The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

An Appeal Panel hearing was held on January 13, 2003, at the request of an advocate, acting on behalf of the claimant. The Panel discussed this appeal on January 13, 2003.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is not acceptable.

Background

On May 15, 2001, the claimant submitted an application for compensation benefits to the Workers Compensation Board (WCB) for right wrist and hand difficulties that she related to years of working on a keyboard. Initial medical information consisted of an electrophysiological study dated March 28, 2000 which revealed bilateral mild carpal tunnel syndrome. On June 19, 2000, a hand specialist recommended surgical decompression of the nerve on the right wrist.

In order to adjudicate the claim, a WCB adjudicator spoke with the claimant on June 20, 2001. In a memo to file of the same date, the adjudicator recorded that the claimant had been employed with the accident employer since 1984 and that she had held her current position for six years. In 1999, the claimant noticed that her hand was tingly in the morning and it would fall asleep while driving to work. Her condition progressively became worse. The tingling and numbness affected her thumb and first 3 fingers.

The claimant provided the adjudicator with additional information concerning her job duties. The claimant traced shipments on the computer, wrote some memos, responded to and sent e-mails. On average, the claimant entered/typed on the computer for 10 to 15 minutes at a time. The claimant answered telephones and used the computer to solve clients’ concerns. The claimant did not partake in any crafts or hobbies and did not have high blood pressure, thyroid problems or diabetes.

On June 29, 2001, a WCB medical advisor reviewed the file information and was of the view that, on a balance of probabilities, the claimant’s job duties were not likely the cause of her carpal tunnel syndrome. The medical advisor noted that the claimant did keyboarding but he could not identify any duties that required repetitive flexion/extension of the wrist against significant resistance.

On July 6, 2001, the adjudicator wrote to the claimant and advised her that he was unable to establish that she had been exposed to significant work related factors, which would lead to the development of her carpal tunnel syndrome. The adjudicator was unable to establish that the claimant suffered a personal injury due to an accident arising ‘out of and in the course of’ her employment. On May 22, 2002, an advocate for the claimant appealed this decision to Review Office.

In a decision dated July 19, 2002, Review Office confirmed that the claim was not acceptable. Review Office was of the opinion that the available evidence did not establish a cause and effect relationship between the claimant’s development of carpal tunnel syndrome and her occupation as a customer support representative. On September 4, 2002, the claimant’s advocate appealed Review Office’s decision and an oral hearing was arranged.

Reasons

Chairperson MacNeil and Commissioner Finkel:

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.”

As the background notes indicate, the claimant first developed swelling and tingling symptoms in her wrists and hands in 1999. Her condition continued for approximately a year when she sought medical treatment. Nerve conduction studies carried out on March 28^th, 2000 confirmed the presence of bilateral mild carpal tunnel syndrome.

According to the medical literature written on carpal tunnel syndrome, it can develop from work related as well as from non-work related risk factors. Work related risk factors could include jobs, which require high force repetitive activity involving movements of the wrist such as twisting, gripping, pulling, pinch pressure and wrist flexion/extension. Conversely, non-work related risk factors could include pregnancy, diabetes, menopause, hypothyroidism, arthritis, skeletal injury to the wrist, age, gender, smoking, obesity and idiopathic etiology.

In a discussion with a WCB adjudicator, the claimant indicated that as a customer service representative her duties included tracing shipments on the computer, sending and responding to e-mails and writing memos. The claimant further indicated that she would not type constantly, but rather, type frequently throughout the day. In this regard, she stated that she would be entering/typing on average for about 10-15 minutes at a time. Other duties included “talking on the phone and doing computer entries for customers in monitoring shipments”.

A WCB medical advisor provided the following opinion when asked if the claimant’s bilateral mild carpal tunnel syndrome could be related to her work activities.

“In my opinion the job duties are not on balance of probabilities likely to be the causation of C.T.S. Admittedly she does keyboarding but I cannot identify any duties requiring repetitive flexion/extension of the wrist against significant resistance.”

We agree with the foregoing opinion. The claimant’s job duties are no doubt repetitive, but the weight of evidence does not lead us to conclude that the performance of these duties has, on a balance of probabilities, resulted in her developing carpal tunnel syndrome. We find that there has been no accident as defined by the Act. Therefore the claim is not acceptable.

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 17th day of February, 2003

Commissioner's Dissent

The worker’s evidence was that she commenced employment in 1984. From 1984 to 1995 her duties mainly involved dispatching. She did some work by computer but the work had a significant manual component to it. The operation changed in 1995 and her work was primarily computer work where she spent 75 – 80% of her day tracking shipments. Her work also involved the use of a computer mouse. Following the introduction of sophisticated computers for her work, the volume of the work also increased.

From 1995 to 1999 her workstation was not ergonomically designed. It was during this period that her hand difficulties started. She reported that during 1999 her difficulties with hand tingling, night soreness and discomfort got progressively worse to the point where she sought medical attention. The problems were more significant on her dominant right hand.

She had an ergonomic assessment in late 2000 that changed her typing position. The mouse pad location was also changed and she was issued a new ergonomic keyboard and was provided with a night and day splint to wear.

The worker in her evidence noted that before the ergonomic intervention she typed with her wrists extended instead of in a neutral position. I note that the WCB medical advisor did not have this information available prior to his response to file questions re job relatedness.

She indicated that the new ergonomics initially reduced her symptoms but this was temporary and her hands continue to worsen to the point where she feels surgery will be necessary for her right hand.

In conclusion, it is my opinion that the etiology of the worker’s CTS arises as a result of poor ergonomic design as well as increased computer volume. She appears to have limited risk factors that predispose her to CTS. I am satisfied, on a balance of probabilities, that her work duties have lead to the development of CTS. The claim should therefore be accepted.

M. Day, Commissioner