Decision #32/04 - Type: Workers Compensation

Preamble

An Appeal Panel hearing was held on January 22, 2004, at the claimant's request. The Panel discussed this appeal on the same day.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is not acceptable.

Decision: Unanimous

Background

The claimant contacted the call centre at the Workers Compensation Board (WCB) to report arthritis in his left thumb which he believed was due to all the injuries he sustained over the years as a mechanic.

Medical information was obtained from a hand specialist dated May 1, 2002 which noted that the claimant had developed osteoarthritis at the basal joint of his left thumb over the past several years but it became significantly more symptomatic over the last six months. A trapezial replacement arthroplasty was recommended and was being arranged.

In a May 28, 2003 memo to file, a WCB adjudicator documented his telephone conversation with the claimant. The adjudicator explained his understanding that the claimant was relating his osteoarthritis to all of the injuries to his left thumb over the years, however, the adjudicator could only locate two prior WCB claims involving the left thumb. The claimant responded that these were the only two injuries that were bad enough for him to see a physician. The claimant commented that a mechanic can sustain several small injuries to his hands daily and that one would not report every one of these or see a doctor every time he hurt himself. The claimant also reported that over a number of years he had worked with inappropriate tools.

On May 28, 2003, a WCB medical advisor was asked to review the file information and to provide an opinion as to whether or not it was probable that the diagnosis of osteoarthritis of the left thumb was related to the claimant's performing his job duties as a mechanic. The medical advisor responded on June 5, 2003 that osteoarthritis was a pre-existing degenerative condition and was not caused by work activity.

In a decision dated June 6, 2003, the claimant was advised by Rehabilitation & Compensation Services that based on a review of all the file information, it was unable to establish that the claimant suffered a personal injury due to an accident arising "out of and in the course of" his employment. The decision to deny the claim was again confirmed to the claimant on June 24, 2003. On July 8, 2003, the claimant appealed this decision to Review Office.

In a letter dated August 1, 2003, Review Office advised the claimant that it did not relate his left thumb osteoarthritic condition to his two prior claims nor did it relate this condition to the new claim, which was not associated to any injury occurring in the workplace, but rather it was a general statement by the claimant that he felt the trauma to his left hand over the years as a mechanic had led to his osteoarthritis. Review Office noted that it had obtained medical opinions from the WCB's healthcare branch on all three files and that none of the medical opinions were in the claimant's favor regarding his claim. It was felt that osteoarthritis was a degenerative condition and did not have a relationship to the claimant's occupation as a mechanic. On September 27, 2003, the claimant appealed Review Office's decision and an oral hearing was convened.

Reasons

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."

An x-ray taken on April 1, 2002 of the worker's left thumb revealed "advanced osteoarthritic change in the 1st carpal metacarpal joint." A WCB medical advisor was asked to comment on whether the osteoarthritis of the worker's left thumb could be related to his performing the job duties of a mechanic. In a memorandum dated June 5, 2003, the medical advisor responded as follows:

“In my opinion no – Osteoarthritis is pre-existing & degenerative not caused by work activity, likely present for many years beforehand. Work duties would not affect OA [osteoarthritis].”

We find based on the weight of evidence that there is no established cause and effect relationship between the claimant’s work duties as a mechanic and his left thumb osteoarthritis. There being no accident as defined by the Act it therefore follows the claim is not acceptable. Accordingly, the claimant’s appeal is hereby dismissed.

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 4th day of March, 2004

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