Decision #146/07 - Type: Workers Compensation
Preamble
On March 13, 2007, the worker filed a claim with the Workers Compensation Board (WCB) for an abdominal injury that he related to his employment activities on March 8, 2007. The claim was accepted by the WCB and the worker was paid wage loss benefits to July 13, 2007 when it was determined by primary adjudication and Review Office that he had recovered from the effects of his compensable injury. The worker disagreed and appealed to the Appeal Commission. A file review then took place on October 28, 2007.Issue
Whether or not the worker is entitled to wage loss benefits beyond July 13, 2007.Decision
That the worker is not entitled to wage loss benefits beyond July 13, 2007.Decision: Unanimous
Background
In March 2007, the worker filed a claim for pain in his lower abdomen which he related to lifting wood on March 8, 2007. The claim was accepted based on the diagnosis of an abdominal muscle strain and the worker was paid wage loss benefits commencing March 9, 2007. Subsequent medical treatment consisted of medication and physiotherapy.
On May 4, 2007, the treating physician outlined subjective complaints of abdominal muscle pain greater than eight weeks. Under objective findings, the physician stated, “Histrionic – exquisitely tender to light touch.” The physician stated that this did not “add up” and suggested that the worker be seen by a WCB medical advisor as soon as possible.
The worker was then assessed by a WCB sports medicine consultant on June 22, 2007. Based on his examination findings and available medical information, the consultant could not correlate the worker’s symptom presentation to a pathoanatomical lesion. He therefore concluded that the worker had recovered from the effects of his compensable injury.
In a decision dated July 9, 2007, the worker was advised that his WCB benefits were ending effective July 13, 2007 as it was felt that he had recovered from the effects of his compensable injury. This decision was primarily based on the call-in examination findings of June 22, 2007.
On July 27, 2007, the WCB sports medicine consultant reviewed additional medical information that was submitted by the worker’s treating physician dated July 18 and July 26, 2007. The consultant stated that these reports presented no new medical information to change the opinion outlined on June 22, 2007.
On July 30, 2007, the worker disagreed with the WCB’s position that he had had recovered from his compensable injury. The case was referred to Review Office for consideration.
In its decision dated August 2, 2007, Review Office confirmed that the worker was not entitled to wage loss benefits beyond July 13, 2007. Review Office made reference to the WCB’s sports medicine specialist’s examination findings of June 22, 2007. Based on the inconsistencies noted in this examination and the fact that the worker was long past a normal range of recovery for an abdominal strain, Review Office agreed with the case manager’s position of July 9, 2007 that the worker had recovered from his compensable abdominal strain injury of March 8, 2007. On August 9, 2007, the worker appealed Review Office’s decision to the Appeal Commission and a file review was arranged.
Reasons
The workers position:
The worker has appealed that his compensable injury has not resolved following numerous visitations to physicians and a course of physiotherapy treatments. He is of the opinion that he requires more specific testing and further treatment. The worker emphasized in his appeal that prior to his examination with a WCB sports medicine consultant he had taken his pain medication so the examination did not reflect his true level of pain.
Applicable Legislation
The Appeal Commission and its panels are bound by The Workers Compensation Act (the Act) regulations, and policies of the Board of Directors.
In accordance with subsections 4(2) and 39(2) of the Act, wage loss benefits are payable for workplace injuries until such time as the worker’s loss of earning capacity ends.
Analysis
In order for the worker’s appeal to be successful, the panel would have to find that he has not recovered from his compensable abdominal strain by July 13, 2007 and was unable to work as a result. The panel was not able to come to this conclusion. We find on a balance of probabilities that the worker has recovered from his compensable injury by July 13, 2007 and therefore is not entitled to further wage loss benefits.
In coming to this conclusion we note the worker attended numerous health care physicians and had a course of physiotherapy following his injury. One of the physicians who saw the worker in May 2007 questioned his medical condition not adding up and requested an assessment from a WCB medical consultant.
The worker, when seen by the WCB sports medicine consultant on June 22, 2007, indicated the course of prescribed analgesics and physiotherapy had not helped him. He reported that avoiding activities and taking medication were the relieving factors. A thorough examination was conducted with various tests that should have resulted in abdominal pain. None of the examination maneuvers resulted in provocative pain in the abdominal area. The sports physician concluded that he was unable to “correlate [the worker’s] symptoms to a pathoanatomical lesion.” He further stated he was unable to relate his presentation to the compensable injury and felt the worker was recovered.
The panel notes that following the assessment of the WCB sports medicine consultant, the worker consulted another physician who indicated the worker reported being on medication that masked his symptoms during the WCB call in exam. The panel notes however that this physician clears the worker for modified duties as of July 1, 2007 but rescinds this on July 31, 2007 without explanation.
The panel is perplexed as to how a strain experienced by this worker in March 2007 would not resolve in some fashion considering the numerous medical consultations the worker underwent between March and June 2007. The panel has weighed all the file medical evidence along with the worker’s submission and places considerable weight on the examination performed by the WCB sports medical consultant. This examination assessed the worker’s symptoms in a variety of positions and could not relate the worker’s presentation to the compensable injury. The panel concurs with the analysis of the WCB sports medicine specialist and concludes that as of July 13, 2007, the evidence does not show, on a balance of probabilities, that the worker has any symptoms related to the compensable injury of March 8, 2007. His appeal is denied and he is not entitled to benefits beyond that date.
Panel Members
A. Scramstad, Presiding OfficerA. Finkel, Commissioner
M. Day, Commissioner
Recording Secretary, B. Kosc
A. Scramstad - Presiding Officer
Signed at Winnipeg this 6th day of November, 2007