The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

A non-oral file review was held on February 20, 2004, at the request of a worker advisor, acting on behalf of the claimant.

Issue

Whether or not the claimant is entitled to payment of wage loss benefits after May 28, 2003.

Decision

That the claimant is entitled to payment of wage loss benefits after May 28, 2003.

Decision: Unanimous

Background

In May 1993, the claimant developed bilateral carpal tunnel syndrome (CTS) which he related to his employment activities as a motor winder. The claim was accepted by the Workers Compensation Board (WCB) and various types of benefits and services were paid to the claimant which included a permanent partial impairment award of 15.1%. The claimant has permanent restrictions to avoid the use of power tools, exposure to heat and cold and work which requires rapid use of his affected hand. In November 1996, the claimant began a permanent position with the accident employer as a Cadcam operator and was provided with an autocad computer system to assist him with his job activities.

In 1999, the claimant began to experience numbness and tingling of his right index finger and thumb. Following repeat EMG studies, the claimant underwent the following surgical procedure on February 29, 2000, "Release of right carpal tunnel, neurolysis right median nerve."

In a memo dated December 11, 2000, a WCB adjudicator noted that the claimant had not returned to work since his February 29, 2000 surgery. The claimant was still experiencing a lot of pain in his right wrist along with swelling and difficulty with fine finger movements. He claimed that he could not return to his employment activities which involved a computer and using a mouse with his right hand.

In June 2001, a worksite assessment was carried out. Contact was made with the claimant's attending physician and his treating psychologist and it was confirmed by both parties that the claimant could perform the duties of the autocad position.

The case was considered by the WCB's quality assurance coordinator on January 30, 2002. The coordinator agreed with the plan to have the claimant return to his autocad position subject to an ergonomically correct workstation.

On May 9, 2002, the WCB informed the claimant that he was to return to work by May 16, 2002 and that a WCB occupational therapist would meet him at the worksite with regard to the set up and use of the furniture. Full wage loss benefits would be paid up to and including May 15, 2002.

In February 2003, the claimant was assessed at the WCB's Pain Management Unit (PMU). It was later documented that the claimant did not qualify for a diagnosis of chronic pain syndrome but that he continued to experience a major depression.

On March 31, 2003, a WCB Vocational Rehabilitation Consultant (VRC) wrote to the claimant. She acknowledged that the claimant continued to have a compensable condition of carpal tunnel syndrome and that restrictions regarding this condition were ongoing. Based on current discussions with the attending physician and the results from PMU, it was determined that the effects of the claimant's injury did not preclude him from working.

In a communication to his employer dated April 2003, the claimant requested alternate employment. The claimant stated, in part, that both his hands had deteriorated despite having an ergonomic workstation. Reference was made to nerve conduction studies that were conducted in February 2003 which revealed severe CTS on the right and mild CTS on the left. He stated that it was common knowledge that computers caused repetitive strain injuries.

On May 27, 2003, the claimant contacted the WCB to indicate that he had restrictions imposed by his physician to avoid working on computers and that his employer did not have any work for him as a result.

In a memo dated June 2, 2003, a WCB VRC documented that the claimant left work on May 22, 2003 because he was experiencing significant wrist pain and that he did not feel he was able to work on a computer. The VRC noted that the claimant was contending his autocad position was not within his physical abilities and that he was disabled from this type of work.

In a June 19, 2003 report, the treating plastic surgeon provided his opinion that computer work exacerbated and worsened the pain in the claimant's hand. The physician suggested that the claimant should avoid this activity.

On July 30, 2003, a WCB medical advisor reviewed the case. He was of the opinion that there was insufficient information on file to support that the claimant should avoid working on a computer. He stated there were many devices that the claimant could use at work to maintain his wrist in a relatively neutral position and that computer work did not involve repetitive wrist movement. This opinion was relayed to the claimant in a decision letter dated August 6, 2003. On August 22, 2003, a worker advisor appealed this decision to Review Office and later submitted a report from the claimant's treating physician dated August 26, 2003 in support of his position that the claimant was entitled to further benefits.

In a decision dated October 17, 2003, Review Office determined that the claimant's compensable injury did not preclude him from the light duty position of working on a computer and that there was no entitlement to wage loss benefits after May 28, 2003. Based on a review of the available information, Review Office could not find any evidence to link the claimant's deterioration in his CTS to his job duties of working on a computer in his autocad position. Review Office noted that an ergonomic work station, keyboard and mouse had been provided to the claimant which placed his wrists in a relatively neutral position. Thus, there would be no compression on the median nerve. Review Office further stated, "The plastic surgeon reported that he did not believe this was a "compression neuropathy" but rather more related to intrinsic abnormalities. Review Office did not find that the claimant's light duty position falls outside of his physical compensable restrictions."

In November 2003, the worker advisor appealed Review Office's decision that the claimant was not entitled to wage loss benefits beyond May 28, 2003 and a non-oral file review was arranged. Further submissions were later received from the worker advisor, the claimant and the employer for the Panel's consideration.

Reasons

As the background notes indicate, the claimant developed bilateral carpal tunnel syndrome as a consequence of his performing employment duties as a motor winder.

It is clear from the medical evidence on file that the claimant underwent a series of unsuccessful surgeries and treatment in respect of his compensable right carpal tunnel syndrome condition. The most recent medical reports in 2002 and 2003 note that the claimant still continues to experience moderate to severe carpal tunnel syndrome. In a letter to the claimant's attending physician dated June 4th, 2003, the treating plastic surgeon noted as follows: …"there is likely intrinsic abnormalities of the nerve that are present…". We find that these 'intrinsic abnormalities' are in all likelihood a consequence of the many surgeries performed to date, and have impacted on the claimant's ability to perform the job duties associated with the autocad position.

As well, we note that the claimant's psychological component, which has been accepted by the WCB as a compensable condition, is also a factor in his failed return to work efforts particularly with respect to the autocad position offered by the employer.

Based on the weight of evidence we have concluded that the claimant's condition has, on a balance of probabilities, precluded his returning to work to his job duties of working on a computer in the autocad position, notwithstanding the ergonomic changes made to date. Therefore, we further find that the claimant is entitled to payment of wage loss benefits after May 28th, 2003. According the claimant's appeal is hereby allowed.

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 23rd day of March, 2004