Decision #105/02 - Type: Workers Compensation

Preamble

A non-oral file review was held on May 30, 2002, at the claimant's request. Following discussion of the case, the Panel requested that the claimant be assessed by an independent orthopaedic specialist prior to rendering a decision on the issue under appeal. The claimant was assessed by the orthopaedic specialist on July 22, 2002 and a copy of his report dated July 22, 2002, was distributed to the claimant for comment. On August 22, 2002, the Panel met to render a final decision on the issue under appeal.

Issue

Whether or not the claimant is entitled to wage loss benefits beyond March 1, 2002.

Decision

That the claimant is not entitled to wage loss benefits beyond March 1, 2002.

Decision: Unanimous

Background

The claimant struck his left knee against the metal edge of a carpet kicker on January 25, 1999 while installing a rug on a stairwell. On September 28, 1999, an MRI of left knee revealed tears involving the medial and lateral menisci. On March 24, 2000, the claimant underwent a lateral meniscectomy of the left knee which was accepted as a Workers Compensation Board (WCB) responsibility.

Subsequent file records showed that the claimant continued to experience difficulties with his left knee and on July 16, 2001, a partial lateral meniscectomy was performed. The costs associated with this procedure were accepted by the WCB and the claimant's benefits were reinstated on July 16, 2001.

In a follow-up report dated September 11, 2001, the treating orthopaedic specialist indicated that the claimant continued to have left knee pain post left knee arthroscopy and partial lateral meniscectomy. The claimant was non-tender over his knee. McMurray's test and patellar grid tests were both considered to be normal. The specialist planned to "rule out residual lateral meniscal tear as this was a horizontal cleavage tear which can extend out to the edge. Plan will be MRI scan and review."

On December 11, 2001, an MRI of the left knee revealed the following: "The lateral meniscus is truncated, consistent with prior surgery. No definite evidence of a residual or recurrent tear, however, is demonstrated."

A further report from the treating orthopaedic specialist dated January 22, 2002, indicated that the claimant continued to experience parapatellar pain. Note was made that the MRI was negative for anything correctable. There were no new meniscal tears and no abnormalities seen. The specialist commented that the claimant may benefit from a GII patellar brace as he had some anterior knee cap pain.

On February 22, 2002, primary adjudication advised the claimant that his case had been referred to a WCB healthcare advisor to review whether there continued to be an ongoing causal relationship. The opinion offered by the medical advisor was that there was no ongoing causal relationship considering the exam and the MRI scan were both normal. Primary adjudication also noted that it was the opinion of the WCB medical advisor that there was no need for restrictions and that the WCB was unable to support the recommendation of a GII knee brace. Primary adjudication ultimately determined that the claimant had recovered from the effects of his work injury and that wage loss benefits would be paid to March 1, 2002, inclusive and final. On February 27, 2002, the claimant appealed this decision and the case was forwarded to Review Office for consideration.

On March 22, 2002, Review Office determined that the claimant was not entitled to wage loss benefits beyond March 1, 2002. Review Office noted that a WCB orthopaedic consultant reviewed the claim and was of the opinion that there was no need to impose work restrictions subsequent to the worker's recovery from the second operation performed on July 16, 2001. Review Office accepted that the claimant was still experiencing discomfort in his left knee but found no basis to warrant the imposition of ongoing work restrictions for a structurally sound knee. On April 9, 2002, the claimant disagreed with Review Office's decision and a non-oral file review was held on May 30, 2002.

Following discussion of the case, the Appeal Panel requested that the claimant be assessed by an independent orthopaedic specialist with regard to his left knee status. On July 22, 2002, the claimant was assessed by an orthopaedic specialist and the examination report was forwarded to the claimant for comment. On August 22, 2002, the Panel met to render its final decision on the issue under appeal.

Reasons

This case involves a worker who injured his left knee, in January 1999, while employed as a carpet installer. His claim for compensation was accepted and medical and wage loss benefits were afforded to him. It was determined by the board that, by March 1, 2002, he had recovered from the effects of the injury and benefits were terminated. An appeal to the Review Office was not successful. He subsequently appealed to this Commission.

The issue before the Panel was whether or not he is entitled to wage loss benefits beyond March 1, 2002.

For his appeal to be successful, the Panel would have to determine that his ongoing medical problems with his knee are causally related to the workplace accident. We were not able to make that determination.

In coming to our decision, we conducted a review of the claims file, after which we referred the claimant for a medical examination by an independent physician. We placed considerable weight on the evidence provided by the independent medical examiner in his report.

We note that the claimant had arthroscopic surgery on his left knee on two occasions, in March 2000 and July 2001. The board accepted these surgeries as necessitated by his compensable injury.

We also note that, at the first procedure, it was noted that he had pre-existing chondromalacia of the patella, chondromalacia of the medial knee joint and a minor tear of the medial meniscus. It was to help the Panel determine whether his current condition was due more to these pre-existing conditions or to his compensable injury that we referred him for the independent medical examination.

This independent physician made the following observations, upon which we relied in coming to our decision:
  • "In my opinion, his current left knee condition is not a result or sequela of his work place injury on January 25, 1999. In my opinion, his current left knee condition is related to his subsequent surgeries of the left knee . and is also related to his pre-existing chondromalacia of the left knee."

  • "In my opinion, the most probable cause of the patient's current left knee condition is chondromalacia of the left knee, synovitis of left knee and post lateral meniscectomy of left knee status.""

  • "In my opinion, the patient's left knee recovered and he was capable of returning to his usual work without restrictions by March 2002."

  • "In my opinion, this patient is now capable of employment without any work restrictions."
Based on the foregoing, we have concluded that - on a balance of probabilities - the claimant's current condition is attributable to his pre-existing condition and no longer to his workplace accident. We also have concluded that he had recovered from the effects of the compensable injury by March 2002. Thus, we uphold the decision of the Review Office.

Accordingly, the appeal is dismissed.

Panel Members

T. Sargeant, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

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

Signed at Winnipeg this 25th day of September, 2002

Back