Decision #154/99 - Type: Workers Compensation

Preamble

A non-oral file review was held on August 26, 1999, at the request of the claimant. The Panel discussed this case on August 26, 1999, and October 26, 1999.

Issue

Whether or not the claimant is entitled to a Permanent Partial Impairment Award for her right knee; and

Whether or not the claimant's impairment award has been correctly calculated.

Decision

That the claimant is not entitled to a Permanent Partial Impairment Award for her right knee; and

That the claimant's impairment award has been correctly calculated.

Background

On October 27, 1995, the claimant fell while carrying two bags with coffee supplies. She attempted to grab a hand railing with her right hand, resulting in her thumb being twisted backwards. The claimant also scraped her right knee at the time. The claim was accepted as a responsibility of the Workers Compensation Board (WCB) and benefits were paid accordingly.

Medical information showed that the claimant was diagnosed with a right hand sprain and a contusion to the right knee. X-rays later revealed a small chip avulsion fracture on the ulnar side of the base of the proximal phalanx. On June 21, 1996, the claimant underwent repair to the ulnar collateral ligament of the right thumb and on January 17, 1997, underwent reconstruction of the ulnar collateral ligament of the right thumb. The claimant continued to experience soreness in her right shoulder which was eventually diagnosed as capsulitis.

The claimant was assessed at the WCB offices on January 28, 1999, for the purposes of establishing a permanent partial impairment rating. According to the examination results, the examining Impairment Awards Medical Advisor awarded the claimant 1.8% for the right wrist and 5.3% for the right thumb (2.5% for the right thumb IP joint, 1.3% for the right thumb MP joint and 1.5% for the right thumb CMC joint). The claimant was also awarded 1% for a cosmetic impairment. Using the combined values chart, the medical advisor indicated that the total PPI was 8%.

On March 17, 1999, the claimant was advised that she was entitled to an award based on an impairment rating of 8% and that the amount of the award had been calculated in accordance with Section 38(2) of the Workers Compensation Act (the Act). The amount of the one time payment was $954.00. It was also noted that the claimant's award was reduced as she was over 45 years at the time the award was calculated.

In a letter of appeal dated March 23, 1999, the claimant asked Review Office to reconsider her case on the grounds that no impairment award was given for her right shoulder and that age discrimination resulted in the reduction of her impairment award. Prior to rendering its decision, Review Office requested the Impairment Awards Medical Advisor to provide a rating for the loss in range of movement of the right shoulder. In a memorandum, dated April 6, 1999, the medical advisor documented that the rating for a shoulder which was ankylosed or fused in a position of function was 25%. The loss in range of movement was therefore 55/560 x 25% = 2.5%. When using the combined values table and including the cosmetic rating of 1%, the final rating was 10%.

On April 9, 1999, Review Office increased the claimant's impairment award from 8% to 10%. Review Office concurred with the claimant that a rating for the shoulder should have been provided considering there was a permanent loss in the shoulder range of movement and the shoulder had been accepted by the adjudicator as a consequence of the accident. The rating for the shoulder was calculated at 2.5% but the overall rating must be calculated according to the combined values table which is used when there are multiple parts of a body that have impairment ratings. This procedure produced a rating of 10% and Review Office found this rating correctly calculated in accordance with the WCB's permanent impairment rating schedule.

Review Office further stated that claimant was not eligible to receive any additional financial settlement because of the stipulations set out in Section 38(2) of the Act. In order for the claimant to receive a lump sum dollar value in excess of what she had already been paid, the impairment rating must be a full 1% greater than the 10% rating currently in effect.

On April 30, 1999, the claimant appealed Review Office's decision stating that she should have an entitlement to a PPI award for her knee injury in addition to the hand and shoulder injury sustained on October 27, 1995. The Appeal Administrator at the Appeal Commission then referred the case back to Review Office to consider this issue.

In a letter, dated June 16, 1999, Review Office advised the claimant, after a review of the medical evidence, that her right knee did not present an ongoing problem as a result of the accident. Therefore, she was not entitled to a permanent partial impairment rating for her right knee. The case was then referred back to the Appeal Commission and a non-oral file review was held on August 26, 1999.

Following the August 26th review, the Appeal Panel requested additional information prior to discussing the case further. Specifically, the Panel requested further clarification from the WCB with respect to the method of calculation of the claimant's PPI award. A response was subsequently received from Healthcare Management Services, dated September 30, 1999, and was forwarded to the interested parties for comment. On October 26, 1999, the Panel met to render its final decision.

Reasons

When first examined by her treating physician on October 27th, 1995, he reported a 2 to 3 centimeter abrasion and contusion to the claimant's right tibia tubercle. In addition, the physician observed that the claimant had normal gait and normal range of movement of the right knee. There has been no medical evidence received on file that even remotely suggests the claimant suffered a loss of range of motion to her right knee as a result of her compensable injury. Accordingly, we find that the claimant is therefore not entitled to a permanent partial impairment award for her right knee.

The method of calculation adopted by the WCB and implemented by its medical consultants is simply to combine or add the two lowest percentages together and the sum is then added to the next higher percentage and so on. If both numbers are less than 5, then the numbers are simply added together without any rounding. Rounding only begins when one or both of the percentages are greater than 5 and it is at this point that the combined value chart is used. It is important to note that the combined value chart requires whole numbers and it is for this reason that the rounding takes place. We have very carefully reviewed the calculation of the claimant's current impairment award and find same to have been correctly calculated in accordance with the permanent partial impairment rating schedule employed by the WCB.

In light of the foregoing determinations, the claimant's appeal is hereby dismissed.

Panel Members

R. W. MacNeil, Presiding Officer
A. Finkel, Commissioner
R. Frisken, Commissioner

Recording Secretary, B. Miller

R. W. MacNeil - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 9th day of November, 1999

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