Decision #08/11 - Type: Workers Compensation
Preamble
This appeal deals with a decision made by the Workers Compensation Board that the worker was no longer entitled to wage loss benefits after August 23, 2009 as he was fit for modified duties. In a decision dated December 3, 2009 Review Office extended the worker’s entitlement to wage loss benefits up to and including October 1, 2009. The worker disagreed with the decision and an appeal was filed with the Appeal Commission. A hearing was held via teleconference on December 9, 2010, to consider the matter.
Issue
Whether or not the worker is entitled to wage loss benefits after October 1, 2009.
Decision
That the worker is entitled to wage loss benefits after October 1, 2009.
Decision: Unanimous
Background
On October 20, 2008, the worker was climbing down from a truck trailer when he lost his footing. The worker grabbed onto a handle to prevent himself from falling out of the trailer, and all of his weight was suspended on his right arm. The worker reported the accident to his employer on October 20, 2008, and continued working as a driver until February 14, 2009.
On February 23, 2009, the worker attended the WCB offices and spoke with a benefits information representative. The worker stated that he had continued to work following the injury but that it had become increasingly difficult due to his shoulder symptoms. He provided a doctor’s note issued January 20, 2009 directing that he perform only modified duties and that he not use his right shoulder for lifting or labour. He indicated that he was having a difficult time getting modified work from the employer, and that he was taking some holiday time due to the problems he was having with his shoulder and to deal with some non-work related issues. The worker advised that he was originally from Thunder Bay and had moved to Winnipeg in August 2008. He was contemplating moving back to Thunder Bay as he did not have a Manitoba health card and was unable to get treatment in Winnipeg. The worker had last seen his doctor on February 20, 2009 and he was awaiting the results of an MRI of his shoulder from three weeks previous.
On March 5, 2009, the employer spoke with a WCB adjudicator and confirmed that the worker had been living in Winnipeg since July 26, 2008 when he received an “open transfer” for personal reasons. Following his injury, the worker was provided with modified duties which did not include deliveries, and which to the employer’s knowledge were performed without incident. The worker then requested and took holidays from February 15 to 28, 2009. He attended at the Winnipeg office and handed in his work related property. When asked by the employer whether he was quitting, the worker replied that he was not but that he was moving back to Thunder Bay. The employer advised the WCB that there were no openings in Thunder Bay and could not accommodate a transfer request. They would be prepared to provide him with light duties in Winnipeg, which would consist of driving duties only.
In a decision dated March 18, 2009, the worker was advised that the WCB was unable to accept responsibility for his time loss from work. According to his employer, the worker would have been provided appropriate modified duties indefinitely had he remained in Winnipeg. Therefore, pursuant to WCB policy 43.20.20, Modified and Alternate Return to Work with the Accident Employer, no further wage loss benefits were payable as he had failed to participate in a modified work plan.
In a letter to the WCB dated March 26, 2009, the employer advised that on March 24, 2009 the worker was offered modified duties at its Winnipeg terminal as of March 25, 2009. The worker indicated, however, that he had already moved back to Thunder Bay and would not report to the Winnipeg terminal. The worker was told that if he did not report to the Winnipeg location on March 25, 2009, he would be considered to have abandoned his job and would be terminated from employment. He was in fact terminated on March 25, 2009.
On May 15, 2009 the worker underwent a right shoulder rotator cuff decompression repair, right shoulder subscapularis release and repair, biceps tenodesis and shoulder arthrotomy. On July 2, 2009, the WCB accepted responsibility for the surgery and related wage loss benefits.
A physiotherapy progress report dated August 5, 2009 stated that the worker complained of tenderness at the end of range of motion and during activities of daily living. It was anticipated that the worker would require 3 treatments per week for the following 12 weeks. In a report to the treating surgeon dated August 12, 2009, the physiotherapist noted that the worker had been performing active range of motion for four weeks and had reported significant pain resolution. The therapist noted that it was approximately three months post-op and there was significant weakness in the cuff in regard to muscular integrity as well as tensile strength. The worker was instructed to perform only light activities of daily living.
A report from the treating surgeon dated August 21, 2009 noted that the worker's pain was better but that his motion and strength were still quite limited. Examination showed an incision that had healed. Passive motion was flexion to 90 degrees and abduction to 80 degrees, and while the rotator cuff was functioning, it was quite weak.
On August 24, 2009, a WCB sports medicine consultant expressed the opinion that the normal range of recovery from surgery would be four to six months. He noted that it was almost four months post surgery and that the worker could perform work activity with restrictions, including no repetitive, resisted pushing/pulling, no use over shoulder height or outside body border and no lifting greater than 10 pounds.
On September 2, 2009, a WCB adjudicator advised the worker that wage loss benefits had been approved for the post surgical healing period from May 15, 2009 to July 9, 2009 and that they would continue until he was able to return to modified duties.
On September 10, 2009, the employer outlined a number of concerns including claim acceptance, wage loss benefits and related issues. On September 15, 2009, Review Office referred the case back to primary adjudication with instructions to obtain further information and to render decisions on the issues raised by the employer.
Information on file dated September 14, 2009, indicated that the worker had provided a modified duty slip to his employer in Winnipeg on January 27, 2009. He took holidays from February 15 to March 1, 2009. According to the worker, the employer had indicated that they may have modified duties available in Thunder Bay. However after relocating to Thunder Bay during his vacation, he was told to check with Winnipeg. The employer said that modified duties were available in Winnipeg, but the worker did not report to work because he had already relocated. The worker's employment was then terminated. The adjudicator advised him that wage loss benefits were being paid for his recovery period from surgery and that recovery norms for this type of surgery were 4 to 6 months. Medical aid would continue until his recovery but if the employer were able to accommodate him with modified duties, his wage loss benefits would end. The worker advised that he was still subletting an apartment in Winnipeg and was willing to return to work if a position became available.
On September 25, 2009, the worker was advised by the WCB case manager that he was fit for modified duties commencing August 24, 2009. As his employer had advised that he would have been accommodated with full time modified duties within the restrictions outlined by the WCB on August 24, 2009 had he not removed himself from employment, he was therefore entitled to wage loss benefits only up until August 23, 2009. According to the employer the duties would have involved performing inventory checks when trucks were unloaded. On October 15, 2009, the worker appealed this decision to Review Office.
Prior to considering the worker's appeal, Review Office sought medical advice from a WCB orthopaedic consultant. On December 1, 2009, the consultant opined that it was reasonable to conclude that the worker was fit for modified duties upon notification on September 25, 2009. He based this on the physiotherapy report and with allowance made for attending continuing physiotherapy for 12 weeks. The consultant concurred with the physiotherapist that it may take 12 months post-operatively to gain maximum medical improvement, and noted that work restrictions should be reviewed at that time. He felt the worker was fit for modified or alternate work on October 1, 2009.
On December 3, 2009, Review Office determined that the worker was entitled to wage loss benefits up to and including October 1, 2009. Review Office noted that the worker was informed on September 25, 2009 of the decision to pay wage loss benefits only up to August 23, 2009. The decision appeared to be based on the WCB sports medicine consultant's opinion of August 24, 2009 that the worker was fit to perform modified duties. Review Office determined that the worker's fitness for modified duties was made by WCB staff, including a medical consultant, without direct support from either the treating surgeon or physiotherapist. This made the determination of the worker's fitness for modified duties and subsequent disentitlement to wage loss benefits a discretionary decision as indicated under WCB policy 44.30.40, Notice of Change in Benefits or Services. When a decision is a discretionary one, Review Office noted that the policy provides a minimum period of notice which was normally seven calendar days excluding any statutory holidays. Review Office therefore determined that the worker was entitled to a period of notice of a change/termination of his wage loss benefits up to and including October 1, 2009. On January 13, 2010, the worker appealed Review Office's decision to the Appeal Commission and a hearing was arranged.
Reasons
The worker participated in the hearing by teleconference. The employer did not participate in the hearing.
The issue before us is whether the worker is entitled to wage loss benefits after October 1, 2009. As of that date, the worker had been declared fit to return to modified duties, with restrictions of no repetitive, resisted pushing/pulling, no use over shoulder height or outside body border, and no lifting greater than 10 pounds. Those restrictions became permanent on May 27, 2010 when the orthopoeadic surgery consultant determined that the worker had achieved maximum medical improvement and noted permanent restrictions of no work with the right upper limb above shoulder level and no lifting or carrying more than ten pounds above waist level.
The determination of the issue before us is dependent upon whether the employer had modified duties available for the worker after October 1, 2009 that were within his restrictions. If modified duties were available to the worker, he would no longer be entitled to wage loss benefits. We find that on a balance of probabilities the employer did not have modified duties available for the worker within his restrictions. The worker is therefore entitled to wage loss benefits after October 1, 2009.
Following his injury in October 2008 the worker continued to work as a long distance truck driver hauling goods between Winnipeg and Thunder Bay. In his evidence he stated that he wanted to continue working, and had requested that his employers provide him with lighter duties. The worker advised the WCB on September 17, 2009 that his dispatchers in Winnipeg had tried very hard between the date of the accident and January 2009 to accommodate him by providing him with direct loads, with no lifting along the way. When he made return trips from Thunder Bay, however, the Thunder Bay dispatcher would not accommodate him with a straight drive back to Winnipeg. She advised him that he was one of the few drivers that “did it right.” He was therefore given loads which required him to stop several times on the return trip and lift large boxes, often weighing 75-80 pounds. The heavy lifting caused increased pain in his shoulder. For a period of time he “did everything one handed,” however by January 2009 he sought medical treatment and was provided with a medical note limiting him to modified duties. In his evidence he stated that when presented the note, the Winnipeg manager informed him there was no such thing as modified duties and that he was to “just drive the truck.” He was then again given a route that required him to do lifting, and at that point he advised his manager that he was taking holidays to deal with both medical and personal issues. He advised that he was probably finished at the Winnipeg terminal, and he would be moving back to Thunder Bay. His manager advised him to see him at the end of the month following his holidays and they would see what they could do.
The worker's evidence was that when he attended on February 28, 2009 at the Thunder Bay office he was told that he would have to call his manager in Winnipeg. He did so, and on March 9, 2009 the manager called him back to advise that there was work for him in Winnipeg driving a truck. On March 12, 2009 he again spoke with the manager who advised that “we have no modified duties so come back and drive the truck.” The worker declined, stating that he could only work modified duties, and he could not perform the duties that were available in Winnipeg. On March 24, 2009 the worker was called by the Thunder Bay manager and given 24 hours to report back to Winnipeg. When he inquired as to the nature of the job that was available in Winnipeg he was told that it involved internal office duties which he understood to include “filing papers and counting and stuff.” The worker expressed concern that the Winnipeg manager would have him driving a truck and he refused to return to Winnipeg. He was then terminated on March 25, 2009.
The panel spent some considerable time with the worker reviewing the precise nature of his duties with the employer, both when based in Thunder Bay and following his move to Winnipeg. The worker’s employer moves goods across Canada. Trucks would transport goods from Winnipeg to Thunder Bay, with delivery either to the employer’s terminal, or to local Thunder Bay stores. On the return trip, product from southern Ontario and eastern Canada would be delivered either locally in Thunder Bay or en route to Winnipeg.
When the worker was based out of Thunder Bay he drove either to Winnipeg or to the United States, but primarily he drove the Thunder Bay/Winnipeg corridor. He typically drove to Winnipeg and back three times per week. While some of the work was “pin to pin”, i.e. he would pick up a trailer, and drop it off, more of it was LTL (less than load) which typically required heavy lifting of product at the point of delivery. On certain trips, in particular the trip leaving Thunder Bay on Sunday evenings, there was a lot of physical work. The trip would require him to leave Thunder Bay with a full trailer (weighing anywhere from 19,000 to 35,000 pounds). He would return to Winnipeg via three other cities, and would spend as much as 2 to 3 hours at each stop delivering product from the truck. This required “hand bombing” with limited or no assistance. He would drag skids to the back of the trailer, unload them on to a pallet and then haul them inside. This might require him to jump in and out of the trailer between 10 and 15 times. After the final stop in Kenora he would proceed with an empty trailer to Winnipeg. The trailer would be reloaded in Winnipeg for the return trip to Thunder Bay, and he would generally leave Winnipeg in the evening and arrive in Thunder Bay in the morning. On some trips goods would be unloaded at local stores with the assistance of store employees. He would then reload pallets on to the trailer and carry on to the Thunder Bay terminal. In some instances he would travel directly to the terminal where he would not be required to assist with the unloading of the trailer. On other occasions he was required to crank dollies, which he could no longer do following his injury as it required the use of two hands.
When the worker relocated to Winnipeg in August 2008 his job duties were virtually identical except they were performed in reverse. He did, however, no longer have to drive to the United States.
After his injury the worker’s job duties did not change significantly. While he requested lighter routes, and was accommodated to some degree by the Winnipeg dispatcher, the same could not be said for the return trips assigned to him by the Thunder Bay office. The employer said in a letter to the Board September 10, 2009 that “as we did not want this worker to further injure himself we offered him a slight variance to his job by eliminating most of the lifting portion of his job. We gave him mostly pin to pin which required him to drop and pick up trailers with very little lifting involved. . . . . Our records also indicate that this worker was only on this modified work program for a very short period of time (one week) and he then continued on with his regular duties with no modifications . . . At no time prior to [January 22, 2009] did he mention anything about his shoulder being sore.”
That is not, however, consistent with information provided by the worker’s manager in Winnipeg, who advised the WCB on March 5, 2009 that following the injury the worker was provided with modified duties not doing any deliveries for a one month period. He also confirmed that the worker had made occasional complaints of his shoulder problems since the date of the accident.
We find that the worker was ready and willing following surgery, to continue his employment as a driver after October 1, 2009. The job that he performed prior to his injury, and that continued to be available to him after his injury was not, however a sedentary one limited to driving duties only. While the restrictions imposed on the worker on August 24, 2009 did not prohibit driving, they did prevent repetitive, resisted pushing/pulling, use over shoulder height or outside body border and lifting greater than 10 pounds. The permanent restrictions imposed on May 27, 2010 while reduced, were nonetheless similarly restrictive, prohibiting work with the right upper limb above shoulder level and no lifting more than 10 pounds above waist level. It is clear from all of the evidence that the job duties associated with driving the truck, whether based in Thunder Bay or in Winnipeg were in excess of the job restrictions put in place by the WCB in August 2009.
We find that the worker was not at any time provided with modified duties following his injury that were within the restrictions imposed by the WCB. At best, the employer accommodated the worker for a one month period by limiting the number of trips which required lifting. Even with the attempts by the Winnipeg dispatcher to assign lighter loads to the worker following the October 2008 injury, the worker was consistently assigned routes that required him to drive 8 to 10 hours and also perform heavy lifting. Notwithstanding that his employer had an “open transfer policy” and the jobs to be performed by the worker whether in Thunder Bay or in Winnipeg were virtually identical, when he reported to work in Thunder Bay on February 28 he was advised that no position was available to him. This was notwithstanding his Winnipeg manager’s advice that he could report to Thunder Bay following his holidays and they would see what they could do. While we do not find that there was any promise of a job in Thunder Bay at the end of the worker’s holidays, we find the insistence by the employer that he return to Winnipeg, reflected an unwillingness on the part of the employer to provide the accommodation that was required whether the worker was based in either Thunder Bay or Winnipeg.
The Winnipeg manager consistently informed the worker in conversations in February 2009 and again on March 9 and 12, 2009 that no modified duties were available. That is undoubtedly the case as the terminal in Winnipeg consisted of a small office which employed only a manager, a dispatcher and a secretary. Six drivers were based in Winnipeg, of which the worker was one. In contrast, the facility in Thunder Bay was the base for twenty drivers. On March 5, 2009 the worker’s Winnipeg manager advised the WCB that light duties would be provided which consisted of driving only. Yet on March 23, 2009 the worker was offered, for the first time, a position in Winnipeg that was purported to involve modified duties, when the employer knew that the worker had already relocated to Thunder Bay for personal reasons. We find that the offer of employment at the Winnipeg terminal made on March 24 by the Human Resources manager was one that was disingenuous, and that on a balance of probabilities there was no job available to the worker that was within his restrictions. While there was a vague proposal for a job involving “filing papers and counting and stuff,” we are not satisfied that such a position was in fact available for the worker. At best the worker would have been returned to a position driving a truck, which inevitably carried with it associated duties that fell well outside of the worker’s restrictions.
In arriving at this conclusion we find it significant that while modified duties were purportedly available in March 2009, the employer advised the WCB in a letter dated September 21, 2010 that the only positions that would have been available to the worker within his restrictions were that of dispatcher or receptionist. However a new position would not have been created for the worker. In our view, that reflects a recognition on the part of the employer that the worker’s restrictions precluded him from returning to work as a driver, notwithstanding that the restrictions in place by September 21, 2010 were in fact less than those in place at the time of the offer of modified duties in March 2009.
The worker’s appeal is allowed.Panel Members
K. Dangerfield, Presiding OfficerA. Finkel, Commissioner
P. Walker, Commissioner
Recording Secretary, B. Kosc
K. Dangerfield - Presiding Officer
Signed at Winnipeg this 28th day of January, 2011