The Appeal CommissionThe Workers Compensation Act of Manitoba

Background

The worker has been a federal government employee for many years. Her job duties and work hours have fluctuated. The worker’s latest job, and the one she began working at in 2001, is that of a general duties clerk. This is a full time permanent position.

The worker explained her duties at the hearing. She explained that she works in three weekly rotations as follows:

• One week is spent at a computer desk. The worker retrieves tubs of documents which she sorts manually sorts by date, then keys in some preliminary information into the computer, then peruses the document for errors. The physical activities involved in this job include pulling, lifting and carrying tubs, grabbing documents with her hands, and typing with her right hand on the numeric key pad. The amount of typing varies. The worker holds the pile of documents in her left hand with the wrist in neutral position;
• The second week is spent at the mail desk. This rotation comprises opening internal mail envelopes with string attachments, date stamping the mail with her right hand, putting mail into piles of 50, and walking the bundles to another station where they are put into slots.
• The third week is spent at a batching desk. This rotation requires the worker to go through various documents and pull out any with latent irregularities, batch and count the remaining documents by flipping with her right hand, then bundling them and carrying them over to another station.

The worker explained that she is right handed and therefore does most tasks with her right hand.

In about October 2002 the worker began suffering from CTS symptoms that occurred at night. When the symptoms did not go away a year later, she decided to see her doctor. She was sent for a nerve conduction study (“NCS”) on January 8, 2004 which revealed severe bilateral CTS, left more than right.

The worker’s claim for compensation was investigated by a WCB claims manager. A March 10, 2004 memorandum outlines the worker’s employment history, duties, and wrist position during the performance of those duties. It also explores some non-occupational factors that are thought to put people at risk for the development of CTS. In the worker’s case, these risk factors include the worker’s age, weight, non compensable medical condition and the fact that she was a smoker for many years (over 30) before quitting in around 2000.

The memorandum notes that the WCB case manager advised the worker that CTS can develop from both work related and non-work related risk factors. The WCB considers the following work related factors as potentially having a causative role in the development of CTS: jobs that require high force, repetitive activity involving motions of the wrists, such as twisting, gripping, pulling, pinch-pressure and wrist flexion/extension, vibratory tools or any type of mechanical stress or force on the wrist.

As mentioned in the preamble, WCB adjudication denied the worker’s claim for compensation in April 2004 as it considered that the worker’s job duties did not involve high repetition and force or any mechanical stresses or altered wrist flexion/extension.

The worker’s family physician disagreed with this decision. She wrote a letter on May 20, 2004 in support of the worker’s claim for compensation. She stated that she felt the worker’s symptoms were a direct result of years of keyboarding. She added:

“She works on a computer keyboard 4 hours a day, and this can be as much as 8 hours a day when she is extremely busy. Though she rotates her position, she spends 1 week intervals at each job. The mail desk has been her easiest work station, however, the [batching] desk is very difficult as she is continually manipulating envelopes and…forms.”

At the hearing, the worker testified that she did not discuss her work duties in any great detail with her family physician. She added that her duties were much more varied than that conveyed by her family physician.

Worker’s position

The worker’s legal counsel submitted that the worker’s bilateral CTS is due to the culmination of 13 years of repetitive and forceful use of her wrists in the performance of her job duties.

Analysis

Subsection 4(1) of GECA provides that to be eligible to receive compensation benefits, a worker must have suffered personal injury by an accident arising out of and in the course of his employment. WCB policy 44.05.10, Definition of ‘Accident’ under the Government Employees Compensation Act, clarifies that this will be interpreted to mean personal injury by accident and that the gradual onset of a personal injury, including an injury resulting from a gradual process or repetitive injurious motion will be considered an accident.

Therefore, to accept the worker’s appeal, we must find, on a balance of probabilities, that her bilateral CTS arose out of and in the course of her employment. We are unable to make that finding.

As stated in the background, it is generally accepted that CTS can be caused by work duties where those duties involve high force, repetitive activity involving motions of the wrists, such as twisting, gripping, pulling, pinch-pressure and wrist flexion/extension, vibratory tools or any type of mechanical stress or force on the wrist.

While the worker’s family physician and legal counsel submit that the worker’s job duties were forceful and repetitive, we are unable to accept those submissions given the evidence on the file and at the hearing. That evidence clearly indicates that although the worker often used her hands to do her duties, this work did not involve flexing or twisting her wrists or gripping, pulling or pinching. Nor was it repetitive in nature. Further, the evidence is that the worker is right handed and does most of her work with her right hand. Despite this, she developed more symptoms in her left carpal tunnel.