Decision #109/02 - Type: Workers Compensation
Preamble
An Appeal Panel hearing was held via teleconference on August 20, 2002, at the claimant's request.Issue
Whether or not worker's chronic lung problems are related to the May 26, 1954 accident.Decision
That the worker's chronic lung problems are not related to the May 26, 1954 accident.Decision: Unanimous
Background
According to an Employer's Report of Accident dated May 28, 1954, the claimant was standing in front of a 4 inch valve which had extreme pressure build-up when the valve broke. The oil from the valve struck the claimant's "chest & face, loosening teeth, swallowing oil, and oil escaped into lungs, oil in lungs and in gastrointestinal tract."The initial medical report dated July 15, 1954, revealed that the claimant was treated on May 29, 1954 and that he suffered a "facial lump and pain in his chest when he was knocked 20 feet by a stream of crude oil. He had a chest plate taken but no treatment was advised."
A chest x-ray dated May 29, 1954 was considered to be negative.
A Surgeon's First Report dated May 29, 1954 noted that the claimant was hit by a stream of crude oil under pressure and that he was knocked 20 feet. He inhaled crude oil, had facial lesions and pain in his chest. The claimant was investigated for possible injury but no injury was found. The claimant had a cough since the accident and had a chemical irritation from the inhaled oil. No treatment was advised. The surgeon commented that he couldn't understand how the claimant had no injuries after the accident.
The claim was accepted by the Workers Compensation Board (WCB) [formerly The Workmen's Compensation Board] as a compensable accident.
The next correspondence on file was from the claimant dated November 25, 1999. The claimant advised that he was having lung difficulties which he related to the 1954 accident.
Subsequent file records revealed that primary adjudication obtained medical information from the claimant's attending physicians concerning his medical status which was then reviewed by a WCB medical advisor on February 9, 2001.
In a decision dated February 23, 2001, primary adjudication noted that the claimant had a history of chronic obstructive lung disease and that the claimant's physician and specialists felt that his airway or lung difficulties were related to excessive smoking through the years. Based on the opinion expressed by the WCB medical advisor, primary adjudication determined that there was no cause and effect relationship between the claimant's ongoing difficulties and his compensable injury. It was felt that the claimant's difficulties were related to airway obstruction due to the amount of smoking over the years.
On December 1, 2001, the claimant's advocate appealed the above decision and provided an x-ray report dated June 1981 which indicated that the claimant had scarring evident in his lungs at that time. The case was then forwarded to Review Office for consideration. Prior to considering the appeal, Review Office sought the opinion of a WCB Internal medicine consultant which is outlined in a memo to file dated December 13, 2001.
On January 4, 2002, Review Office determined that the claimant's chronic lung problems were not related to the May 26, 1954 accident. Review Office placed weight on the medical reports on file when the claimant was assessed immediately following the 1954 accident along with the following opinions that were expressed by the WCB's internal medicine consultant:
- "The diagnosis that fits the picture most is chronic obstructive lung disease.
- The exposure to crude oil did not result in aspiration as confirmed by the chest x-ray done in May 1954.
- In the absence of any objective data, a diagnosis of pneumonitis cannot be made.
- The long history of cigarette smoking, history of chronic cough and sputum production and severe airflow limitation unresponsive to bronchodilators confirms the diagnosis of chronic obstructive lung disease. Significant exposure to welding fumes of zinc may play a part.
- There is no relationship between the accident and the present findings."
Reasons
This case involves a pipeline worker who was injured when a valve broke, spewing oil under pressure directly at him. He was thrown some distance from the pipeline and may have ingested some oil into his stomach and may have aspirated some into his lungs. This accident occurred in May 1954.In 1999, the claimant requested that benefits be reinstated, in particular, medical benefits and a permanent impairment award. It is his contention that the medical problems he is suffering now are a result of the 1954 workplace accident.
His request was investigated but ultimately denied by the board. That decision was upheld upon reconsideration by the Review Office. He then appealed to the Commission.
For his appeal to be successful, the Panel would have to determine that his current lung problems are causally related to the 1954 accident. We were not able to make that determination.
In coming to our conclusion, we made a thorough review of the claim file, as well as holding an oral hearing, via teleconference, at which the claimant presented argument in favour of his case.
We based on our conclusion on the following:
- The accident occurred on May 26, in the late afternoon. According to the information on file, the claimant didn't receive initial medical treatment until May 29, at 3.00 p.m. In his report, the doctor wrote:
- "We investigated this fellow carefully for possible injury. No injury found. Has a cough since the accident - has a chemical irritation from the inhaled oil. No treatment advised."
He further noted that he "can't understand how this man has no injuries after the accident."
- An x-ray taken on May 29 was negative, showing no evidence of ingested oil.
- Although, the claimant maintains that he was taken by ambulance to the Brandon General Hospital, where he was treated for a few days, there is no evidence on file to this effect. A thorough search of microfiche records, by the Brandon Regional Health Authority, did not turn up any evidence to support this.
- He has a long history of smoking. Two of his family physicians reported him to be a "fifty pack year" smoker. A third reported that, until he quit in about 1992, he had smoked 25 cigarettes a day since the age of 18. In his testimony to us, he claimed that he had not been a heavy smoker.
- In 1994 or 1995, he had an incident at work when, while welding zinc, he inhaled some of the fumes which exacerbated his already existing chronic obstructive pulmonary problems.
- In a December 2000 report, his doctor expressed the opinion "that the major problems with his airways or lungs are secondary to 50 pack years of cigarette smoke, however it must be assumed that the inhalation of oil did indeed cause a significant degree of chemical tracheitis, bronchitis and pneumonitis which also contributed to his permanent partial impairment."
- His current diagnosis is chronic obstructive pulmonary disease, the most common cause of which is extensive exposure to cigarette smoke.
- A board medical advisor notes that if the claimant had suffered lung damage secondary to aspiration of oil, he would most likely be suffering from restrictive - not obstructive - lung problems.
- The Internal Medicine Consultant to the Board, noting that the chest x-ray taken in 1954 showed no evidence of aspirated oil, stated that "in the absence of any objective evidence, a diagnosis of aspiration pneumonitis cannot be made.
Based on the foregoing, we have concluded - on a balance of probabilities - that the claimant's current chronic lung problems are not causally related to his workplace accident.
Accordingly, the appeal is dismissed.
Panel Members
T. Sargeant, Presiding OfficerA. Finkel, Commissioner
C. Monk, Commissioner
Recording Secretary, B. Miller
T. Sargeant - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 30th day of September, 2002