Public Decisions | The Appeal Commission

Decision #166/99 - Type: Workers Compensation

Preamble

A non-oral file review was held on November 16, 1999, at the request of the claimant.

Issue

Whether or not the claimant is entitled to benefits beyond August 19, 1998 in relation to her compensable injury of June 29, 1998.

Decision

The claimant was not entitled to benefits beyond August 19, 1998 in relation to her compensable injury of June 29, 1998.

Background

While performing the duties of a meat wrapper on June 29, 1998, a co-worker accidentally bumped the claimant in the back with a meat tray resulting in pain down the claimant's leg and up her back. The initial diagnosis reported by the attending physician was SI joint pain and nerve irritation. The claimant continued working after the accident and attended physiotherapy treatments for approximately six weeks which did not help. By August 18, 1998, the claimant discontinued working due to increasing pain.

During a telephone conversation with the claimant on August 28, 1998, a Workers Compensation Board (WCB) adjudicator documented that the claimant never had any prior low back difficulties but had injured her tailbone about 20 years ago. The claimant described a sharp stabbing pain on the low left side of her back when she walked too much or if she laid down too long. The claimant said she experienced a numbing sensation on the top and outside of her left leg down to her knee. The claimant advised that she never had numbing in her leg until the injury. She further indicated that her doctor told her she had phlebitis which was causing the numbness in her leg. The claimant felt, however, that this was related to the compensable injury as she never had it previously. The claimant stated she was six months pregnant and that her pregnancy had been uneventful.

On September 17, 1998, the case was reviewed by a WCB medical advisor at the request of the adjudicator. In the opinion of the medical advisor, the claimant's signs and symptoms, on a balance of probabilities, were secondary to her pregnancy. In a letter to the claimant, dated September 28, 1998, primary adjudication conveyed the medical advisor's opinion to the claimant. She was further notified that no benefits would be issued for time loss as of August 19, 1998 or for any costs associated with medical treatment.

The next report on file was prepared by a chiropractor, dated September 17, 1998. The diagnosis was left sacroiliac joint syndrome and the chiropractor prescribed chiropractic adjustments. In a subsequent report, dated October 1, 1998, the chiropractor's view was that the claimant's symptoms were consistent with the work injury as opposed to her being pregnant.

A report was also received from the attending physician, dated October 8, 1998. The physician stated that he had initially treated the claimant on July 3, 1998 and that she exhibited tenderness at the left SI joint on palpation with pain running down her leg. When seen on July 31st the claimant had a slight episode of phlebitis which was related to her pregnancy. By August 18, 1998, the claimant was still experiencing pain in her back and SI joint. In the opinion of the physician, the claimant's back problems were a direct result of her injury at work and were not related to her pregnancy.

In view of the above reports, primary adjudication referred the case back to the WCB medical advisor for further comments. On October 22, 1998, the medical advisor stated that the claimant sustained a contused lower back from the description of injury and that she would not have full hip mobility if there were any serious problems with the SI joint. In the opinion of the medical advisor, the attending physician did not provide objective information to support his opinion. On a balance, the claimant's SI joint dysfunction was secondary to her pregnancy and was not related to her being bumped with a tray. On October 27, 1998, primary adjudication advised the claimant that there would be no basis to change its previous decision of September 28, 1998.

On November 23, 1998, a worker advisor advanced the argument that the claimant was entitled to wage loss benefits as it was impossible to differentiate between whether her symptoms were due to her pregnancy or to the compensable injury based on the weight of medical evidence. Prior to rendering a final decision, Review Office requested that statements be obtained from the claimant and the accident witnesses. As well, a work site visit was also conducted. The purpose of the visit was to determine the amount of force involved in the original accident and the precise location of trauma to the claimant's back.

The claimant, in her statement, dated January 19, 1999, described the injury as follows:

"When the accident happened on June 29/98 I has (sic) stepped back a step and [co-worker's name] walked into me from behind. She was carrying a metal tray that is approximately 2 1/2 feet long by 1 foot wide. The corner of the tray hit me just to the left side of the tailbone area, on the upper left buttock area. At the time I felt a sharp pain to the area where the tray hit me. The accident happened at 1:00 - 2:00 p.m. My shift ended around 4:00 - 5:00 p.m. and it was probably a couple hours after that, while at home that I started to get the numbness down the front of the left thigh (from upper thigh) down to knee level (whereas my other numbness to the left leg was on the outer side of the thigh). I also started to get pain at that time, to a lesser degree to the left hip area surrounding the area where I got hit by the tray."

The claimant was also asked, "With what force were you hit with the tray?" The claimant responded, "The force was not hard enough to knock me forward. I don't think the force in which I got hit was the big issue, but rather the area in which I got hit and because I got hit by the corner of the tray. It is very hard to explain the amount of force in which the tray hit me." The claimant also advised that she was not aware of any bruising in the area hit with the tray.

On January 19, 1999, the manager of the meat department stated that he did not witness the accident but that the claimant did report the injury shortly after it occurred. He was also unaware of the claimant's having any back or leg symptoms prior to the accident.

On January 19, 1999, a WCB Field Representative, who attended the work site, noted that the aisleway was not confined to one or two steps and that there was room to walk a far distance back from the meat cutting area. The tray was described as a big aluminum cookie sheet with rounded corners and a lip at the top of the tray (rolled aluminum).

On January 25, 1999, the file documentation was reviewed by a WCB orthopaedic consultant at the request of Review Office. The orthopaedic consultant stated the following:

"A tray striking the lower portion of the back will not produce any significant injury to the sacroiliac joint. This is the strongest joint in the body and is a diarthrodial joint and requires major trauma in order to disrupt it or cause any dysfunction to the joint itself. The mechanism of injury could give rise to a local soft tissue contusion or possibly a bone bruise - neither of which should produce any significant work time loss or require any specific treatment other than initially local ice to the tender area followed by heat over a period of 48 to 72 hours."

On January 29, 1999, Review Office determined the following:

the claimant's injury (left sacroiliac joint problems) after August 19, 1998 were not a probable or reasonable consequence of the work related accident she suffered on June 29, 1998; and
the particular injury was more likely to be a complication of the claimant's pregnancy;
the effects of her work-related accident did not likely contribute materially to the left sacroiliac joint problem which persisted after August 19, 1998; and
benefits were not payable under the provisions of the Workers Compensation Act, for the effects of the left sacroiliac problem which apparently because the predominant reason for the claimant's disablement and symptomatology after August 19, 1998.

Review Office was of the opinion, based on the weight of medical evidence, that the claimant's left sacroiliac problem was not a reasonable or probable consequence of the "minor" work related trauma the claimant experienced in June 1998 but was more likely to be a common complication of pregnancy.

On October 5, 1999, the worker advisor appealed Review Office's decision and requested a non-oral file review. Included with her request was additional evidence for the Panel's review and consideration. On November 16, 1999, a non-oral file review was conducted.

Reasons

The weight of medical evidence does not, on a balance of probabilities, support the claimant's contention of continued disability beyond August 19th, 1998, as a result of her compensable injury of June 29th, 1998. In arriving at this conclusion, we attached considerable weight to the mechanism of injury as well as those opinions expressed by the WCB medical advisors.

On October 22nd, 1998, a WCB medical advisor reviewed the file and recorded the following comments in a memorandum:

"From the description of injury she at most sustained a contused lower back. She would not have full hip mobility if there was any serious problems with the SI joint. On balance, if she does have a SI joint dysfunction it would be secondary to her pregnancy and not being bumped with a tray."

The orthopaedic consultant to Review Office was asked to provide his opinion with regard to a causal connection between the claimant's work accident and her medical difficulties. In a memorandum, dated January 25th, 1999, he responded by saying:

In accordance with our findings, 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 7th day of December, 1999

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