The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

An Appeal Panel hearing was held on January 11, 2001, at the request of the employer. The Panel discussed this appeal on January 11, 2001.

Issue

Whether or not the employer is entitled to cost relief.

Decision

That the employer is not entitled to cost relief.

Background

On November 25, 1998, the claimant filed an application for compensation benefits indicating that he was unloading freight from air cans. When he attempted to lift a heavy box he felt a sharp pain in his groin. The claimant was employed as a part-time sorter/unloader at the time of the accident. The injury date was recorded as October 24, 1998 and was reported to the employer on the same day. The injury was with respect to his right testicle.

The claimant sought medical attention at a local hospital on October 24, 1998. The claimant provided a history of lifting heavy boxes at work and since then he experienced pain to his right groin and testicle. There was no lump or urinary symptoms. A diagnosis of "traumatic epididymitis" was reported by the emergency physician.

A Doctor's First Report dated February 3, 1999 (date of first visit was December 23, 1998) noted that the claimant was lifting heavy boxes at work on October 24, 1998 and hurt his right groin. The diagnosis was "strain groin".

The case was reviewed by a Workers Compensation Board (WCB) medical advisor at the request of primary adjudication on February 11, 1999. The medical advisor provided the opinion that the current diagnosis was an unspecified groin injury. The medical advisor confirmed there was a cause and effect relationship between the claimant's current diagnosis and his work injury.

An Occupational Health/Fitness Assessment Form dated March 8, 1999 noted, in part, "adductor muscle strain groin made worse by twisting and bending at hip and waist."

A WCB medical advisor examined the claimant on April 1, 1999. The differential diagnoses included an indirect hernia on the right hand side, right sided sacroiliac strain and an adductor strain, which was reported to be "quite low on the list based on today's examination." A referral to a general surgeon or a urologist was suggested.

The next report was received from a general surgeon dated December 29, 1998. He reported that the claimant was seen on December 23, 1998 because of right groin pain since October 24, 1998. According to the specialist, the claimant developed right groin pain and right testicular pain after lifting heavy boxes at work on October 24, 1998. The claimant was treated for epididymitis by an emergency room physician who prescribed Tetracycline and Tylenol #3. The claimant then developed severe pain on December 22, 1998. When assessed at the hospital, the specialist indicated that he could not detect any groin hernia and therefore he treated the claimant as having a right groin strain.

A report was received from another specialist dated April 6, 1999, which indicated that the claimant had been assessed on March 3, 1999 and March 17, 1999. On March 3, 1999, it was felt that the claimant had a chronic right groin strain over his proximal right thigh adductor muscles. When seen on March 17, 1999, the claimant stated that he felt much the same with no perceived improvement with respect to his right groin discomfort.

On April 22, 1999, another specialist wondered whether the claimant had a subtle right inguinal hernia, but he could not find any obvious genitourinary pathology.

On July 6, 1999, a WCB physical medicine and rehabilitation consultant assessed the claimant. The clinical examination showed localized tenderness appearing to be in the area of the hip adductor and hip flexor tendons at the groin. An x-ray of the hip and pelvis and a bone scan of the right hip area was suggested.

The impression of a bone scan performed September 7, 1999, read: "Normal regional bone scan." X-rays of the pelvis and both hips taken September 7, 1999 revealed: "Minor subchondral sclerosis of the superior acetabular margins bilaterally. Possibly this may be related to early degenerative change. No other abnormality is seen."

On February 7, 2000, the employer requested that the WCB provide a letter outlining the claimant's initial diagnosis together with a review of its claim regarding cost relief. On February 15, 2000, the employer was informed by the WCB that the claimant had been initially diagnosed with a strain to his right groin and based on the mechanism of injury of October 24, 1998, the WCB therefore accepted responsibility for his claim. The employer's request for cost relief was denied.

On May 29, 2000, the employer appealed the decision concerning cost relief. The employer considered the length of time it took for the claimant's injury to resolve, the lack of concrete medical findings to support a conclusive diagnosis and the non-compensable degenerative condition located on x-rays was more than enough to grant its application for cost relief. The case was referred to Review Office for consideration.

On June 8, 2000, Review Office referred the case to a WCB orthopaedic consultant for review. The consultant provided his opinion that a pulled groin muscle, i.e. strain, was the diagnosis most consistent with the effects of the October 24, 1998, work place injury. "Traumatic" epididymitis was unlikely. In the opinion of the consultant, it was not unusual for problems to present for this length of time. There were no identified pre-existing condition contributing or delaying the claimant's recovery from his work place injury.

In a decision dated June 16, 2000, Review Office confirmed that the employer was not entitled to cost relief. Review Office indicated it was unable to establish that a pre-existing condition had contributed or prolonged the claimant's disability, which resulted from his compensable injury. On September 18, 2000, the employer disagreed with Review Office's decision and an oral hearing was arranged.

Reasons

WCB policy 31.05.10 outlines the circumstances in which cost relief is made available to eligible employers. The provision upon which the employer is relying in the present case reads as follows: "Where the claim is either caused by a pre-existing condition or is significantly prolonged by the pre-existing condition."

We find that the weight of evidence does not support the employer's contention that the claimant's pre-existing degenerative hip condition prolonged the recovery of his compensable injury. In light of this finding, the employer is not entitled to cost relief. Consequently, the appeal is hereby dismissed.

Panel Members

R. MacNeil, Presiding Officer
A. Finkel, Commissioner
B. Leake, Commissioner

Recording Secretary, B. Miller

R. MacNeil - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 9th day of February, 2001