Decision #55/06 - Type: Workers Compensation

Preamble

An appeal panel hearing was held on March 22, 2006, at the request of a worker advisor, acting on the worker's behalf. The worker and her worker advisor appeared. The employer did not.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is not acceptable.

Decision: Unanimous

Background

Reasons

Claim History
On May 30, 2005, the worker filed a claim with the Workers Compensation Board (hereafter the "WCB") for bilateral carpal tunnel syndrome (hereafter "CTS"). The worker's claim was denied. The Review Office upheld the denial by a decision dated July 6, 2005. It is this decision that the worker appeals.

Background
The worker worked as an administrative support person for fourteen years starting in 1990.

In 1996, the employer upgraded its computer system. This upgrade entailed an increase in keyboarding duties for the worker. Not only was she was required to work overtime hours to input all pre-existing data into the new system, but once the system was up and running, her employment duties changed to include keyboarding all work, shop and customer orders, inventory counts, invoicing, bin locations and receiving.

The worker testified that whereas prior to 1996, keyboarding was only a small part of her duties, subsequent to 1996, the majority of her day was spent on this activity. She did however answer the telephone and assisted other personnel with their duties.

In or about 1998 the worker experienced tingling in her left forearm when she was drying her hair with a hairdryer. She consulted her family physician who told her that this was a sign of CTS and advised her to wear a splint; she did so while at work. The worker also advised her supervisor of her symptoms. However, no green card or accident report was filled out at that time.

With time, the worker began experiencing similar symptoms in her right wrist. In 2000, she went to a sports medicine clinic where she was advised once again to wear a splint, which she did. She now was wearing splints on both hands while at work. However, she took the splints off outside of work.

The worker continued to work at her regular duties. On occasion her supervisor would verify her work station to ensure that she was appropriately positioned. The worker stated at the hearing that she sat at her workstation with her arms by her side, bent at a 90 degree angle out front; her wrists were at approximately the same angle as she wore splints on both wrists. She stated however that she never could get comfortable at her work station as she found it difficult to work with the splints on; she felt that she could not perform as well with them.

The worker's hand symptoms continued to progress. She felt excruciating pain and would sometimes take a day off to recuperate.

In September, 2004, the worker left employment with her employer. Her CTS symptoms continued however began to deteriorate after that date. By May 2005, the worker could no longer wash her hair without pain. She attended at a neurologist who, on the basis of nerve conduction test results, advised the worker that she had severe CTS in her right hand, and moderate CTS in her left hand. He recommended surgery for her right hand. Given this latest advice, the worker filed a WCB claim because she would be required to be off work.

Worker's Position
The worker takes the position that her bilateral CTS was caused by her work duties which were repetitive and high volume in nature. She relies on several reports from her treating physicians, excerpts of which follow:
  • Medical report from her family physician dated November 3, 2005: "It is my opinion that she developed carpal tunnel syndrome due to the repetitive activity related to her type of work."

  • Medical report from her treating neurologist dated November 14, 2005: "In my September 14, 2004 letter… I indicated that data entry could be a contributing factor to her carpal tunnel syndrome. It is my understanding that this involved repetitive use of the hands which could become a strain on the wrists and contribute to carpal tunnel syndrome."
Analysis
Section 4(1) of The Worker's Compensation Act (hereafter the "Act") provides:
4(1) 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 the case before us therefore, the panel must find that the worker's CTS arose out of and in the course of employment. On the basis of the evidence before us, we are unable to make that determination.

CTS has many causes. In the case where a worker develops bilateral CTS, there is a strong suggestion that the cause is found elsewhere than in her work duties. For this reason, it is extremely important to understand the nature of the worker's duties and the stresses placed on her wrists or the position her wrists are in during the performance of these duties to determine whether it is the work duties that are causing stress on the worker's carpal tunnels. Indeed, as opined by the worker's own treating physicians, under certain circumstances repetitive data entry work can cause strain on the wrists and lead to CTS.

At the hearing, the panel heard lengthy evidence about the worker's job duties. These duties certainly involved keyboarding. However, the keyboarding was done mainly with the worker's right hand, and was not time pressured or repetitive in nature. For example:
  • With respect to receiving, the worker would place a one to two page packing slip to her left, and then enter that information into the computer. This consisted in keying in a six digit purchase order number using the tab key and numerical key pad. The purchase order corresponding to the packing slip would appear on the screen. The worker would then review the information on screen and validate it with respect to the items received and the orders pending; this entailed scrolling down the computer screen with the arrow keys and inputting numbers using the numerical key pad. When finished, the worker would place the packing slips in a basket on a filing cabinet; the packing slips were filed at a later time, often at the end of the day;

  • With respect to releasing orders, the worker would enter another screen on the computer and press "R" for all orders that needed to be released;

  • With respect to entering customer orders, the worker would enter a four digit customer number, the date, a one digit tax code, part numbers and quantity, and product description.
This description suggests that the worker's duties were more involved or varied than simply entering data; they required her to put some thought into the information she was entering. Not only did she need to look at the screen and the paper documents, but she also had to reflect as to whether the information on the computer was correct. For this reason, the worker would need to stop her keyboarding to review and verify the information she was entering. She was also interrupted in her keyboarding duties by telephone calls, filing duties and miscellaneous inquiries from her co-workers.

The worker also described her wrist position during her work duties as more or less neutral. In other words, the wrist was not flexed in such a manner as to put pressure on the carpal tunnel.

In our opinion, this description of work duties and the position of the worker's wrist in performing these duties are not indicative of stress on the wrists that could cause CTS.

We find it significant that the worker's CTS symptoms developed first in her left hand in 1998. This onset is not contemporaneous with the increase in her work duties and is not consistent with her mainly right-handed use on the computer. We also find it significant that the worker's symptoms continued to plague her after she ceased her employment in September, 2004.

For these reasons, we do not find that the worker's CTS arose out of and in the course of her employment.

Panel Members

L. Martin, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

L. Martin - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 27th day of April, 2006

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