Decision #160/01 - Type: Workers Compensation

Preamble

An Appeal Panel hearing was held on November 21, 2001, at the request of a union representative, acting on behalf of the claimant. The Panel discussed this appeal on November 21, 2001.

Issue

Whether or not the claim is acceptable.

Decision

That the claim was acceptable.

Background

On December 3, 2000 the claimant filed an application for compensation benefits indicating that he had carpal tunnel in both hands.

A Workers Compensation Board (WCB) adjudicator contacted the claimant by phone on January 2, 2001, and the following information was obtained:

  • The claimant has been with his employer since 1979. For the past 15 years he has worked as a truck driver driving a 5-ton truck. The claimant is right hand dominant.
  • For the past 7 years the claimant described his job duties as follows: he lifts bags of inedibles onto his truck which weigh approximately 80 to 100 lbs.; he rolls barrels weighing approximately 300 lbs. by hand onto his truck; lifts and folds the tail gate of his truck which weighs about 150 lbs.; shoveling; washing truck with hose; maneuvers vats by pushing them off a hoist onto truck, then pushing them 20 feet into truck. The vats weigh 500 lbs.
  • The claimant indicated that he drives alone, inside and outside of the city.
  • His right hand has bothered him for the last 2 years, more so over the last year. His left hand started to bother him within the last year.
  • In the spring of 2000, the claimant said his foreman was made aware of his bilateral hand difficulties. The claimant was not sure if a cause was mentioned.
  • With respect to medical treatment, the claimant indicated that he sought medical attention in March 2000 and was then referred to a specialist.
  • The claimant indicated that he performed his regular duties as a truck driver until September/October 2000 when his truck was taken off the road because its engine blew. He then worked in the plant as a cooker and his duties involved lots of shoveling and washing up.

On January 4, 2001, the claimant's foreman was contacted. The foreman indicated that the claimant had complained about both wrists and his back for the past 1- years. He confirmed all of the duties described by the claimant, except for the vats, which the foreman said, were empty and weighed 100 lbs. He did not recall the claimant mentioning what caused his wrist difficulties. Contact was also made with several of the claimant's co-workers who confirmed that they were aware of the claimant's hand difficulties.

Further information was obtained from the claimant's foreman on January 12, 2001 with regard to the claimant's job duties. He stated that the claimant would handle about 50 bags per shift. One day a week he would handle 30-40 barrels and other days a couple of barrels. The claimant would handle about 10 vats per shift and would spend approximately 5 hours driving and 3 hours loading/unloading per shift.

On January 3, 2001, the claimant's attending physician indicated that the claimant was seen in March 2000 for his wrist problem but there was no indication on his notes that it was work related.

Nerve conduction studies dated April 5, 2000 confirmed bilateral carpal tunnel syndrome, mild to moderate on the left and severe on the right.

A consultation report was obtained from the claimant's treating orthopaedic surgeon dated September 27, 2000. He noted that the claimant was seen for long-term right hand numbness, worse at night. The claimant related his difficulties to his previous job in which he had to lift heavy bags. X-rays of the right wrist were normal and nerve conduction studies showed severe right carpal tunnel syndrome. Plans were made for the claimant to undergo a right carpal tunnel release.

A WCB medical advisor reviewed the case on January 15, 2001. The medical advisor was of the opinion that the claimant's work activities would involve episodic repetitive movements of the hands and wrists, which were not consistently putting the wrists at extreme flexion and extension. The medical advisor did not believe there was a causal relationship between the claimant's work activities and carpal tunnel syndrome.

Taking into consideration the information obtained from the claimant and employer as well as the medical opinions/reports on file, it was the opinion of Rehabilitation and Compensation Services, that it could not be established that the claimant's work activities were the direct cause of his bilateral wrist difficulties. The claimant was advised that his claim for wage loss benefits and medical aid benefits had been denied in a decision letter that was dated January 17, 2001.

On March 21, 2001, a union representative appealed the above decision to Review Office. The union representative argued that a comprehensive review of the claimant's job demands had not been performed. She stated that in her opinion the demands of the claimant's employment, which involved lifting of significant weights as well as pinching and gripping, had resulted in the claimant developing bilateral carpal tunnel syndrome.

In a decision dated May 25, 2001, Review Office indicated that it concurred with the union representative with regard to her statement that a comprehensive job task analysis ought to have been performed during the initial adjudication of the claim. Unfortunately, the job which the worker contended resulted in him developing carpal tunnel syndrome no longer existed.

Based upon file information, Review Office noted that the claimant performed identical job duties for a number of years without developing any symptomology and that he was most symptomatic at night. Review Office believed that these facts, as well as the nature of the claimant's work duties suggested that his carpal tunnel syndrome was not causally related to his employment. On September 13, 2001 the union representative appealed Review Office's decision and an oral hearing was convened.

Reasons

This case involves a worker employed by a rendering plant. A description of his job duties is noted above in the "Background".

He has been diagnosed with bilateral carpal tunnel syndrome (CTS), which he believes was caused by his work activities. He applied for workers compensation, but was denied. A reconsideration by the Review Office upheld the adjudication decision. He has appealed to this Commission.

The issue before the Panel is whether or not the claim is acceptable.

For the claimant's appeal to succeed, the Panel must determine that - on a balance of probabilities - the claimant's carpal tunnel syndrome is causally related to his job duties. We have so determined.

In coming to this decision, we carefully reviewed the claims file, as well as conducting an oral hearing, at which we heard testimony from the claimant. He was both credible and forthright in his testimony.

We took note of the view of the board medical advisor, who was of the opinion that the nature of the claimant's work would not put his wrists at extreme flexion and extension and thus would not cause his CTS.

We had the advantage of personally querying the claimant in this regard. His description of his job duties led us to believe that his wrists were regularly strained in such a way as commonly leads to the development of CTS.

We also took note of the comments of a second board medical advisor, who wrote in response to a question as to the etiology of CTS:

    "Any activities of daily living at home or at work involving repetitive finger and wrist movement leading to a non-specific tenosynovitis of the flexion tendons within the carpal tunnel can give rise to a CTS."

In response to a query as to whether or not the worker's self-described work activities might have caused his CTS, this doctor wrote:

    "As stated some of the activities might cause a CTS to be symptomatic, but it is not necessarily causal for the development of the condition."

We made the following findings of fact, which we consider to be relative to our determination:

  • The claimant was diagnosed as having carpal tunnel syndrome, for which he has had surgery, on both hands in two separate operations;
  • The claimant's work duties - as described to the Panel - are consistent with activities which can lead to CTS;
  • One board medical advisor has stated that his own description of his job duties - as recorded on file - could lead to the development of CTS.

We find that the preponderance of evidence supports the conclusion that the claimant's CTS is causally related to his job activities.

Accordingly, this appeal is allowed.

Panel Members

T. Sargeant, Presiding Officer
B. Popowich, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

T. Sargeant - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 20th day of December, 2001

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