The Appeal CommissionThe Workers Compensation Act of Manitoba

Introduction

As stated in the preamble, this appeal deals with claim acceptability. At issue is whether the worker’s left foot/ankle injury is, on a balance of probabilities, causally related to his employment. This determination essentially hinges on the positioning of the worker’s foot during the performance of his employment duties and whether this positioning could have, on a balance of probabilities, caused the worker’s injury.

Background

The worker has been a heavy duty mechanic for many years and has essentially performed the same duties. To do his job, he is required to purchase CSA steel toe boots of his own choosing.

In October 2005 the worker began to feel pain in his left ankle where the boot laces up and where the bend in his left leg and foot meet. The worker had purchased this particular pair of boots about a year and one-half earlier and had not had any problems with them. The worker’s left ankle pain increased and his ankle began to swell. He was later diagnosed with tendonitis/tenosynovitis.

The worker has explained the nature of his job duties to the WCB as well as to the panel at the hearing. These duties include climbing up and down ladders and the steps of plow trucks, graders, and other heavy equipment. They also include working overtop or underneath this equipment on a sloped cement floor, in bent or crouched positions. When in these positions, he is “left leg dominant” which means that his right knee is on the floor and his left knee is bent up. This position requires him to put pressure and weight on his left foot which is often in both flexed and extended positions.

The relationship between the worker’s tendonitis/tenosynovitis and employment duties has been commented on by the WCB and several medical practitioners.

Both a family physician and a sports medicine specialist were doubtful that the worker’s condition was caused by his employment duties. The reasons for this doubt are not however expressed in their respective medical reports. The worker did however testify at the hearing that neither doctor questioned him specifically about his foot positioning during the performance of his duties.

An occupational health physician thought that the most likely cause of the worker’s tenosynovitis was the worker’s prolonged positions kneeling in steel toe boots with the toes in extension and ankle dorsiflexed against the compressive pressure of the laced boot. He also noted that the sloped floor that the worker works on would place his feet and ankles in more awkward positions, sometimes for prolonged durations in order to perform common tasks of the mechanic. That said, the occupational health physician was not clear as to what precisely might have set off the worker’s acute episode given his lengthy work history doing the same duties. At the hearing, the worker testified that he spent a considerable amount of time with this physician explaining his foot positioning.

Worker’s Position

The worker says that his claim should be accepted because his injury was caused by his foot positioning. While he cannot say why this injury occurred without a specific injury, especially since he’s been doing this job for quite some time, he thought it might be related to an increase in duties after the departure of two other employees in the last one and a half years.

The employer was not represented at the hearing, but the earlier adjudications at the WCB level had concluded variously that there were no specific incidents or general job duties that could have caused the injury, or that an injury caused by the work boots was not compensable as it arose out of a personal choice made by the worker in respect of the boots he had purchased.

Analysis

Subsections 4(1) and 1(1) of the Act provide that to be compensable, the worker must suffer personal injury arising out of and in the course of employment. To accept the worker’s appeal therefore, this panel must find on a balance of probabilities that the worker suffered an injury to his left foot/ankle arising out of and in the course of his employment. We are able to make that finding.

As stated previously, there is no dispute that the worker did suffer a bout of tendonitis/tenosynovitis in October 2005. What is in dispute is whether the worker’s job duties caused or contributed to the onset of this injury.

The explanation by the occupational health physician of the mechanics required to cause the worker’s condition is extremely helpful in determining the worker’s appeal – toes in extension and the ankle dorsiflexed. During the hearing, the panel had the opportunity to view specific body postures that the worker maintained at the workplace while performing certain parts of his job duties, and to question the worker at length in respect of those body positions and his job duties. We find that the descriptions provided by the worker mirror the scenarios for mechanism of injury that are suggested by the occupational health physician, namely pressure by the boot on the top of the foot/ankle while the foot was flexed upward.

While there was no specific injury or event to set off the worker’s condition, the Act does not require an acute injury, for there to be a compensable accident.

Based on these findings, we conclude that the worker did, on a balance of probabilities, suffer an accident within the meaning of the Act on or around October 26, 2005. Accordingly, the worker’s appeal is accepted.