Decision #36/01 - Type: Workers Compensation
Preamble
An Appeal Panel hearing was held on February 19, 2001, at the request of the claimant. The Panel discussed this appeal on February 19, 2001.
Issue
Whether or not the claim is acceptable.
Decision
That the claim is acceptable.
Background
In November 1999, the claimant filed a compensation claim for bilateral carpal tunnel syndrome (CTS) which she related to her employment activities in a garment manufacturing plant.
In a Doctor’s First Report dated November 10, 1999, the attending physician outlined the claimant’s history of injury as follows: “Bilateral hand numbness, right more than left, especially severe at night. Perceived hand weakness. First reported August 11/99.” Subjective complaints were as follows: “Patient lifts heavy fabric bundles and pushes heavy carts of fabric.” The diagnosis was bilateral CTS. On January 19, 2000, a specialist recommended that the claimant undergo right sided carpal tunnel release.
In a letter from the employer dated December 13, 1999, it was noted that the claimant worked as sewing machine operator for one month, a sample maker for one month and was a supervisor for the past 20 years. The duties were not considered to be repetitive in nature and the work did not expose the claimant to excessive forces. On November 22, 1999, the claimant indicated she had sore wrists but did not complain much.
On February 9, 2000, a WCB medical advisor was asked to review the file and to respond to several questions that were posed by primary adjudication. In brief, the medical advisor confirmed that CTS was the correct diagnosis and was of the opinion that the diagnosis was not consistent with the claimant’s work duties. The medical advisor stated that “obesity” was identified as a significant non-work related risk factor in this case.
On February 17, 2000, primary adjudication denied the claim for CTS stating that the claimant’s non-work related risk factors were significant and that her work activities did not play a role in the development of CTS. On May 25, 2000, the claimant appealed the decision and the case was referred to Review Office for consideration.
In a decision dated June 23, 2000, Review Office confirmed that the claim for CTS was not acceptable. It was the opinion of Review Office that on a balance of probabilities, the evidence did not support the claimant’s contention that she developed CTS as a result of her employment in the garment factory. Review Office stated it was “highly unlikely that the specific actions involved in the worker’s job description are repetitive and that they create risk hazards sufficient for the worker to develop carpal tunnel syndrome.” On December 2, 2000, the claimant appealed Review Office’s decision and an oral hearing was convened.
Reasons
This is the case of a woman who has been diagnosed with bilateral carpal tunnel syndrome, which she believes is due to her work activities. The WCB has determined that this injury is not work-related. Her appeal to the Review Office was denied.
At issue in this appeal, therefore, is whether or not the injury arose out of and in the course of the worker’s employment. As provided for in section 4(1) of The Workers’ Compensation Act, compensation is payable when a worker sustains an injury in such circumstances.
There is no debate as to the diagnosis. Her attending physician, specialist and the Board medical consultant agree with it. The debate is as to its cause. Her family doctor and the specialist to whom she was referred are of the view that it arose out of her work. The board consultant has attributed its cause to obesity.
After reviewing the file and hearing the presentation of the claimant, we have concluded that her CTS arose out of and in the course of her employment.
We found the claimant to be a very credible witness. We found her to be a dedicated employee, who has missed very little time as a result of her injury. The claimant and her daughter, who was assisting her with her presentation and has worked in the same workplace, described her typical work activities. She has held the same job for over twenty years. Typical activities include pushing and pulling carts, carrying fairly heavy bundles and other activities which place some stress on her wrists and arms. While her principal job is supervisory, there is enough regular physical work that, over many years, could lead to CTS. This description convinced us that, at least on a balance of probabilities, her injury could very well be causally related to her job.
We were further persuaded, in this regard, by the report of the specialist, who noted that when she was off work for a five-week vacation, her symptoms improved significantly. After her return to work, the symptoms came back.
We also considered the matter of 'obesity'. It was on the basis of her supposed obesity that the Board consultant determined that her CTS was not work-related. We note that, while obesity may place a person at-risk of contracting CTS, it is not necessarily the cause. In meeting the claimant at the hearing, we found her to be short and of a "stocky" build, but was not what any of us considered to be obese (although, we do recognize that her BMI fits the medical definition of obese.) We particularly noted that her arms are as slender as those of a much slimmer person. We felt that - on the balance of probabilities test - obesity was not the principal factor in her contracting CTS.
In conclusion, we are of the view that the claimant's Carpal Tunnel Syndrome did arise out of and in the course of her employment.
Accordingly, the appeal is allowed.
Panel Members
T. Sargeant, Presiding Officer
E. Krosney, Commissioner
M. Day, Commissioner
Recording Secretary, B. Miller
T. Sargeant - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 2nd day of March, 2001