Decision #102/02 - Type: Workers Compensation

Preamble

An Appeal Panel hearing was held on August 15, 2002, at the request of an advocate, acting on behalf of the claimant. The Panel discussed this appeal on August 15, 2002.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is acceptable.

Background

On November 6, 2000, the claimant submitted a claim for compensation benefits to the Workers Compensation Board (WCB). The claimant indicated that in March 1997, an orthopaedic surgeon advised him to undergo nerve conduction studies to both hands. Since undergoing these tests, he has been on a waiting list to have surgery performed on his right hand. The injury reported was carpal tunnel syndrome.

In a letter to the WCB dated December 15, 2000, the employer advised that the claimant's work activities involved using a computer to process directives and to make inquiries. "In an 8 hour shift, the worker would use a computer for short tasks on a high frequency basis."

To assist adjudicating the claim, primary adjudication obtained medical information from the claimant's treating physicians and an occupational therapist. In addition, contact was made with both the claimant and his employer regarding the claimant's work history, job duties, etc. On November 17, 2000, the claimant filled out a WCB carpal tunnel questionnaire.

Following consultation with a WCB medical advisor on February 7, 2001, primary adjudication determined that the claim for compensation was not acceptable given the mechanics of the claimant's job duties and his diagnosed condition. On March 7, 2001, an advocate for the claimant appealed this decision to Review Office.

On March 23, 2001, Review Office confirmed that the claim was not acceptable. Review Office noted that the claimant's employment involved extensive keyboard use with his right hand entering numeric codes. The claimant had been doing this both in his present job and in the position that he previously held.

Review Office felt that the claimant's work duties were no doubt repetitive in nature but did not involve high force repetitive actions that involved motions of the wrist such as extreme twisting, gripping, pulling, pinch pressure and wrist flexion/extension. On a balance of probabilities, Review Office concluded that the claimant's bilateral carpal tunnel syndrome was not related to his occupation. It was also noted by Review Office that the claimant had a bilateral condition, when in fact his work involved usage of his right hand only on a numeric keyboard. On May 23, 2002, the claimant's advocate appealed Review Office's decision and an oral hearing was arranged.

Reasons

Chairperson MacNeil and Commissioner Day:

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 keeping 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

(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.”

Within a few months after moving to his present job in 1995, the claimant began to experience tingling in his hands worse in the right than the left. The new job involved almost constant typing at a computer keyboard. According to the evidence, the claimant’s keyboard and workstation were not ergonomically designed and as a result he was typing with his wrists in extreme extension.

Q. And I believe you mentioned or Mr. [name of claimant’s advocate] mentioned that you first began to experience the problem approximately one year earlier. Now one year earlier, was that in March of 1996?

A. Well, I don’t have a specific date.

Q. Approximately?

A. Well, I’d say approximately.

Q. Can you describe what symptoms you were experiencing in 1996?

A. Well, I was doing a lot more typing and at the work site I used to stretch my hands. They were just sort of closing up on me.

Q. Yes.

A. So I use to go like this all the time –

Q. Yes.

A. - - sort of shake them, and I didn’t know what it was. I just kept stretching them. I’d be typing away and then all of a sudden I’d have to stretch my fingers.

Q. Right.

A. It turns out that’s the worst thing to do, is stretching your fingers. You’re supposed to be turning your fingers in apparently. I find that out after, but - -

The claimant reported his hand difficulties to his employer in 1997. According to the evidence an occupational therapist was consulted at this time.

Q. And when did your carpal tunnel symptoms first show up?

A. I reported it in March of 1997, but I was having problems up to a year prior on my hands. I noticed - - I live out of town, so I drive to and from work, and I noticed my hands were starting to numb. And I went to see an orthopaedic surgeon and he recommended going for nerve conduction tests. I didn’t know what it was at the time.

Q. Now in 1997 you consulted - - [the employer] got an occupational therapist. You consulted her?

A. That’s correct. I’d happened to gone to see, on March 20th I went to see a Dr. [name], he’s an orthopaedic surgeon, about another matter and I had mentioned about my hands, and he suggested I report it to [the employer] and [the employer] should have an occupational therapist. And they just happened to be hiring [name] the day after, on the 21st. So I said, well, I’d like to see her that day and I did. And then I reported it to [the employer].

Q. And what did she do?

A. Basically she examined my hands and she did a bunch of tests, and she suggested wearing temporary splints at night and doing some finger exercises, stretching and stuff like that, prior to working.

Q. And she arranged an ergonomic keyboard?

A. Yes, she, being an occupational therapist, she suggested that I switch the keyboard to one of these ergonomic keyboards where you type sort of in, and it’s got a bigger resting pad for your hands so it’s easier to type. The old - - I just wanted to mention, the old keyboard is your standard keyboard and the work station, you use to type like this, because it’s sort of, it’s narrow and I’ve got big hands, so I’d have to have the keyboard inverted. So I use to type like this, in an upward. Now I type down. So I was sort of stretching my hands.

The claimant has been living in a rural setting since approximately 1983 and heats his home by way of a wood burning furnace. He testified that he consumes anywhere from six to ten cords of wood a winter. In recent years, however, a load of five cords would be delivered before Christmas and another five cords at the end of January. These cords arrive at his property in eight-foot lengths and are later cut up by the claimant into manageable lengths with a chain saw. The claimant indicated that he would handle the chain saw for about two hours at a time over the course of a four to six week period while cutting up a load of wood.

In determining that there has been an accident arising out of and in the course of the claimant’s employment, we considered several other factors in addition to the claimant’s job duties. As pointed out by Review Office in its decision of March 23rd, 2001, carpal tunnel syndrome often results from “work activities that involve frequent and repetitive use of the hand or wrist with regular tasks requiring the generation of high force by the hand. This also involves regular or sustained tasks that require awkward hand positions.”

We note and are aware that the operation of a chain saw can involve high force repetitive movements of the hands and wrists such as extreme twisting, gripping, pulling, pinch pressure and wrist flexion/extension and that such actions could possibly lead to the development of carpal tunnel syndrome. Other contributing factors to this condition can also include an individual’s height and weight. The claimant presented as a very tall and heavyset man.

After considering all of the evidence, we find on a balance of probabilities that the claimant’s physical size, weight and several years of woodcutting contributed in all likelihood to his developing bilateral carpal tunnel syndrome. We further find that this condition was, on a balance of probabilities, asymptomatic until such time when the claimant aggravated it by his keyboarding duties to the point where surgery has become necessary. We are satisfied that the claimant sustained an accident as defined by the Act. 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,

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

Signed at Winnipeg this 13th day of September, 2002

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