Decision #30/00 - Type: Workers Compensation
An Appeal Panel review was held on March 7, 1999, at the request of the claimant.
Whether or not the claimant's current left hand problems are causally related to the compensable injury; and
Whether or not responsibility should be accepted for costs associated with the claimant's medical appointment on May 13, 1999.
That the claimant's current left hand problems are not causally related to the compensable injury; and
That responsibility should not be accepted for costs associated with the claimant's medical appointment on May 13, 1999.
In 1994, the claimant submitted a claim for compensation benefits indicating that she experienced tingling in her fingers for the past 2 years which she related to her employment activities as a laundry operator. The claimant was diagnosed with bilateral carpal tunnel syndrome and underwent surgery to both wrists. The claim was accepted by the Workers Compensation Board (WCB) and wage loss benefits were paid accordingly.
On August 8, 1996, the attending physician noted that the claimant was seen on March 8, 1996. At this time, the claimant reported no numbness in her fingers since she had surgery to her left wrist in June of 1995. The claimant, however, did feel burning and pain on the scar area on the volar side of the wrist. She had full motion of the left wrist itself and the wrist joints were painless. The scar remained well healed, although there was some redness and hyperemia. X-rays of the left wrist were noted to be normal. The physician reassured the claimant that the hyperemia and pain about the scar area would subside in time.
On May 3, 1999, the claimant contacted the WCB to report that she was having further difficulties with her left hand. The claimant said she worked in the housekeeping department five days per week, 6 hours per day, with no ongoing complaints. One day at work she was mopping and noticed that she lost all her grip strength in her left hand. This lasted about 5 minutes. The claimant said she thought nothing about it until it happened again. She did not remember the dates as to when these two events occurred. The claimant advised that she was being seen by a specialist in Winnipeg on May 13, 1999.
At the request of the WCB, medical information was received from the orthopaedic specialist whom the claimant saw on May 13, 1999. The specialist noted that the claimant had a sharp pain on the volar aspect of her left wrist on two occasions. Once was one year ago which lasted for 5 minutes while she was mopping at work. The claimant had a similar problem six months ago that lasted 10 minutes that caused her pain about the scar. Along with the pain the claimant felt some numbness in her hand.
Examination revealed a scar from previous surgery for carpal tunnel. The specialist indicated that the claimant had full range of motion in the wrist and that there was no pain. X-rays of the wrist were normal. She was advised to continue with her usual activities as tolerated.
On September 23, 1999, the claimant advised a WCB adjudicator that she was claiming time loss from work to attend the appointment with the specialist along with traveling expenses.
Following consultation with a WCB medical advisor on October 5, 1999, Rehabilitation & Compensation Services advised the claimant that the evidence did not support a cause and effect relationship between the compensable injury and her ongoing left hand symptoms. The claimant was further advised that no responsibility would be accepted for any medical treatment, time loss or medication. On October 12, 1999, the claimant appealed this decision stating that she wished reimbursement for hotel, mileage and meals for her as well as her family with respect to the doctor's visit that took place on May 13, 1999.
In a decision dated November 5, 1999, Review Office noted that the claimant, on her own volition, scheduled an appointment with a Winnipeg specialist for May 13, 1999. The examination findings of that date did not provide any objective evidence to account for the claimant's symptoms and the examination was reported as being normal. A WCB medical advisor also provided the opinion that there was no evidence to support a causal relationship between the claimant's symptoms and the compensable injury. Based on the above commentary, Review Office was unable to accept responsibility for the claimant's left hand problems as they were not considered related to her 1994 compensable injury. There was also no entitlement to reimbursement for any costs associated with the May 13, 1999, medical appointment. On January 19, 2000, the claimant appealed Review Office's decision and a non-oral file review was arranged.
The claimant was last examined with respect to her compensable injury by her treating orthopaedic surgeon on March 8th, 1996. The claimant presented with hyperemia and occasional burning pain on the scar area of her wrist. The surgeon noted that the claimant had full motion of the wrist and that the wrist joints were painless. The claimant was advised "that with time the hyperemia as well as the pain about the scar area should subside as is usually the case.
There was no further medical evidence received on file until the WCB acquired a copy of the treating orthopaedic surgeon's examination notes of May 13th, 1999. He recorded the following comments:
"This lady apparently had a sharp pain on the volar aspect of her left wrist on two occasions. Once, one year ago which lasted for five minutes while she was at work, using a mop. Then again she had a similar problem some six months ago that lasted for about 10 minutes that caused her pain about the scar. Along with the pain she also felt some numbness in her hand. However, this happened only on these two occasions and did not last very long. She has mention of numbness or tingling in her hand. On examination there was a scar from previous surgery for carpal tunnel. She had full range of motion in the wrist. There is no pain. X-rays of her wrist were normal. She was advised to continue to do her usual activities, as tolerated."
We are in agreement with the WCB medical advisor's opinion that there is no evidence of any cause and effect relationship between the claimant's symptoms recorded by the orthopaedic surgeon and her compensable injury. In addition, we note that there had been no referral by the treating physician to the orthopaedic surgeon for the May 13th, 1999 appointment. Accordingly, responsibility should not be accepted for the claimant's costs. The claimant's appeal is hereby dismissed.
R. W. MacNeil, Presiding Officer
A. Finkel, Commissioner
R. Frisken, Commissioner
Recording Secretary, B. Miller
R. W. MacNeil - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 31st day of March, 2000