Decision #144/02 - Type: Workers Compensation

Preamble

An Appeal Panel hearing was held on September 12, 2002, at the request of the claimant. The Panel discussed this appeal on September 12, 2002 and again on November 18, 2002.

Issue

Whether or not the WCB should accept responsibility for costs associated with the completion of insurance forms; and

Whether or not the WCB should accept responsibility for costs associated with the purchase of a pair of shoes.

Decision

The first issue was withdrawn at the hearing at the claimant's request;

That the WCB should not accept responsibility for costs associated with the purchase of a pair of shoes.

Decision: Unanimous

Background

While performing the duties of a power engineer on August 15, 2001, the claimant stated he was coming off a hanging ladder and that he missed a step and landed on his left foot, injuring his back. Medical attention was sought on August 16, 2001 and the claimant was diagnosed with a SI joint sprain/strain. Arrangements were made for the claimant to attend physiotherapy treatments. The claim was accepted by the Workers Compensation Board (WCB) and benefits were paid accordingly.

On January 29, 2002, a discussion took place between the claimant and a WCB adjudicator with respect to whether or not the WCB would pay for a pair of shoes prescribed by the attending physician as well the payment of fees associated with a Clarica report (insurance forms). The adjudicator advised the claimant that the WCB was unable to pay for the Clarica report as this was not a requirement of the WCB. The adjudicator also informed the claimant that the WCB would not cover the costs associated with his shoe prescription as it was felt that the need for the shoes was not related to his compensable injury. On February 11, 2002, primary adjudication confirmed to the claimant in writing that the costs associated with the Clarica report and for the pair of running shoes would not be covered by the WCB.

In a letter dated February 23, 2001, the claimant indicated that he injured his sacroiliac joint when he fell from the ladder and at one point he lost confidence in his movement, his pelvis shifted and he experienced panic. To help address this, his physician prescribed a pair of shoes. The claimant felt that the shoes helped him to gain confidence in his movements. With regard to the Clarica report forms, the claimant felt that the WCB should pay for the costs associated with these forms as they were jointly prepared by the WCB and his employer and were to be filled out by his physician after each and every visit.

In a March 15, 2002 decision, Review Office indicated that it was unable to accept responsibility for any costs associated with the completion of the Clarica report forms or for any costs associated with the purchase of a pair of running shoes. Review Office stated that the Clarica report forms had absolutely nothing to do with the WCB and that there was no evidence provided by the claimant's doctor on how a pair of running shoes was directly related to the compensable injury. In April 2002, the claimant appealed Review Office's decision to the Appeal Commission and an oral hearing was held on September 12, 2002, at which time the claimant withdrew the issue of whether or not the WCB should accept responsibility for costs associated with the completion of insurance forms.

After the oral hearing, the Panel met to discuss the case and requested that additional information be obtained from the claimant's attending physician prior to discussing the case further. A report from the attending physician dated October 11, 2002 was later received and was forwarded to the interested parties for comment. On November 18, 2002, the Panel met to render its final decision and took into consideration a final submission received from the claimant.

Reasons

As the background notes indicate, the claimant sustained sacroiliac joint sprain/lumbosacral strain when he slipped off of a ladder. The evidence on file confirms that the claimant has flat feet and that his treating physician prescribed orthotic footwear for better arch support. In a letter to the Appeal Commission dated October 11th, 2002, the treating physician advised as follows: "According to the chart, on November 13, 2001 I gave Mr. [the claimant] a prescription for new foot wear specifically with recommendations that the new shoes have good medial arch support and also good motion control. Mr. [the claimant], I found over-pronates."

We find that this condition is not in any way related to the claimant's compensable injury. Accordingly, the WCB should not accept responsibility for costs associated with the purchase of a pair of shoes. The claimant's appeal is hereby dismissed.

Panel Members

R. W. MacNeil, Presiding Officer
J. MacKay, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

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

Signed at Winnipeg this 11th day of December, 2002

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