Decision #01/99 - Type: Workers Compensation
Preamble
An Appeal Panel hearing was held on October 6, 1998, at the request of an advocate, acting on behalf of the claimant. The Panel discussed this case on October 6, 1998, and again on November 24, 1998.
Issue
Whether the claimant's claim for bilateral knee complaints is acceptable in accordance with sections 1(1) and 4(1) of The Workers Compensation Act; and
Whether the claimant is entitled to benefits.
Decision
That the claimant's claim for bilateral knee complaints is not acceptable in accordance with sections 1(1) and 4(1) of The Workers Compensation Act; and
That the claimant is not entitled to benefits.
Background
On March 27, 1995, the claimant submitted an application for compensation benefits indicating that he recently had liquid removed from his right knee and that he was told by his doctor this injury was sustained from his walking back and forth on a plating line at work. The injury had been reported to the employer on March 16, 1995.
On May 4, 1995, a signed statement was provided by the claimant to a Workers Compensation Board (WCB) field representative. The claimant stated that he was employed as a crane operator. His duties consisted of standing on a raised wooden platform dipping various pieces of metal in different solution tanks. He did not lift the materials. He operated a crane by pressing buttons on a control handle. The claimant indicated that he first began to experience pain in his knees in 1989. In early March 1995, his right knee began to swell up and he consulted an orthopaedic specialist. The claimant stated that there was no specific incident that precipitated the onset of pain but rather, the knee just started to swell one day. The claimant thought that all the walking he did on the line was what caused the problem with his knee.
A statement was provided by the claimant’s employer dated May 4, 1995. The employer stated the claimant approached him in early March 1995, regarding his knees. The claimant said that his knee was swollen and that he was in pain. There was no injury reported. The claimant merely stated that his knee was swollen and that he was going to see a doctor. The employer said there had never been any accident reported.
Medical information was obtained from an orthopaedic specialist dated April 10, 1995. The orthopaedic specialist reported that he first saw the claimant on November 9, 1989 and that the patient had history of knee pain especially at the end of a day’s work. Based on clinical findings of minor synovial thickening and pain deep to the patella, the clinical diagnosis was chrondromalacia patella. The orthopaedic specialist reviewed x-rays of both knees which revealed narrowing of the medial joint compartment on the right side associated with degenerative type of bony lipping at the femoral and tibial condyle. On March 16, the claimant had aspiration of the knee with micro of the fluid. The claimant was advised to use non-steroidal anti-inflammatory drugs and to avoid jobs and activity which required squatting and kneeling. The specialist expressed the opinion that the claimant had worked in the same job for more than 15 years and that his condition was definitely job related particularly when it involved carrying and pushing heavy objects together with periodic squatting. On March 22, 1995, an arthroscopy was advised to determine the extent of the damage and osteoarthritic change involving the right knee.
Other medical reports on file consisted of physicians’ letters dated September 29, 1994, February 8, 1995, and May 8, 1995, regarding treatment of the claimant’s knee condition between 1991 and 1995.
On May 10, 1995, Claims Services determined that a relationship did not exist between the claimant’s current condition and his employment in accordance with Sections 4(1) and 1(1) of The Workers Compensation Act (the Act). On February 5, 1998, this decision was appealed by the claimant’s advocate. He contended the claimant was entitled to benefits based on commentary that was expressed by the orthopaedic specialist in a letter dated April 10, 1995.
In a decision dated February 27, 1998, the Review Office determined that the claimant was not entitled to benefits for the effects of bilateral knee problems which resulted in absences from work beginning about March 1995. The Review Office did not find sufficient evidence to show that the claimant’s knee problems were, on balance of probabilities, the result of an accident arising out of and in the course of his employment. Further, Review Office was not satisfied that the claimant’s employment activities contributed any significant increased risk for this type of condition to occur. Review Office considered that the bilateral knee problems were just as likely related to obesity and the normal wear and tear of daily living. Review Office concluded that the medical evidence supported a causal relationship between this type of knee problem and extraordinary strain or trauma to a person’s knees. However, it did not consider there was any evidence to show that the claimant’s employment activities resulted in such extraordinary strain or trauma. In a letter to the claimant dated April 20, 1998, the Review Office confirmed the above decision and denied the advocate’s request for a Medical Review Panel.
On October 6, 1998, an Appeal Panel hearing was held at the request of the advocate. Following the hearing and discussion of the case, the Panel requested additional medical information be obtained from the claimant’s treating orthopaedic specialist.
On November 5, 1998, all interested parties were provided with the additional medical information which included a November 2, 1998, report from the treating orthopaedic specialist and an operative report dated August 25, 1995. On November 24, 1998, the Appeal Panel met to render its final decision after taking into consideration a letter received from the claimant’s advocate dated November 9, 1998.
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 accordance 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. That is, “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.”
The medical evidence clearly establishes that the claimant has a pre-existing non compensable osteoarthritic condition of both his left and right knees. There is no evidence to suggest that this condition arose out of or in the course of his employment. Further, we do not accept the claimant’s advocate’s contention that the claimant’s bilateral knee problem is an occupational disease within the meaning of the Act.
The claimant left his place of employment a short time after April 26, 1995, and has not been back to work since because of his knee difficulties (pain and swelling). X-rays taken of the claimant’s knees on March 15, 1995, revealed narrowing of the medial joint compartment on the right side associated with degenerative type of bony lipping, both at the femoral and tibial condyle. Arthroscopic examination of the right knee resulted in a chondroplasty of the degenerative articular surface including lateral release.
Recent x-rays taken on April 21, 1998, displayed well advanced osteoarthritis of the right knee and moderate osteoarthritis of the left knee with more progression of the severity of the left arthritis, as reported by the radiologist. There is no evidence that the claimant’s work duties enhanced this condition, as the radiological reports suggest an acceleration of the osteoarthritis after his leaving the workforce on a permanent basis.
We find, based on the weight of evidence, that there has been no accident within the meaning of the Act. Therefore, the claim is not acceptable and the appeal is hereby dismissed.
Panel Members
R. W. MacNeil, Presiding Officer
A. Finkel, Commissioner
C. Monk, Commissioner
Recording Secretary, B. Miller
R. W. MacNeil - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 4th day of January, 1999