Decision #156/05 - Type: Workers Compensation
Preamble
A non-oral file review was held on August 25, 2005, at the worker's request.Issue
Whether or not the worker's right knee condition is related to his right foot injury of August 30, 2004.Decision
That the worker's right knee condition is not related to his right foot injury of August 30, 2004.Decision: Unanimous
Background
On August 30, 2004, the worker injured his right foot during the course of his employment as a painter. The worker described his injury to the Workers Compensation Board (WCB) as follows:"The chain let go of a bale grab and fell onto the top of my foot. I was wearing steel toed boots but the chain also hit the middle of my foot where no protection was."A Doctor's First Report showed that the worker was examined on August 8, 2004. Subjective complaints were small bruising and mild swelling. Objective findings were recorded as "neurovascularly intact" with minimal decrease in range of motion. The diagnosis rendered was a soft tissue injury of the right foot. Recommended treatment plans included ice, compression and elevation.
On September 3, 2004, the WCB accepted the claim on the basis of a soft tissue injury to the right foot and benefits were paid to the worker from August 31, 2004 to September 3, 2004 inclusive and final. On September 7, 2004, the worker returned to his employment activities.
The next medical report on file is from an orthopaedic specialist dated December 24, 2004 which indicated that the worker was having difficulty with his right knee. The specialist stated,
"Right now he has difficulty extending the knee fully and bending it full flexion. Attempt to do so causes pain. Full extension is not possible, even with force. Apparently this happened a few days ago when he was bending the knee full and he heard a crack and since then he is unable to get the full range of motion. …He had an almost 700 pound metal outfit fall on his right foot, from about two feet. Fortunately he was wearing a steel toed shoe and he twisted the leg at that time. Immediately after the accident he was concentrating on the foot pain…One week after the injury he noticed the knee snaps and there is more pain in the knee. As the foot got better, his symptoms in the knee got worse. It tends to give way and it locked on him. Last Friday it really locked when he was bending the knee…It should be noted he had no trouble with the knee until the accident happened at work. I suspect he has sustained a medial meniscal injury at that time. The clinically (sic) findings suggest it is a medial meniscal injury, possibly a bucket handle tear."On January 6, 2005, a WCB case manager contacted the worker regarding his right knee difficulties. The worker indicated that no new accident happened at work. He indicated that his knee started to bother him about a week after his foot injury. The worker was asked if he had any problems or signs and symptoms with his knee when he injured his foot. The worker stated that he did not remember twisting his knee but that the accident happened fast and he pulled his foot back. He took a couple of days off and the next week when he returned to work he noticed signs and symptoms after crouching. The worker indicated that he told a co-worker that his knee was bothering him. He stated that the whole time he blamed his foot injury to have caused his knee problems.
On January 2, 2005, an MRI examination of the right knee confirmed a bucket handle tear of the medial meniscus.
In a decision dated January 18, 2005, Rehabilitation & Compensation Services informed the worker that it was of the view that his present disabling condition involved a different body part than what was injured at the time of the accident and that it was not related or caused by his right foot injury of August 30, 2004. Therefore, he was not entitled to wage loss benefits or medical expenses related to his right knee. In February 2005, the worker appealed this decision to Review Office.
On February 24, 2005, Review Office determined that the worker's right knee condition was not related to his right foot injury of August 30, 2004 based on the following evidence/rationale:
- the worker did not mention a right knee injury to his initial treating physician or to the WCB on September 1, 2004 or September 4, 2004 when he spoke with WCB staff representatives;
- the worker advised the WCB on January 6, 2005 that his right knee started to bother him about one week after the right foot injury, however, he indicated in his appeal submission that his knee started to bother him one month after the right foot injury; and
- a bucket-handle tear of the medial meniscus was not in harmony with the mechanics of injury as described occurring on August 30, 2004.
Reasons
According to the worker's accident report "a bale grab fell onto the top of [his] foot" on August 30, 2004. An x-ray taken on that same day of his right foot revealed some soft tissue swelling at the dorsum of the foot, but no fracture or dislocation was identified. Approximately four months later, an MRI of the worker's right knee disclosed a bucket handle tear of the medial meniscus. As the background notes indicate, the claim was accepted by the WCB as being a soft tissue injury to the right foot. The worker was able to return to work on September 7, 2004.The evidence confirms that at the time of the right foot injury there was no mention by the worker of right knee difficulties to the employer, the attending physician or the WCB. After closely analyzing the mechanism of injury in conjunction with the rest of the evidence on file, we find that the worker's right knee condition is not, on a balance of probabilities, related to his right foot injury of August 30, 2004. Accordingly, the worker's appeal is hereby dismissed.
Panel Members
R. W. MacNeil, Presiding OfficerA. 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 October, 2005