, that she had ongoing symptoms with respect to her pre-existing osteoarthritis as she was taking Arthrotec.
There is no persuasive evidence to support the left thumb osteoarthritis became work related as of March 3, 2014. Additionally, while I reviewed the documentation provided by the worker’s representative, it is my understanding that osteoarthritic changes are very common in the general population and there is no compelling evidence that the arthritic process is accelerated by repetitive stress. What is more plausible is that the worker’s joints may be more symptomatic because of their use, thereby creating the impression that the osteoarthritis is related to her work.
With respect to the compensable left wrist tendonitis/tenosynovitis I note the worker was assessed at Altum Health – WSIB Hand & Wrist Speciality Program and the assessment report of April 30, 2014 made no mention of the condition. The only diagnoses provided were in reference to the left CMC joint arthritis and bilateral CTS. No further diagnostics were recommended. Therefore, there is no basis for ongoing entitlement to the left wrist tendonitis/tenosynovitis and any ongoing limitations are not related to the compensable injury under this claim.
CONCLUSION
The issues are concluded as follows:
The denial of entitlement for left thumb osteoarthritis is confirmed.
The determination that the left wrist tenosynovitis resolved is confirmed.
The worker’s objection is denied.
DATED March 23, 2015
M. Kimevski
Appeals Resolution Officer
Appeals Services Division