Worker v. Employer, 2025 CanLII 24858

APPEALS RESOLUTION OFFICER DECISION

Decision Number: 20250022

OBJECTING PARTY: Worker

REPRESENTED by: Worker representative

RESPONDENT PARTY: employer

REPRESENTED by: Employer representative

HEARING: HEARING IN WRITING

HEARD by: S. Johnson, appeals resolution officer DATED: February 18, 2025

ISSUE

The worker objects to the Eligibility Adjudicator’s reconsideration decision letters dated September 29, 2023 and October 24, 2024 that denied initial entitlement to a right wrist carpal tunnel syndrome injury.

BACKGROUND

On August 9, 2022, the worker filed a claim with the Board for a gradual onset of right wrist and hand pain they attribute to their work duties as a long-haul truck driver that exposed them to long periods of driving for 11 to 13 hours per day, six days per week.

In telephone conversations with the Customer Service Representative and the Eligibility Adjudicator on August 10, 2022, the worker described their right wrist and hand injury is due to holding the steering wheel for 11 hours per day and the vibration associated with driving a long-haul truck with this employer. The worker reported their symptoms started within a few months after they were hired by this employer in 2020 and progressively worsened to the extent they received outside medical treatment on April 13, 2022.

In the clinic chart note for the visit on April 13, 2022, the physician documented the worker was seen with complaints of pain and tingling in the right hand and fingers for years with a worsening over the past two months. The physician recommended an electromyography (EMG) study and prescribed the worker medications. The EMG report dated May 19, 2022 observed severe right wrist carpal tunnel syndrome. The physician referred the worker for consultation with a plastic surgeon. In a medical report dated July 16, 2022, the plastic surgeon confirmed the diagnosis of severe right wrist carpal tunnel syndrome and scheduled surgical repair on July 25, 2022.

In the Employer’s Report of Injury/Disease (Form 7) dated August 11, 2022, the employer documented the worker first reported their right wrist injury on August 8, 2022 with surgery completed on July 25, 2022.

In a decision letter dated August 16, 2022, the Eligibility Adjudicator allowed initial entitlement for the worker’s right wrist carpal tunnel injury, surgical repair on July 25, 2022 and full loss of earnings (LOE) benefits from July 25, 2022 up to and including August 11, 2022 because medical compatibility was established. The employer representative objected to this decision.

In reconsideration decision letters dated September 29, 2023 and October 24, 2024, the Eligibility Adjudicator rescinded the allowance of initial entitlement to a right wrist carpal tunnel syndrome injury, surgery and LOE benefits because there was insufficient evidence to support a causal relationship existed between the worker’s duties and the development of a right wrist carpal tunnel syndrome injury.

This is the issue for my review and determination.

AUTHORITY

Operational Policy Manual 11-01-01 Adjudicative Process Published November 3, 2008

Section 13(2) Worker’s Compensation Act, 1997

ANALYSIS

I have carefully considered all the available information, legislation and relevant operational policies in reaching this decision.

I find initial entitlement to a right wrist carpal tunnel syndrome injury is denied.

The Operational Policy Manual (OPM) Document No. 11-01-01 – Adjudicative Process – provides an analytical framework that decision-makers apply when considering a worker’s initial entitlement to benefits. This framework is known as the five-point check system that sets out an allowable claim must have the following five points:

• an employer
• a worker
• personal work-related injury
• proof of accident, and
• compatibility of diagnosis to accident or disablement history.

There is no dispute three of the five criteria in the above policy have been met as there is an employer, a worker and proof of accident. The issues to be resolved is the third and fifth criteria in the OPM Document No. 11-01-01 – Adjudicative Process – that states there must be personal work-related injury and compatibility of diagnosis to accident or disablement history.

Worker Representative Submissions

In a submission dated January 30, 2025, the principal argument put forth by the worker representative is the worker’s duties as a long-haul truck driver contributed to the development of their right wrist carpal tunnel syndrome injury. The worker worked longer shifts driving with very limited task rotation. While driving, the worker would be performing repetitive movements of the hands and wrists coupled with static contraction and periods of continuous gripping of the steering wheel. They would also be exposed to vehicle vibrations. The diameter of the cushion on the steering wheel resulted in an increased grip and extended thumb.

The worker representative relied on additional information, resource materials and studies that posit opinions on significant risk factors for the development of musculoskeletal disorders that include repetition with inadequate rest, awkward or static postures, high forces, vibration, contact stress and prolonged/extended hours of exposure. Specific reference was made to several Workers’ Compensation Appeals Tribunal (WCAT) and Workplace Safety and Insurance Appeals Tribunal (WSIAT) decisions in support of the position the worker’s job duties are a significant contributing factor that led to the development of their right wrist carpal tunnel syndrome injury.

Significant weight was placed on the Health Clinic A reports dated May 29, 2024 and July 24, 2024 that concluded the worker’s duties was likely an important factor in causing their carpal tunnel. It was put forth the worker was exposed to continuous grasping and vibration that could contribute to causing their right wrist carpal tunnel syndrome injury. The worker does not have any predisposing medical conditions such as diabetes, thyroid disorders, neurological conditions or a history of prior wrist trauma that would explain the development of their right wrist carpal tunnel syndrome condition. In the absence of this evidence, there is nothing other than their work duties that is the significant contributing factor to the development of their right wrist carpal tunnel syndrome condition.

The worker representative submits the rescission of initial entitlement appears to rely on an overly narrow interpretation of causation and fails to recognize the cumulative impact of prolonged gripping, repetitive hand movements and vibration exposure during the worker’s employment. The medical evidence submitted to the case record and the additional resource materials all support the worker’s duties as a long-haul truck driver is the significant contributing factor to their right wrist carpal tunnel syndrome injury.

It was put forth any suggestion that the medical literature is unsettled or inadequate is inaccurate. The following is a summary of the worker representative’s additional reference materials:

• Locomotor Diseases Among Male Long-Haul Truck Drivers and Other Professional Drivers, Anker Jensen, Linda Kaerlev, Finn Tuchsen, Harald Hannerz, Soren Dahl, Per Sabro Nielsen and Jorn Olsen, published July 2008 (7):821-827. This article documents the objective of this study was to determine high risks for locomotor disease for bus and truck drivers in general however, little is known about the specific risks of long-haul truck drivers (my emphasis).
• Cumulative Trauma Disorder, Vern Putz-Anderson (edited), 1988 (1^st edition), republished December 13, 2017. This article examines the development of cumulative trauma disorders in workers performing hand-intensive jobs that are associated with repeated or sustained exertion in awkward or static postures or with a high concentration of stress in the upper extremities. Only the abstract is available and the content associated with this book is out of print and no longer available for purchase.
• Movement of the wrist and the risk of carpal tunnel syndrome: a nationwide cohort study using objective exposure measurements, Christina Bach Lund, Sigurd Mikkelsen, Lau Caspar Thygesen, Gert-Ake Hansson and Jane Frolund Thomsen, August 2019, 76(8):59-526. The objective of this study was to determine the association between work-related wrist movements and carpal tunnel syndrome in 30 jobs that included office work, child care, laundry work and slaughterhouse work. It was concluded jobs with high levels of wrist movement were associated with an increased risk of carpal tunnel syndrome. There was a clear exposure-response association between wrist angular velocity and carpal tunnel syndrome. These patterns were different for men and women. Jobs with high levels of wrist movements included cleaning, laundry work and slaughterhouse work.
• Work-related musculoskeletal disorders: the epidemiologic evidence and the debate, Laura Punnet and David H. Wegman, February 2004, 14(1):13-23. This abstract examines the controversy between epidemiological principles and gaps in scientific literature. The physical ergonomic features of work frequently cited as risk factors for musculoskeletal disorders include rapid work pace, repetitive motion, forceful exertions, non-neutral body postures and vibration. However, some dispute the importance of these factors. While the available epidemiological evidence is substantial, it is confirmed it could benefit from more longitudinal data to better evaluate gaps in knowledge concerning latency of effect, natural history, prognosis and potential for selection bias in the form of the healthy worker effect. There is no gold standard and exposure assessments have been limited to crude indicators such as job title.
• Optimal work-rest cycles for an isometric intermittent griping task as a function of force, posture and grip span, Mahmut Eksioglu, February 2006, 10;49(2):180-201. The aim of this study was to investigate acceptable contraction frequencies (i.e., work-rest cycles) for an isometric-intermittent handgrip task as a function of grip span, applied force and shoulder posture using psychophysical and physiological approaches in approximately 12 healthy males as subjects. The results indicate that subjects work faster with a narrower grip span in comparison to working with the optimal and the wider spans.
• Grip force on steering wheel as a measure of stress, Sahar Y. Elbaum, June 6, 2021. This article examines the relationship between driver performance and stress usually characterized by stressful or careless driving. The aim of the research was to examine whether grip force can be used as a useful measure of stress in driving tasks. Approximately 21 participants took part in the study, male between the ages of 24 and 34. The purpose of this study was to determine the extent of which grip force serves as an additional index of stress in driving.
• The quantitative evaluation of the relationship between the forces applied to the palm and carpal tunnel pressure, Kazutoshi Kubo, Mayo Clinic, published January 3, 2018. This article examines the etiology of carpal tunnel syndrome which is not fully understood. It has been identified that forces applied to the palm would affect the carpal tunnel, however, the quantitative relationship between palmar contact force and carpal tunnel pressure is not known. The study was performed on eight human cadaveric hands that involved the use of a custom made device to apply forces to the palm for the desired carpal tunnel pressure.
• The WCAT Decision No. 268 released on February 20, 1987 that allowed entitlement to a right tennis elbow injury arising from the intense physical labour involved that included moving boxes, materials and equipment in and out of the storeroom and in and around the department. The Panel found the worker’s continuous lifting of boxes and materials were particularly strenuous for this female worker who was not used to such activities that involved repeated and forceful wrist extensions and intense muscular activity involving strong hand grasps. The worker was exposed to direct trauma to the right epicondyle. The worker’s testimony confirmed they experienced a change in jobs to a full-time sales section head that involved a large amount of physical labour. The worker’s predecessor left the position twice and provided testimony in support of the worker’s description of the heavy nature of the physical work that involved handling heavy stock approximately 75 percent of the shift. The stock orders came in large cartons left on the main aisle floor. The worker had to physically move the items by hand and store them at various spots in the store, shelves, or stack them in the stock room. Items weighed up to 50 pounds and typically performed by part-time male students. When the work took on the job in September 1982, they did not have a male student to perform the lifting. The worker took over all the lifting and moving of the stock previously performed by the male sales section head and two part-time male students.
• The WCAT Decision No. 42/89 released on September 20, 1989 that allowed entitlement to the worker’s heart attack.
• The WCAT Decision No. 280 and Decision No. 802 that examines the reliance on the test of a significant contribution in rendering a decision on the causative issue.
• The WSIAT Decision No. 1614/13 released on December 31, 2013 that allowed entitlement to a permanent aggravation of the worker’s underlying lower back degenerative disc disease. The Panel found the work duties that involved training the students, handling shells that weighed 800 pounds and transporting the shells to the school permanently aggravated the worker’s pre-existing asymptomatic lower back condition.
• The WSIAT Decision No. 1614/13R released on August 5, 2014. In this decision, the Vice-Chair denied the employer’s request for a reconsideration of the WSIAT Decision No. 1614/13 that found the worker’s activities rendered their underlying lower back degenerative condition symptomatic.
• The WSIAT medical discussion paper, Carpal Tunnel Syndrome, prepared by Dr. Graham, MD, FRCSC, Head, University Health Network and University of Toronto Hand Program published February 2000, Revised May 2001 and Illustrations added March 2003, that examines the controversy about the role of vibration exposure in the etiology of carpal tunnel syndrome. This document states that there is reason to consider a possible etiological connection between exposure to vibration and carpal tunnel syndrome given a reasonable duration and extent of exposure. Despite this finding, it is still unknown as to how much exposure constitutes a threshold beyond which the relationship should be held to exist.
• The Administrative Practice document, Initial Entitlement (Disablement), published January 2005 that provides the decision-maker with guidelines to examine conditions that emerge gradually over time.

Employer Representative Submissions

In a submission attached to the Respondent Form dated January 22, 2025, the employer representative agrees with the Eligibility Adjudicator’s reconsideration decision letter dated September 29, 2023 that denied initial entitlement to a right wrist carpal tunnel syndrome injury. The employer representative does not dispute the worker works 11 to 13 hours per day, six days per week. Where the employer representative disagrees is the worker’s duties that predominantly consists of driving the long-haul truck does not involve repetitive and forceful hand activities and vibration for a reasonable duration. While the steering wheel is padded and ergonomically correct, it does not equate to the amount of force and degree of wrist flexion required to consider it to be a significant contributing factor to the onset of the worker’s right wrist carpal tunnel syndrome condition.

The employer representative also relied on the previous submission dated September 13, 2023. In this submission, the previous representative prepared a chronological summary of the case evidence and relied on the medical discussion paper prepared for the Alberta Workers’ Compensation Board, Diagnosis, Causation and Treatment for Carpal Tunnel Syndrome: An Evidence-Based Assessment, Dr. Bruce Fisher MD, Dr. Ron Gorsche, MD, Patricia Leake, Master of Public Policy, published May 2004 and the WSIAT medical discussion paper, Carpal Tunnel Syndrome, prepared by Dr. Graham, MD, FRCSC, Head, University Health Network and University of Toronto Hand Program, published February 2000, Revised May 2001 and Illustrations added March 2003. It was posited these additional medical reference documents support the etiology of carpal tunnel syndrome is multi-factorial and includes many non-work-related activities and medical conditions. The worker’s body mass index of 61 is a significant risk factor and precursor for the development of carpal tunnel syndrome. Specific reference was made to the following excerpted statements:

Alberta Workers’ Compensation Board, Diagnosis, Causation and Treatment of Carpal Tunnel Syndrome: An Evidence-Based Assessment, Dr. Bruce Fisher, MD, Dr. Ron Gorsche, MD, Patricia Leake, Master of Public Policy, May 2004

The work-relationship criteria includes one or more of the following:

• frequent, repetitive use of the same or similar movements of the hand or wrist (>1,000/hr)
• regular tasks requiring the generation of high force by the hand (grip > 20 lbs, pinch > 8 lbs)
• regular or sustained tasks requiring awkward hand positions (e.g., extreme range of radial or ulnar deviation)
• regular, frequent use of vibrating tools
• frequent or prolonged pressure over the wrist or base of the palm
• cold temperature exposure in the work environment
• high force, high repetition, posture and duration may have a synergistic effect

WSIAT medical discussion paper, Carpal Tunnel Syndrome, prepared by Dr. Graham, MD, FRCSC, Head, University Health Network and University of Toronto Hand Program, published February 2000, Revised May 2001 and Illustrations added March 2003

• The role of vibratory exposure in the etiology of carpal tunnel syndrome is unclear.
• The available literature does not satisfy these criteria and so a definitive relationship between exposure to vibration and the development of carpal tunnel syndrome has not been proven.
• What remains unknown is how much exposure constitutes a threshold beyond which this relationship should be held to exist.
• Systemic pathologies or conditions that increase intra-tunnel pressure (local edema, pregnancy, obesity, diabetes mellitus, thyroid dysfunction and arthritis).

It was pointed out the employer’s Physical Demands Analysis report on file does not provide evidence to support any occupational risk factors present such as repetitive, forceful, awkward wrist postures with minimal opportunity for rest and recovery. There is no fine and firm frequent and repetitive grasping. There is also nothing to support the vibration is the sole occupational cause for the development of the worker’s right wrist carpal tunnel syndrome condition. Despite using both hands for steering, the worker did not have similar symptoms or problems with the uninjured left wrist/hand and rebuts any relationship between the job activities of driving, operating the steering wheel and vibration and the development of a unilateral right wrist carpal tunnel syndrome injury only. This should automatically rebut any argument on causation.

Since the worker is claiming entitlement to a right wrist carpal tunnel syndrome injury on a disablement basis due to the general job duties of a long-haul truck driver, the presumption clause under section 13(2) of the Workplace Safety and Insurance Act, 1997 does not apply and the onus is on the worker to demonstrate how the condition arose out of and in the course of their employment.

Based on the above, the employer representative submits there is no evidence to support there were occupational risk factors associated with the worker’s duties that contributed to the development of their right wrist carpal tunnel syndrome condition and requests the decision to deny initial entitlement not be disturbed.

Findings

Criterion 4: Personal Work-Related Injury

I find the evidence does not support personal work-related injury to the worker’s right wrist region.

To establish whether the worker’s right wrist injury arose out of their employment, it is necessary to examine the specific mechanics of how they performed the work duties of a long-haul truck driver with this employer. It is not enough that an injury occurs in the course of employment. There must be some injuring process, which is part of the worker’s employment, to establish their right wrist injury arose out of their employment.

In my review of this issue, I first examined the worker’s evidence regarding their body motions, forces and frequency of hand and wrist movement to drive the long-haul truck summarized below:

• In the Worker’s Report of Injury/Disease (Form 6) dated August 8, 2022, the worker documented they developed numbness and pain in the right wrist and hand shortly after they started working for the employer. They work typically six days per week driving a long-haul truck from 11 to 13 hours per day using both hands and wrists consistently throughout each shift.
• In telephone conversations with the Customer Service Representative and the Eligibility Adjudicator on August 10, 2022, the worker reported they developed right wrist symptoms in June/July 2020 that progressively worsened over two years. They use both hands and wrists consistently all day. In their previous job, they only worked four to five days per week, less hours and had less deliveries to make.
• In a telephone conversation with the Case Manager on August 17, 2022, the worker confirmed they drive an 18-wheeler. They hold the steering wheel for 11 hours per day. Someone else does the loading and unloading of the truck. The worker also hooks up the trailer and does safety inspections.
• In the Health Clinic A report dated May 29, 2024, the physician documented the worker reported they sit in the truck for hours driving. They did not load the truck. There were relatively infrequent stops and they drove, on average, from seven to 13 hours per day. They have a 30 minute break but often missed it. The truck is automatic. They used both hands on the padded steering wheel to drive the truck. There was vibration and constant gripping of the wheel to make frequent turns. They worked for another transportation company performing long-haul driving prior to being hired with this employer. They described there were more frequent stops made and more breaks from continuous driving.
• In the Health Clinic A report dated July 24, 2024, the ergonomist completed an interview with the worker over the telephone on July 11, 2024. The worker described their primary job tasks involved driving an automatic truck using both hands on a padded steering wheel. Their breaks were often spent doing things like dropping off the trailer, getting fuel and sitting at the border. Fifty percent of the loads were drop and hook where the worker would crank down the dolly and hook up the line. The other loads were live loads where they would have to wait for someone to load and unload the trailer with the items.

The worker’s evidence is largely consistent with the employer’s evidence about their work duties.

Both the worker and employer representatives ably presented their arguments. The worker and employer representatives do not dispute the worker’s description of their duties and tasks while performing their pre-injury work duties as a long-haul truck driver. The worker representative relied upon a significant amount of medical research documents and case law materials in support of the position the worker’s duties are the significant contributing factor to the development of their right wrist carpal tunnel syndrome condition. The employer representative rebuts this position and relied on medical discussion papers that support there are no occupational risk factors present such as repetitive, forceful, awkward wrist postures with minimal opportunity for rest and recovery. There is also no fine and firm frequent and repetitive grasping and nothing to support the vibration is the sole occupational cause for the development of the worker’s right wrist carpal tunnel syndrome condition.

I considered all the case law decisions previously summarized on page five of this decision. In my examination of these decisions, I find they were not helpful because they are distinguishable from the facts and circumstances in this worker’s case. I am also not bound by the findings and conclusions reached in these decisions as it relates to the case before me.

The worker representative contends any suggestion that the medical literature relied upon is unsettled or inadequate is inaccurate. I am unable to agree with this position. I accord little weight to this additional medical literature because the majority of the studies are limited, required more longitudinal data, acknowledged the controversy between epidemiological principles and gaps in scientific literature, scientific bias, selection bias, and the unknown quantitative relationship between palmar contact force and carpal tunnel pressure. I find it significant the conclusions and opinions reached in these medical reference documents were based on a limited population or group that included 12 healthy male subjects to examine grip task as a function of force, 21 males between the ages of 24 and 34 to examine grip force on a steering wheel as a measure of stress while driving and not a musculoskeletal disorder, examined wrist movements in workers employed in office work, child care, laundry work and slaughterhouse and eight human cadaveric hands to examine the quantitative evaluation of the relationship between the forces applied to the palm and carpal tunnel pressure. I note one medical reference document is no longer available for purchase and out of print (Cumulative Trauma Disorders, Vern-Putz-Anderson, December 13, 2017) and only the brief abstract is available for view. I am unable to reconcile how a medical reference document can be relied upon when it is no longer available for purchase, out of print and unavailable to review anything beyond the limited abstract. I find it is difficult to accept the conclusions reached in all these studies. There is simply no gold standard and a lack of reliable data about the frequency, forces, motions and duration of activities to perform long-haul truck driving duties.

The employer representative correctly pointed out the statutory presumption set out in section 13(2) of the Workplace Safety and Insurance Act, 1997 does not apply to an injury by disablement. To be granted initial entitlement, it must be proven that the personal injury by accident both arose out of and in the course of employment. The worker representative also correctly pointed out the significant contributing factor test is applied to questions of causation. The issue before me is whether the worker’s job duties as a long-haul truck driver contributed significantly to the development or onset of their right wrist carpal tunnel syndrome condition. This test does not require their job duties to be the predominant or sole cause. On this issue, I find the evidence does not establish, on a balance of probabilities, that the worker’s right wrist carpal tunnel syndrome arose out of and in the course of their employment.

I acknowledge the worker’s position they work up to 13 hours per day, six days per week. I also accept the worker has several opportunities during the course of a workday to take breaks that include sitting in the truck for up to 1.5 hours while waiting for someone else to load the trailer on live loads, performing truck inspection, hooking the line, preparing reports and sitting at the border waiting to cross over. While the worker maintains their position they rarely took their 30-minute break, there are plenty of times the worker was not exposed to any driving duties. In coming to this conclusion, I relied on the employer’s Physical Demands Analysis report that documents the following non-driving tasks:

• at the beginning of every shift when they perform truck inspections and hooking up the line for a loaded trailer
• at the beginning of the shifts when they have to sit and wait in the truck for up to 1.5 hours when a live load is being loaded by someone else
• waiting in the truck once they arrive to the destination and the trailer is being loaded by someone else
• inspection of the trailer once the load is unloaded
• fuelling up the truck and finish off paperwork on the completed shift at the facility

I find the worker is not exposed to any repetitive, frequent, forceful and/or awkward wrist positions on a continuous basis while driving an automatic long-haul truck. There is also no substantive reliable evidence to support the worker was exposed to an unreasonable extent and duration of vibration while driving. This particular finding is not in dispute and reflected in the Health Clinic A report dated July 24, 2024. In this report, the ergonomist opined the use of the padded steering wheel may increase or decrease the gripping forces needed to operate the steering wheel and decrease the vibration from the wheel (or not). The medical reference documents pertaining to vibration is rather limiting and potentially conflicting. In my view, the worker’s exposure to vibration through the steering wheel was not severe, unreasonable or at a degree of intensity and duration. I also find the pictures that show the worker’s wrist positioned on the padded steering wheel helpful because it does not show the wrist posture in a flexed or highly extended or awkward position. While the ergonomist pointed out the worker’s “thumb extends out quite a bit,” I do not see this reflected in the picture. There is nothing in the picture that depicts the worker exerting physical forces on the padded steering wheel.

I accord the greatest amount of weight to the employer’s Physical Demands Analysis report because it is consistent with the worker’s evidence about the nature and characteristics of their job duties as a long-haul truck driver. In this report, the worker is only required to lift to secure the bungee cords, inspect the engine or pick up something that fails to unload. Anything that is heavy or bulky is done with equipment. A simple grasp is required for driving and the only repetitive activity is the use of the foot to drive, brake and use the clutch. The worker has multiple non-driving periods of time during the course of their day while at the loading facility, unloading the items at the destination and post-trip inspection. They also have the opportunity to alternate their hands and arms to rest on the door frame/window or gears/arm rest while driving or sitting idle waiting to cross the border. I also note the worker would have to, at the very least, take a break to use the washroom during the course of an 11 to 13 hour workday. It would be patently unreasonable to accept this worker sat in their truck continuously all day without the need to stop and use the washroom facility during the course of a workday. The worker is not exposed to work activities that involve handling medium to heavy loads, constant lifting, firm cylindrical grasps or fine repetitive finger movements on a frequent basis throughout their workday. I find the worker’s gripping of the steering wheel did not rise to the level and amount of repetitive and forceful use to the degree necessary to be a significant contributing factor in the development of their right wrist carpal tunnel syndrome condition. I accept that the majority of the worker’s workdays were spent driving with brief and sporadic wrist postures yet no tasks using hand or wrist motions repeatedly and continuously with significant force.

In my view, the evidence before me does not support a conclusion that the worker’s duties while driving involved significant, repetitive, frequent and forceful flexion, extension, ulnar deviation or radial deviation of the right hand or the wrist. The worker maintains a predominantly neutral posture while operating the long-haul truck. I acknowledge the worker’s sincerely held belief their right wrist carpal tunnel syndrome is related to their employment duties. While I am empathetic to this position, I find the weight of the evidence does not establish a work-related association between the worker’s duties and the development of personal work-related right wrist injury.

It is instructive the ergonomist also reviewed the employer’s Physical Demands Analysis report that documented the worker is rarely exposed to instances of lifting, pushing or pulling. They are exposed to simple grasping and sitting while driving and operating the steering wheel. I note the ergonomist’s examination of the Physical Demands Analysis report is silent on all other aspects of the worker’s job duties and preferred to rely on extensive medical reference documents which I have already determined to be of little significance.

I considered the worker representative’s argument that the absence of any other known non-occupational risk factors means the worker’s right wrist carpal tunnel syndrome is work-related. It was argued that there were no demonstrable pre-existing or underlying medical conditions in the present case which would outweigh the occupational factors. It must be concluded that the worker’s right wrist carpal tunnel syndrome is work-related. I am unable to agree with this position. It is instructive the Board is not required to establish that the worker’s right wrist injury was due to some other cause. Rather, the issue to be resolved is whether there is sufficient evidence to establish the requisite cause-and-effect relationship between the worker’s employment and their right wrist injury. I have determined this has not been met for the rationale previously documented on pages nine to 10 of this decision.

I conclude the third criterion in the OPM Document No. 11-01-01 – Adjudicative Process – has not been established as there is no evidence of personal work-related right wrist injury. I am not convinced, on the balance of probabilities, that the worker’s job duties of driving a long-haul truck that required gripping the steering wheel or vibration is a significant contributing factor in the development of their right wrist carpal tunnel syndrome condition.

Criterion 5: Compatibility of Diagnosis to Accident or Disablement History

I find medical compatibility does not exist between the diagnosis of a right wrist carpal tunnel syndrome and the worker’s duties as a long-haul truck driver.

The worker representative placed significant weight on appeal decisions, medical reference documents and assessments by the physician and ergonomist at Health Clinic A in support of the position the diagnosis of right wrist carpal tunnel syndrome is compatible with the worker’s duties as a long-haul truck driver. I have already determined the appeal decisions, medical reference documents and assessment by the ergonomist at Health Clinic A. are limited and of little probative value. There is no need to revisit previously resolved matters.

I acknowledge the physician at the Health Clinic A relied extensively on the ergonomist’s report dated July 24, 2024 to reach the conclusion the worker’s driving could quite conceivably play a role in the development of their right wrist carpal tunnel syndrome condition. For this reason, I am unable to accord any weight to the medical opinions expressed by the physician because they are grounded in medical reference documents and the ergonomist’s assessment I have already determined to be limited.

The issue of medical compatibility hinges on the establishment of personal work-related injury in the OPM Document No. 11-01-01 – Adjudicative Process. I have already found there is no evidence of personal work-related right wrist injury. Since I have found the worker’s duties as a long-haul truck driver are not the significant contributing factor for the development of their right wrist carpal tunnel syndrome condition, the issue concerning medical compatibility between the diagnosis and disablement history cannot advance.

CONCLUSION

I conclude initial entitlement to a right wrist carpal tunnel syndrome injury is denied.

The objection is denied.

DATED February 18, 2025

S. Johnson Appeals Resolution Officer Appeals Services Division