The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

An Appeal Panel hearing was held on November 6, 2003, at the request of a union representative, acting on behalf of the claimant. The Panel discussed this appeal on November 6, 2003.

Issue

Whether or not the diagnosis of bilateral Carpal Tunnel Syndrome is acceptable as a consequence of the compensable injury of September 2001 and/or in relation to the general nature of the claimant’s job duties.

Decision

That the diagnosis of bilateral Carpal Tunnel Syndrome is not acceptable as a consequence of the compensable injury of September 2001 and/or in relation to the general nature of the claimant’s job duties.

Decision: Unanimous

Background

On January 20, 2001, the claimant suffered a crush injury to his fourth and fifth fingers of his right hand during the course of his employment as a sheet metal mechanic. As a result of the accident, the claimant underwent several surgical procedures involving the right ring and little fingers. The Workers Compensation Board (WCB) accepted the claim and benefits and services have been provided to the claimant.

With respect to the issue under appeal, a report was received from a neurologist dated June 28, 2002. The neurologist reported that the claimant began to develop right sided neck pain a few weeks ago which was intermittent. The claimant had some fluctuating pain and cramping in his right index and middle finger with occasional numbness since the accident. The neurologist outlined his examination findings and the results of nerve conduction studies. He concluded that the claimant’s residual pain may be a component of causalgia and there was some local ulnar nerve injury in the fingers. The claimant had slowing in both median nerves at the wrist, moderate on the right and severe on the left.

On August 16, 2002, the claimant filled out a Carpal Tunnel Syndrome (CTS) questionnaire in which he described the repetitive work duties that he performed, the signs/symptoms that he felt in his hands, wrist and neck and details of his past medical history. The accident employer also provided the WCB with information concerning the type of work duties that the claimant performed and the percentage of time that he performed these duties during the week.

On October 2, 2002, a plastic surgeon reported that the claimant’s recent nerve conduction studies showed the presence of moderate right and severe left CTS. The claimant, however, did not complain of any significant symptoms in either wrist and the surgeon recommended to leave this condition alone for now and to treat the claimant conservatively.

Following consultation with a WCB medical advisor on November 1, 2002, primary adjudication advised the claimant on January 3, 2003 that the WCB was unable to accept responsibility for his bilateral CTS condition as it considered his condition was unrelated to the amputation injury of September 2001 and would not be related to his regular job duties. It also felt that the claimant’s bilateral CTS condition did not meet the requirements of Section 4(1) of The Workers Compensation Act (the Act) and would not be accepted as a new workplace injury.

On March 25, 2003, the claimant’s union representative wrote to Review Office contending that the claimant’s CTS condition was a work related. In support of his position, the union representative provided the WCB with a report prepared by the claimant’s treating physician dated February 20, 2003, who stated, in part, “Mr. [the claimant] denies any problems with symptoms related to carpal tunnel syndrome prior to his work-related injury of September 20, 2001 and I believe that the problems with his carpal tunnel syndrome are indeed work-related.”

Prior to considering the appeal, Review Office asked a WCB orthopaedic consultant to provide his opinion as to whether or not the claimant’s bilateral CTS condition was due to either the original compensable accident or to his work duties, or to a combination of both. The consultant’s response to this query is dated April 1, 2003.

On April 18, 2003, Review Office determined that the claimant’s bilateral CTS condition was unrelated to the amputation injury of September 2001 or to his regular job duties based on the following factors:

• there was no evidence to support the conclusion that the claimant’s left CTS condition was related to the amputation injury as the left hand was uninjured in the accident. There was also no evidence to support the conclusion that the right CTS condition was related to the nature of the accident.

• the claimant denied any symptomatology prior to the accident when he was working on a regular basis. It was not until 10 months post accident when he began to make complaints that led to the investigation of CTS. Review Office believed that the development of his symptoms were not consistent with his work activities given the late onset of his complaints.

On July 15, 2003, the claimant disagreed with Review Office’s decision and an oral hearing was arranged.

Reasons

After thoroughly reviewing all of the evidence, we find that the claimant’s carpal tunnel syndrome is, on a balance of probabilities, idiopathic in nature and not in anyway related to his job duties. In arriving at this decision, we attached considerable weight to the following body of evidence:

In conclusion, we find based on the preponderance of evidence that the diagnosis of bilateral Carpal Tunnel Syndrome is not acceptable as a consequence of the compensable injury of September 2001 and / or in relation to the general nature of the claimant’s job duties. Accordingly, the claimant’s appeal is hereby dismissed.

Panel Members

R. W. MacNeil, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Miller

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

Signed at Winnipeg this 9th day of December, 2003