The Appeal CommissionThe Workers Compensation Act of Manitoba

On June 3, 1997, the claimant submitted an application for compensation benefits in relation to a right foot and left arm injury that occurred on February 11, 1997 when he fell on a wet and snowy deck of a truck. The claimant advised that he did not seek immediate medical attention as he did not think his injuries were serious enough and he continued to work until his arms progressively got worse.

On June 19, 1997, the claimant advised a Workers Compensation Board (WCB) representative that he was claiming for costs associated with physiotherapy and time missed from work in order to attend the physiotherapy appointments. The claimant advised that he broke 3 bones on the side of his foot as he hit the truck while falling. The claimant said that he grabbed the tarp straps to stop him from falling and this was what caused the injury to his elbow. In February, his doctor prescribed an elbow brace.

In another memo dated July 10, 1997, the claimant advised a WCB adjudicator that because he was favoring his left arm, this led to difficulties with his right arm. He then began to do less and less heavy lifting at work. The claimant advised that he had full range of motion in both arms and that his left arm was still painful.

On February 19, 1997, the attending physician noted gradual onset of pain in the elbows with lifting at work. The diagnosis was bilateral epicondylitis.

On a July 10, 1997 physiotherapist’s report, the diagnosis of the claimant’s condition was entered as rotator cuff tendinitis and lateral epicondylitis. In July 1997, the WCB accepted responsibility for the physiotherapy treatments and the claimant’s time loss to attend therapy.

On November 19, 1997, the claimant contacted the WCB indicating that he attended physiotherapy over the summer and that he also performed home exercises. He was feeling fine up until last week and then started to experience discomfort in both arms. He was not sure what happened but he did mention that he had been moving furniture over the weekend. He attended a chiropractor for treatment.

A sworn statement was taken from the claimant outlining the activities and difficulties that he experienced between July 1997 and January 1998. Effective January 22, 1998, the claimant was laid off as he was unable to perform his work. In the interim, he received employment insurance benefits and took computer skills training.

In a March 31, 1998 report, the attending physician indicated that the claimant presented with increasing shoulder problems since December 1997. X-rays showed some degenerative changes in the glenohumeral joint with marked degenerative changes in the acromioclavicular (AC) joint. The physician suspected that the claimant had some impingement of his rotator cuff associated with a marked degeneration of his AC joint.

On May 13, 1998, a WCB medical advisor reviewed the case at the request of Claims Services. The medical advisor was of the view that:

• the claimant had bilateral epicondylitis from repeated lifting, likely initiated by the compensable injury;

• the degenerative changes in the shoulder were not due to the compensable injury; and

• the claimant’s neck complaints were “questionably” related to the accident.

In a report dated June 29, 1998, an orthopaedic surgeon noted that the claimant likely had a case of rotator cuff tendinitis. Referrals were made for the claimant to attend physiotherapy and for a right shoulder arthrogram to be conducted in order to rule out a rotator cuff tear.

Following his review of the case on June 18, 1998, a WCB physiotherapy consultant indicated that he would not authorize any further treatment to the claimant’s shoulder as there was no recent objective medical information to warrant same.

A right shoulder arthrogram was carried out on June 25, 1998. The impression read, “Mildly irregular under surface to the rotator cuff suggesting mild degeneration but no tear identified.”

On July 29, 1998, Claims Services wrote to the claimant stating the following:

• that the WCB would not accept responsibility for his shoulder or neck complaints as they were not considered a consequence of his compensable accident;

• although the claimant’s elbow complaints were considered compensable, the need for time loss from January 8 to 22, 1998 and January 29 to May 1, 1998 had not been established; and

• the WCB would not pay for physiotherapy costs directed towards the shoulder as the shoulder complaints were not considered work related.

Subsequent to the July 29^th decision letter, Claims Services wrote the claimant on February 25, 1999 and May 31, 1999 confirming that his shoulder complaints were not considered related to the February 19, 1997 work place accident. In November 1999, the claimant appealed the decision to Review Office.

In a January 7, 2000 decision, Review Office determined that the claimant was entitled to benefits up to March 25, 1998 and that any right shoulder complaints after this date were not considered to be related to the compensable accident. In addition, Review Office determined that the claimant was not entitled to reimbursement of any of his costs associated with a retraining program.

Review Office stated that the claimant injured his right foot and left elbow when he fell in February 1997. He later developed right shoulder and right elbow complaints. Review Office accepted that these complaints did result from the claimant’s favoring his left elbow while working. The right foot and bilateral elbow complaints resolved during 1997. The right shoulder remained symptomatic and was periodically aggravated by specific events.

Review Office indicated that the degenerative changes to the right AC joint and degenerative changes of the right rotator cuff were naturally occurring changes and in no way were the result of the claimant’s compensable accident. In the opinion of Review Office, the claimant’s right shoulder complaints subsequent to March 25, 1998, were related to his pre-existing, non-compensable degenerative changes. This determination was based on the comments expressed by the physiotherapist that the claimant had been discharged from treatment on March 25, 1998, with the recommendation that he avoid overhead work. The claimant was therefore entitled to wage loss benefits from the time he missed work due to his right shoulder complaints up until March 25, 1998, inclusive.

Review Office accepted no responsibility for the claimant’s retraining expenses, as the recommendation that the claimant obtain alternate employment was made in respect of his non-compensable shoulder condition. In April, 2000, the claimant appealed Review Office’s decision and an oral hearing was arranged.