Decision #82/01 - Type: Workers Compensation

Preamble

An Appeal Panel hearing was held on May 10, 2001, at the request of a worker advisor, acting on behalf of the claimant. The Panel discussed this appeal on May 10, 2001.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is acceptable.

Background

On June 12, 2000, the claimant submitted an application for compensation benefits in which he related his bilateral carpal tunnel syndrome to his employment activities as a truck driver.

When speaking to a Workers Compensation Board (WCB) adjudicator on June 28, 2000, the claimant indicated that he had been employed as a long distance truck driver since September 1997. The majority of his job duties were driving and he assisted with the unloading of trucks only about twice a year. He stated that the only repetitive duty was steering the truck. He had had no previous injuries to either of his wrists and was right hand dominant. It was learned that the claimant was 5 foot 8 inches and he weighed 246 pounds. The claimant advised that he did not smoke or consume alcohol and caffeine. The claimant was also a diabetic.

Medical information on file showed that the claimant had undergone left wrist surgery on June 21, 2000 and was scheduled to have right wrist surgery on July 19, 2000. Nerve conduction studies were performed on September 1, 1999 and the report stated, in part, that the claimant had mild bilateral carpal tunnel syndrome. "The left had been tested in 1997 and it was similar to today's test."

On July 4, 2000, the claimant was advised by primary adjudication that his claim for compensation was not accepted as it was felt that his bilateral carpal tunnel syndrome was not directly related to his work activities as a truck driver. On September 26, 2000, a worker advisor disagreed with this decision and submitted a report from an orthopaedic specialist dated September 7, 2000 in support. The worker advisor emphasized the orthopaedic specialist's opinion that the repetitive trauma of the work duties aggravated the carpal tunnel syndrome and that the claimant's work duties caused enhancement of his condition.

In a decision dated October 20, 2000, Review Office determined that the claim was not acceptable. Review Office indicated that the case was referred to a WCB orthopaedic consultant for an opinion as to whether or not he felt that grasping of a truck's steering wheel could be the cause of the claimant's bilateral carpal tunnel syndrome (CTS) wrist condition. The consultant responded as follows:

    "Diabetes mellitus is a risk factor for Carpal Tunnel Syndrome. The commonest cause of Carpal Tunnel Syndrome is a non-specific tenosynovitis of the flexor tendons within the Carpal Tunnel. The grasping of a vehicle steering wheel would not give rise to a tenosynovitis and hence a Carpal Tunnel Syndrome."

Review Office was of the opinion that the claimant's job was not one which would produce the type of significant wrist trauma one would expect to see in attempting to draw a relationship between the employment activities and the diagnosis of CTS. It was noted that long distance truck driving involved lengthy periods of highway driving where there was little wrist activity required to guide the wheel in order to keep the vehicle within its lane. Review Office concluded the claimant's job description was very similar to the activity risks one would incur in normal daily living, and it felt that there was not enough trauma incurred by the job duties to either produce or aggravate a condition of bilateral CTS. Review Office was of the position that the claimant's non-work related risk factors greatly outweighed any employment risk factors and the development of bilateral CTS. In February 2001, the worker advisor appealed Review Office's decision and an oral hearing was convened.

Reasons

Section 4(1) of The Workers Compensation Act (the Act) provides for the payment of compensation benefits to a worker where he or she sustains personal injury by accident arising out of and in the course of employment.

“Where, in any industry within the scope of this Part, personal injury by accident arising out of and in the course of the employment is caused to a worker, compensation as provided by this part shall be paid by the board out of the accident fund, subject to the following subsections.”

In accordance with this section, the Panel must, initially, be satisfied that there has been an accident within the meaning of Section 1(1) of the Act. That is, “a chance event occasioned by a physical or natural cause; and includes

(a) A wilful and intentional act that is not the act of the worker,

(b) any

(i) event arising out of, and in the course of, employment, or

(ii) thing that is done and the doing of which arises out of, and in the course of, employment, and

(c) an occupational disease and as a result of which a worker is injured.”

The treating physician referred the claimant to a neurologist for nerve conduction testing on September 1st, 1999. According to the neurologist’s chart notes, the claimant presented with a several year history of “intermittent numbness of the left hand more than the right hand, median innervated fingers”. These symptoms bothered the claimant especially at night and sometimes during the day when he was long distance truck driving. The outcome of the nerve conduction studies revealed a mild bilateral carpal tunnel syndrome and the left median nerve variation was apparently similar to that of testing undertaken in 1997.

The file information further reveals that the claimant suffers from diabetes mellitus. The medical community recognizes this disease as a risk factor with respect to the development of peripheral neuropathy and carpal tunnel syndrome.

The claimant underwent surgical decompression for his right carpal tunnel syndrome on June 21st, 2000 and for his left carpal tunnel syndrome on July 26th, 2000. The surgeon, who performed these operations, forwarded a four-page report dated September 7th, 2000 to the claimant’s worker advisor. In that report, he expressed the following comments:

“Mr. [the claimant] suffers from diabetes mellitus which is a known aetiology for peripheral neuropathy. However, his compressive and entrapment neurological signs and symptoms, I feel, are related to his excessive wrist activity which could be caused by his type of work. As his wrist condition required surgical intervention in order to improve his symptomatology, it seems that his case would fall into the Enhancement Category based on your classification.”

We are satisfied based on the evidence that the claimant’s carpal tunnel syndrome was a pre-existing condition. We further find that the claimant’s job duties as a truck driver had, on a balance of probabilities, aggravated the pre-existing carpal tunnel syndrome to the point where surgical intervention became necessary. Accordingly, the claim is therefore acceptable.

Panel Members

R. W. MacNeil, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

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

Signed at Winnipeg this 15th day of June, 2001

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