Decision #129/01 - Type: Workers Compensation
Preamble
An Appeal Panel hearing was held on August 30, 2001, at the request of a worker advisor, acting on behalf of the claimant. The Panel discussed this appeal on August 30, 2001.
Issue
Whether or not the claim is acceptable.
Decision
That the claim is not acceptable.
Background
In March 2000, the claimant submitted an application for compensation benefits in relation to right hand difficulties which she attributed to her employment activities as a compensation advisor, pay and benefit specialist. The claimant described her injury as follows: "Over the past 10 years my right hand has progressively deteriorated. I suffer with swelling, tingling and numbness. I have lost my strength, ability to grasp and hold and the mobility is limited. My sleep is disturbed because of the numbness, tingling and pain up my right arm. I have carpal tunnel in my left hand as well. Due to the degree of C.T. in my left hand Dr. [name] has recommended I purchase and wear a wrist brace."
Subsequent file documentation contained medical reports from the treating physicians and a WCB questionnaire completed by the employer dated April 17, 2000 and from the claimant on April 19, 2000. On May 3, 2000, the claimant provided a WCB adjudicator with details surrounding her medical treatment. The claimant also gave a description of her daily work activities that she felt caused her CTS condition.
On May 26, 2000, a WCB medical advisor reviewed the case at the request of primary adjudication. The medical advisor concurred with the diagnosis of carpal tunnel syndrome. He did not believe that computer work would cause CTS. The medical advisor noted that the claimant had a hypothyroid condition.
On June 28, 2000, the claimant was advised that her claim for compensation was not acceptable as Section 1(1) and 4(1) of the Workers Compensation Act (the Act) had not been met. Primary adjudication was of the view that carpal tunnel syndrome was a condition that could develop from both work related as well as non-work related risk factors. The medical advisor's comments of May 26, 2000, i.e. that computer work would not cause CTS was taken into consideration when rendering the decision. On December 12, 2000 a worker advisor appealed this decision to Review Office.
Prior to considering the appeal, Review Office arranged for a WCB rehabilitation specialist to visit the work site and perform a job analysis of the worker performing her duties. A medical opinion was also sought from a WCB orthopaedic consultant on March 8, 2001.
In a decision dated March 9, 2001, Review Office determined that the claim for compensation was not acceptable. Review Office noted that it was apparent from the clinical examination and Nerve Conduction Studies that the claimant had bilateral CTS that was mild on the left side and severe on the right side leading up to surgery performed on the right wrist. The claimant attributed her condition to the performance of her daily work duties as a compensation advisor, pay and benefits specialist.
Review Office took into consideration the nature of the claimant's employment activities and the fact that the claimant had some non-work related risk factors that were known to cause CTS to develop, i.e. hypothyroidism, smoking, her gender and general age. Review Office did not believe that it had been demonstrated that the claimant's bilateral CTS arose out of and in the course of her employment as a pay and benefits specialist. Review Office found no evidence to support that the claimant's bilateral CTS was enhanced by her employment activities. In conclusion, the evidence had not established that the claimant sustained personal injury by accident arising out of and in the course of her employment. On May 9, 2001 the worker advisor appealed Review Office's decision and an oral hearing was arranged.
Reasons
This case involves a worker who has been diagnosed with bilateral carpal tunnel syndrome. Believing it to be work-related, she filed a claim with the WCB. The claim was not accepted. An appeal to the Review Office was not successful. It is the latter decision that she has appealed to the Appeal Commission.
The issue is whether or not the claim is acceptable.
For her appeal to be successful, the Panel must determine that her injuries arose out of and in the course of her employment, as required by section 4(1) of The Workers Compensation Act.
We were not able to make that determination.
Carpal tunnel syndrome (CTS) is caused by swelling of the tendons that line the carpal tunnel. There are many reasons for developing this swelling of the tendons. It can result from highly repetitive and forceful movements of the wrist during work activities.
As noted in the decisions of both the Adjudicator and the Review Office, there are many other, non-work-related factors which are also known to contribute to the development of CTS. These include: pregnancy, diabetes, menopause, hypothyroidism, arthritis, age, gender, smoking and obesity, among others.
A number of these affect the claimant, including hypothyroidism, age, gender and smoking.
The claimant is employed as a pay and benefits specialist with a large organization. This job involves spending a large part of her day working at a desktop computer. However, it was noted from her testimony and from a workplace assessment that she does not spend all day typing on a keyboard. Her day is broken up by other tasks, including retrieving information from filing cabinets and/or binders; answering phone calls; and going to a front counter to deal with clients.
There remains considerable debate in medical literature as to what work factors may cause CTS. Occupational factors most commonly reported to be associated with CTS include forceful and repetitive hand motions, awkward positions, mechanical stress at the base of the palm and vibration. It is generally conceded that the greatest frequency of occupationally-related CTS is found where job duties involve high force and high repetition.
It was argued by the claimant and her advocate that the job of typing on a keyboard is a repetitive task, which involves awkward hand positions that place stress on her wrist and palms. There is no consensus that typing on a keyboard is a cause of CTS. While, in some specific occupations, typing on a keyboard may be highly repetitive, it, invariably, involves low force. In reviewing the claimant's testimony, as well as the file, we find that her job is reasonably repetitive, with moderate volumes of typing on a keyboard and a variety of tasks that take her away from computer use. However, her job involves a minimum of mechanical stress and force.
For the foregoing reasons, we have concluded that, on a balance of probabilities, her carpal tunnel syndrome is not work-related and, thus, does not meet the test required by section 4(1) of the Act.
Accordingly, the appeal is dismissed.
Panel Members
T. Sargeant, Presiding Officer
A. Finkel, Commissioner
B. Leake, Commissioner
Recording Secretary, B. Miller
T. Sargeant - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 19th day of October, 2001