The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

An Appeal Panel hearing was held on December 8, 1998, following receipt of an appeal from a union representative, acting on behalf of the claimant. The Panel discussed this appeal on December 8, 1998.

Issue

Whether the chiropractic treatment for the claimant's right arm, right shoulder and right neck are related to his August 6, 1997, left elbow injury.

Decision

That chiropractic treatment for the claimant's right arm, right shoulder and right neck are not related to his August 6, 1997, left elbow injury.

Background

On February 12, 1998, the claimant submitted an application for compensation benefits in relation to fall at work on August 6, 1997, when he slipped and fell on a wet floor landing on his left elbow. At the time of accident, the claimant did not miss time from work but later attended a chiropractor for treatment on August 27, 1997. The chiropractor reported that the claimant slipped and fell at work striking his left elbow and jarring his neck and upper back. The diagnosis was a cervicothoracic subluxation/sprain with nerve root irritation. The next chiropractic report, dated March 17, 1998, referred to discomfort and stiffness of the right lower neck and top of the shoulder region.

On February 19, 1998, a Workers Compensation Board (WCB) adjudicator spoke to the claimant by phone. The claimant stated that on the day of accident he was running to get the telephone when he slipped on a puddle of water and his feet went from underneath him. His left elbow landed on a metal tool box which was three feet high and on wheels. The claimant said he hit his elbow at the bottom of the tool box. Additionally, the claimant advised the adjudicator that he split and bruised his elbow and did not remember hitting his head. About one week later he began to notice pain in his shoulder near the collar bone. The claimant advised that he did not immediately seek medical treatment as the pain was not that bad after the injury occurred. The claimant added that his chiropractor suggested that his shoulder pain was like a form of whiplash and that this was how the shoulder pain was related to the fall. It was also noted that prior to the compensable injury the claimant was being treated for a motor vehicle accident by the chiropractor.

Following consultation with a WCB chiropractic consultant on April 6, 1998, Case Management wrote to the chiropractor on May 20, 1998, indicating that treatments in relation to the claimant's right neck and arm were not related to the August 6, 1997, workplace injury and that any billings should be referred to another firm or agency. On June 18, 1998, the claimant appealed this decision to the Review Office.

On July 17, 1998, the Review Office confirmed that no responsibility would be assumed for chiropractic treatments for the right shoulder, arm and right neck as a relationship between this treatment and the injuries sustained to the left elbow could not be established. Review Office noted the following when rendering its decision:

• the claimant did not seek medical attention until August 27, 1997, approximately three weeks after the fact when he reported to his chiropractor;
• subsequently, in March 1998, the claimant again contacted his chiropractor complaining of discomfort and stiffness in the right lower neck, right shoulder region and right arm. There appeared to be no treatment provided to the claimant between August 27, 1997, and March 17, 1998.
• the Review Office concluded that any difficulty the claimant was experiencing to his right neck, shoulder, or arm was unrelated to the injury sustained to the left elbow on August 6, 1997.

The claimant appealed the Review Office's decision and an oral hearing was held on December 8, 1998.

Reasons

In arriving at our decision, we attached considerable weight to an opinion expressed by the WCB's chiropractic consultant. His opinion is contained in a memo to file, dated April 6th,1998.

"In my opinion, the cause/effect relationship cannot be established between present status and the effects of the compensable injury. There was a one week interval between his injury and development of R CT/shoulder problems. One would expect impact on the L elbow to effect the L shoulder primarily and that the effects would manifest symptomatically before 7 days had passed. Further, mechanical spinal pain is well known to occur idiopathically and fairly frequently in the general population. In my opinion, there is not sufficient evidence to establish cause/effect."

We find, based on the weight of evidence, that the mechanism of injury is not consistent with the difficulties for which he sought treatment some three weeks subsequent to his fall. Consequently, the chiropratic treatment for the claimant's right arm, right shoulder and right neck are not, on a balance of probabilities, related to his August 6th,1997, left elbow injury.

The 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 26th day of January, 1999