Decision #96/08 - Type: Workers Compensation

Preamble

The worker filed a claim with the Workers Compensation Board (“WCB”) for pain in her right forearm and elbow area that she related to the repetitive nature of her job duties. Both primary adjudication and Review Office agreed that the worker’s diagnosed condition was not consistent with her job duties and her claim for compensation was denied. The worker disagreed with the decision and filed an application to appeal with the Appeal Commission. A hearing was held on June 17, 2008 to consider the matter.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is acceptable.

Decision: Unanimous

Background

The worker filed a claim with the WCB on November 12, 2007 for pain in her right forearm and elbow which she related to the following work activity:

“On Nov. 06.07, while doing my job working on my computer using a mouse, writing & stapling, I started to feel pain in my right forearm/elbow area. The pain persisted and got worse while waiting 3 weeks to see my doctor on 26.11.06 who diagnosed it as tennis elbow…”.

The employer’s accident report for this claim dated December 13, 2007 included a letter which stated the following:

“Employee complained of sore right forearm in early November and contributed (sic) it to pulling suitcases on a vacation…after consulting her doctor it became evident that the injury was from repetitive motion. She then started to have physio therapy for the condition but little improvement was noted. It was then pieced together later that an increase in her use of the mouse and keyboards caused the pain. Employee had also broken her right forearm 2 years prior.”

A physiotherapy report on file indicated that the worker was seen on November 27, 2007 with subjective complaints of pain (less than four weeks) with mousing and picking up objects. The pain was worse by the end of the day and overnight. The area of injury was right dorsal forearm and lateral epicondyle. The diagnosis rendered was lateral epicondylitis.

On December 21, 2007, a WCB adjudicator called the worker and the following information was provided:

· The worker stated she had no prior right forearm or elbow injuries. She confirmed that she broke her wrist in 2002.

· The worker performed the same job for over seven years. She worked on a computer 90% of the day and her other work duties include talking on the phone, photocopying, faxing, etc. She also copied and pasted information into letters.

· None of the worker’s job duties involved force, gripping, twisting or lifting.

· The worker first noticed pain in her right forearm and elbow on November 6, 2007.

· The worker said she originally related her elbow pain to pulling suitcases on a trip two weeks earlier but then realized it was from using a mouse and typing.

· On November 5, 2007, the worker said she did a bit more typing and used a mouse more than usual.

· The worker was right hand dominant and the mouse is on her right hand side. The computer station had a good set up and she used proper technique.

On December 28, 2007, the worker was advised that the WCB was unable to accept responsibility for her claim on the grounds that her work duties did not involve the anatomical movements required for the development of her diagnosed condition, right lateral epicondylitis.

On January 9, 2008, the worker submitted additional information for primary adjudication’s consideration. The worker stated, in part, that her current position required her to move her wrist repetitively while typing and that she grips her computer mouse, grips and squeezes a stapler and signs letters. She stated that she had been in her current position for approximately five years. Her prior position included lifting of files, repetitive typing, computer and moving a mouse. On a daily basis she opened the front doors of her employer’s building and the washroom doors numerous times during the day. The doors were heavy and required a forceful gripping movement to open. The worker further advised that she related her difficulties to a project that was started on November 5, 2007 where there was a great deal of constant computer usage, copying and pasting, stapling and signing of letters (repetitive wrist and finger movement).

In a decision dated January 11, 2008, the adjudicator advised the worker that the new information she provided did not alter the previous decision. As the worker’s symptoms started in November 2007, the adjudicator stated she could not relate the worker’s work duties that she performed over 5 years ago to her current symptoms.

The case was then considered by Review Office on March 6, 2008 at the worker’s request. Review Office indicated that the worker was relating her condition to a multitude of different tasks in the work environment which consisted of typing, using a mouse, stapling, hand writing, pushing open doors and answering telephones. Review Office was of the opinion that although it could be argued that some of these tasks were repetitive, the job description was not providing the type of trauma to the elbow area that would indicate a cause and effect relationship existed between the worker’s duties and the diagnosis of lateral epicondylitis or that her condition had arisen out of and in the course of her employment. On March 17, 2008, the worker appealed Review Office’s decision to the Appeal Commission and a hearing was arranged.

Reasons

Applicable Legislation:

The worker is employed by a federal government agency or department and her claim is therefore adjudicated under the Government Employees Compensation Act (“GECA”). Under the GECA, an employee who suffers a personal injury by an accident arising out of and in the course of employment is entitled to compensation. The GECA defines accident as including “a willful and an intentional act, not being the act of the employee, and a fortuitous event occasioned by a physical or natural cause.”

Pursuant to subsection 4(2)(a) of the GECA, a federal government employee in Manitoba is to receive compensation at the same rate and under the same conditions as a worker covered under The Workers Compensation Act (the “Act”).

The key issue to be determined by the panel deals with causation and whether the worker’s right forearm/elbow condition arose out of and in the course of her employment.

Worker’s Position

The worker was self represented at the hearing. The position advanced on behalf of the worker was that for many years, she managed her regular job fine without any difficulties, but when she worked on a special project in November 2007, she started to experience difficulties in her right forearm and elbow. The special project involved sending out a large blitz of letters in a short amount of time. The heavy duty blitz was probably done in less than a month. While working on the special project, the worker was required to do considerably more mousing activity than she normally did. After the first day of working on the project, she had a sore arm. As the weeks progressed, the pain got progressively worse until finally, she sought medical treatment.

At the hearing, the worker indicated that the areas where she experienced pain were not only in the lateral epicondyle elbow area, but also included her wrist and both the dorsal and anterior aspects of her forearm.

Analysis

To accept the worker’s appeal, we must find on a balance of probabilities that the worker’s right forearm/elbow condition was caused by her employment. We are able to make that finding. In making this finding, the panel relies upon the following evidence:

  • The fact that the worker’s onset of symptoms occurred contemporaneously with a “letter blitz” special project and an increased use by the worker of her right hand when mousing and keyboarding;
  • The repetitive nature of the increased mousing by the worker with her right hand;
  • An ergonomic assessment conducted on January 10, 2008 indicated that the mouse being used by the worker was too small for her hand and that she tended to grip it while mousing, causing tension and discomfort;
  • At the hearing, when demonstrating how she used the mouse, the worker’s manner of operating the mouse involved somewhat vigorous finger movements when clicking;
  • Although the physiotherapist’s report gives a diagnosis of lateral epicondylitis, the physiotherapist’s description of area of injury and examination findings also reference the right dorsal forearm, pain in the wrist, decreased wrist flexion and reduced right sided grip strength. This is consistent with the worker’s evidence at the hearing, which was that she experienced pain in her entire forearm, on both sides from the elbow joint down to the wrist;
  • The worker’s right forearm/elbow condition resolved with treatment and rest and did not recur after she returned to work in her normal job duties.

The panel accepts that an overuse injury could result from the repeated mousing which the worker was required to do during the special work project in November, 2007 and we find on a balance of probabilities that the change in the worker’s job duties did in fact lead to the onset of the worker’s symptoms. It is therefore our decision that the claim is acceptable. The worker’s appeal is allowed.

Panel Members

L. Choy, Presiding Officer
A. Finkel, Commissioner
M. Day, Commissioner

Recording Secretary, B. Kosc

L. Choy - Presiding Officer

Signed at Winnipeg this 1st day of August, 2008

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