The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

An appeal panel file review was held on July 10, 2006, at the request of the worker. The panel discussed this appeal on the same date.

Issue

Whether or not the worker is entitled to wage loss benefits beyond February 3, 2006 in relation to the September 2, 2005 compensable injury.

Decision

That the worker is not entitled to wage loss benefits beyond February 3, 2006 in relation to the September 2, 2005 compensable injury.

Decision: Unanimous

Background

On September 20, 2005, the worker contacted the Claims Information Centre at the Manitoba Workers Compensation Board (WCB) to report an injury to his right wrist/hand that occurred on September 2, 2005. It was reported that on the day of accident, the worker was shuffling boxes of paper when a strap broke resulting in the box falling against his right hand/wrist. He further reported that his right hand/wrist was previously disabled in 1983 as a result of a crush injury. The WCB accepted financial responsibility for this claim and wage loss benefits were extended effective September 6, 2005.

A review of the worker's 1983 claim file reveals that on September 16, 1983, while piling lengths of lumber, they slipped out of the worker's left hand and fell upon the right hand/wrist. The accident resulted in a ligamentous disruption of the wrist for which the worker has had numerous surgical procedures including a fusion of the wrist. As a result of the accident, the worker received support from the WCB by way of temporary total disability benefits, vocational rehabilitation services as well as a 33% permanent partial disability award.

In relation to the 2005 claim, the worker sought medical treatment from his family physician on the date of accident. The physician provided a diagnosis of contusion of the right wrist and prescribed anti-inflammatory medications, analgesics and rest. An x-ray of the right wrist was ordered the results of which identified the previous fusion procedure. No other complications were identified.

The worker continued to seek treatment from his family physician and according to the submitted reports, the worker's progress was slow with occasional set backs due to the effects of the previous injury. In addition, from conversations with the case manager, the worker expressed concerns with respect to his right hand condition and his employment situation. The worker indicated that his current position is being phased out and he only has two years in which to find suitable alternate employment. In light of the fact that he is once again on WCB benefits, the worker expressed frustration with respect to his overall situation.

In light of these complexities, arrangements were made for the worker to be assessed by a WCB orthopaedic surgeon on November 17, 2005 followed by an assessment by the WCB Pain Management Unit (PMU) which took place on November 29, 2005.

The November 17, 2005 examination by the WCB orthopaedic consultant did not reveal any swelling about the right wrist, hand or fingers. The WCB orthopaedic consultant did not detect any evidence of a significant soft tissue or bony injury. Nonetheless, the consultant wished to review some recent wrist x-rays which were performed on October 3, 2005 and in addition, arrange for the worker to have a bone scan performed.

The October 3, 2005 x-rays were reviewed and again revealed the previous surgical interventions. The report also indicated no evidence of a recent fracture. The orthopaedic consultant reviewed the film and compared the results to the previous x-ray of September 2, 2005 and indicated that he could not detect any changes on these films.

The bone scan was performed on November 23, 2005 at the Nuclear Medicine Department of a local clinic. The results of the bone scan were reviewed by the radiologist in correlation with the submitted radiographs of the worker's right wrist and hand as performed on September 2, 2005. The impression was as follows:

"Moderate focal activity in the right wrist in the central distal carpal region and head of the 3^rd metacarpal. This may represent sites of micro motion within the arthrodesis. There is no hyperemia to suggest infection or a recent fracture."

The bone scan results were subsequently reviewed by the orthopaedic consultant on December 28, 2005 at which time he opined that the September 2, 2005 accident resulted in a soft tissue injury, the effects of which would have now resolved. It was felt that the worker was fit to return to his pre-accident duties in accordance with the permanent restrictions imposed as a result of the 1983 injury.

The worker was assessed by the PMU on November 29, 2005. The assessment was arranged as the worker was continuing to experience difficulties with prolonged pain. Present at this assessment was the worker as well as the PMU psychology advisor and medical advisor. Based on the interview and assessment, the PMU reported a good prognosis for the worker with respect to returning to work. He was felt to be an individual who has proven himself as career-oriented, motivated and determined. It was further felt that the barriers to recovery appeared to be significant report of pain and disability, mood/affective difficulties and deconditioning.

Following a telephone conversation on January 26, 2006, the case manager provided the worker with a letter confirming that financial responsibility for the effects of the September 2, 2005 compensable injury would end February 3, 2006. The case manager indicated, based on a balance of probabilities, that recovery from the effects of the compensable injury had been achieved. In support of this conclusion, the case manager referenced the mechanism of injury, test results including x-ray and bone scan as well as the opinion of the WCB orthopaedic consultant.

By way of letter dated February 9, 2006, the worker requested reconsideration of the case manager's decision.

Review Office reviewed the matter at the worker's request and by letter dated March 3, 2006, determined that the decision of primary adjudication should stand. In reaching this conclusion, Review Office noted that the worker had ongoing complaints of pain following his previous injury in 1983 for which permanent restrictions had been imposed and for which continuing treatment was being sought. Note was made of recent assessments at the pain clinic in February 2004 for complaints of significant cold sensitivity which increased the worker's pain levels to a reported 9/10. It was further noted that the worker was incurring time loss from work of approximately 35 days per year as a result of the injury and in addition, was using large amounts of analgesics for pain control. In addition, Review Office accepted the opinion of the WCB orthopaedic consultant who indicated that the September 2, 2005 accident resulted in a soft tissue injury the effects of which had since resolved.

On April 28, 2006, the worker completed an application to appeal requesting consideration by the Appeal Commission. A file review into this matter was conducted on July 10, 2006.

Reasons

To accept the worker's appeal, we must find that the effects of his September 2, 2005 workplace accident have not resolved. We are unable to make that finding.

The worker suffered from pre-existing ongoing complaints since his 1983 workplace accident for which he received surgical treatment. The September 2, 2005 workplace accident resulted solely in soft tissue injury.

The worker's written submissions to the WCB appear to suggest that he feels he suffered more than soft tissue injury. The test results do not bear this out; they only show evidence of prior surgery to his right hand as a result of the 1983 accident.

When seen by the WCB orthopaedic consultant on November 17, 2005 there was no longer any swelling or other symptoms consistent with a soft tissue injury. We therefore find, on a balance of probabilities that the worker's soft tissue injuries from the September 2, 2005 accident had resolved. Consequently, we find that the worker is not entitled to wage loss benefits beyond February 3, 2006 in relation to the September 2, 2005 compensable injury.

Accordingly, the worker's appeal is denied.

Panel Members

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

Recording Secretary, B. Kosc

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

Signed at Winnipeg this 10th day of August, 2006