Decision #87/02 - Type: Workers Compensation

Preamble

An Appeal Panel hearing via teleconference was held on June 25, 2002, at the request of the claimant. The Panel discussed this appeal on June 25, 2002.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is not acceptable.

Decision: Unanimous

Background

The claimant filed a compensation claim with the Saskatchewan Workers' Compensation Board on May 29, 2001, with respect to a sternum and rib cage injury that occurred in the early 70's while lifting a 400 lb. snowmobile unassisted. On June 7, 2001, a Client Service Representative forwarded the file contents to the Manitoba Workers Compensation Board (WCB) as the claimant did not have right to elect coverage within the Province of Saskatchewan. Following a search conducted by the Assessment branch of the Manitoba WCB, it was determined that the claimant had coverage as a partner at the time.

On November 13, 2001, a WCB adjudicator spoke with the claimant by phone concerning his claim. The claimant advised that he had been off work for a couple of weeks after the date of accident doing light duties. He was unable to continue working as the job required heavy lifting. The claimant tried some office type jobs, went to university for one term and then went from job to job. The claimant was on social assistance in 1980 and was now on Canada Pension Plan disability. The claimant advised that he was unaware that he could claim compensation. He advised that he underwent surgery (sternum amputation without removal) when he was five years old. His rib is separated from his rib cage on the right side. The claimant felt his current difficulties were related to the 1972 accident as he was able to work up until that time and after the accident he was unable to do any physical type of work.

On December 3, 2001, a different adjudicator contacted the claimant. The adjudicator documented that the claimant stopped working in 1978 as he couldn't take the pain anymore. He was claiming for wage loss benefits.

A report from the attending physician dated October 31, 2001, noted that the claimant was seen in March 1972 by a physician who was now deceased. The accident in 1972 was described by the worker as "lifting a snowmobile, bent over in back of truck and slipped on ice. Fell onto bum, chest hitting knees at prior surgical site." The diagnosis rendered was a possible chest contusion.

On December 17, 2001, primary adjudication denied the claim for compensation as it was determined that the information did not establish that the claimant suffered an accident at work as well as the delay in reporting the claim. On February 13, 2002, the claimant appealed the decision and the case was forwarded to Review Office.

In a decision dated March 1, 2002, Review Office noted that the claimant decided to file a claim almost three decades after an alleged injury at work. The claimant contended that due to the injury sustained at work he had not worked since 1978. The only medical documentation on file refers to an examination in March 1972 where a doctor diagnosed a chest contusion.

Due to the inordinate delay in the worker filing a claim with respect to this accident, Review Office believed that the onus was on the worker to provide complete medical documentation pertaining to his chest both prior to and after the alleged accident. Review Office therefore made the determination that the claim was not acceptable and that no compensation was payable. On April 22, 2002, the claimant appealed Review Office's decision and an oral hearing was held via teleconference.

Reasons

Section 4 (1) of the Workers Compensation Act (the Act) provides for 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 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. An accident is defined as,
    "a chance event occasioned by a physical or natural cause; and includes
    1. a wilful and intentional act that is not the act of the worker,
    2. any
      1. event arising out of and in the course of, employment, or
      2. thing that is done and the doing of which arises out of, and in the course of, employment, and
    3. an occupation disease
    and as a result of which a worker is injured."
The weight of evidence does not, on a balance of probabilities, support the claimant's contention that his current physical and psychological difficulties are in any way related to the February 9th, 1972 incident. There is no evidence to indicate that an aggravation and/or enhancement of the claimant's pre-existing condition (pigeon chest or funnel chest) ever occurred at this time. Therefore, the claim is not acceptable and the claimant's appeal is hereby dismissed.

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 4th day of July, 2002

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