The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

This is an appeal from the decision of the Review Office of the Workers Compensation Board (“WCB”), which held that the worker’s right carpal tunnel syndrome was not related to her work duties. The worker filed an appeal with the Appeal Commission through the Worker Advisor Office. A hearing was held on January 11, 2011 to consider the matter.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is acceptable.

Decision: Unanimous

Background

On October 5, 2009 the worker completed a Worker Incident Report for injury to her right hand and wrist that she attributed to her repetitive job duties as a packer at a facility where she packed potato chip bags. The worker explained that over the previous week her right hand and right wrist had been sore and aggravated and that she had first reported the problem to her employer on September 30, 2009. The worker reported that on October 5, 2009 she woke up and was unable to make a fist. She attended at a hospital health centre in the early morning of October 5, 2009.

According to the hospital records, the worker was examined by a physician who noted a decreased range of motion in her right hand on flexion and extension. A diagnosis of possible repetitive strain injury was noted and the worker was advised to stay off work.

The worker was next examined by her physician on October 9, 2009. The Doctor’s First Report indicated that the worker complained of pain, stiffness, numbness, tingling and weakness in her right hand. Objective findings noted that the worker’s right hand was puffy and stiff with decreased flexion and power. A positive Phalen’s test was also noted. The physician indicated a diagnosis of repetitive strain injury and ordered nerve conduction studies to determine if the worker suffered from carpal tunnel syndrome. The worker was advised to take anti-inflammatory medication, use a tensor bandage, rest her arm and remain off work.

The WCB adjudicator spoke to the worker on October 6, 2009. The worker indicated that on approximately September 29, 2009 she felt a cramp in her right hand while grabbing one of the boxes from the chute. She went to get a tensor bandage and advised her lead hand that her hand was bothering her. She continued working her regular duties for the next few days until the weekend, hoping the pain would go away. Instead the pain stayed and was shooting into her forearm; her fingers were going numb and appeared swollen. The worker also complained to her co-workers. When she woke on Monday morning, the worker described her hand as twice the normal size; painful and she was unable to make a fist. That morning the worker attended at the hospital.

The adjudicator spoke to the worker’s lead hand who confirmed that the worker had complained of a sore thumb on September 30, 2009 although she had not related it to a specific work incident. The worker applied ointment and ice to her hand and the lead hand moved the worker to a different job. The lead hand also sent a co-worker to help the worker. The lead hand advised that the worker had been in the job for at least 5 years and there had been no change in the job duties or an increase or decrease in production.

The adjudicator also spoke to a co-worker who confirmed that she noticed that the worker was in pain while working on the boxes and that the worker complained that her wrist was hurting her although she did not relate it to a specific event. The co-worker advised that she assumed that the pain was from working on the boxes as it was very repetitive work. She also advised the adjudicator that the worker had been fine the previous day.

The WCB adjudicator obtained a copy of the Functional Job Analysis prepared in 2007 for the jobs of “Packer” and “Carton Make-up and Supply”, which set out the essential job functions carried out by the worker. The job of Packer involved the packing of bags or boxes of potato chips into shipping boxes. The job of Carton Make-up and Supply involved assembling shipping boxes and sending them down a chute to the chip packing line. The worker’s job duties encompassed both functions.

The worker was next examined by her physician on October 22, 2009. The physician reported that his previous diagnosis had not changed. He also indicated that the worker’s condition had improved and that she would be able to return to regular duties on October 26, 2009. The physician noted that nerve conduction studies had been ordered.

The WCB adjudicator advised the worker by phone on October 22, 2009 that the claim could not be allowed without a confirmed diagnosis and the nerve conduction studies would have to be completed first. In the written decision that followed, the adjudicator denied the worker’s claim on the basis that the diagnosis of repetitive strain injury or carpal tunnel syndrome was not clear and without a clear diagnosis, the WCB was unable to determine that the worker’s condition was work-related.

Nerve conduction studies were completed on November 16, 2009, which revealed mild carpal tunnel syndrome in the right hand. The studies were forwarded to the WCB.

In a decision dated December 9, 2009, the WCB adjudicator denied the worker’s claim on the ground that the worker’s right handed carpal tunnel syndrome was not work-related. The adjudicator was of the opinion that accepted work-related factors for developing carpal tunnel syndrome require both high repetition and the use of force. The adjudicator reviewed the functional job analysis and determined that the worker's job duties while repetitive, did not involve force. The decision was appealed to the Review Office by a union representative, acting on the worker's behalf.

In a decision dated March 3, 2010, the Review Office concluded that the worker's right carpal tunnel syndrome was not related to her employment activities. In reaching its decision, the Review office noted that the worker’s job did not involve the degree of force and awkward positioning that is generally associated with developing carpal tunnel syndrome. In addition, the worker has several non-work related risk factors for carpal tunnel syndrome such as gender, age, body mass and smoking. The Review office also noted that despite performing the same job for six years, the worker only reported symptoms one to two weeks prior to filing the claim suggesting that the development of carpal tunnel syndrome was related to factors other than work.

On May 13, 2010, the union representative appealed the Review Office's decision to the Appeal Commission and a hearing was arranged.

At the hearing before the Appeal Commission held on January 11, 2011, the worker appeared with a union representative and two employer representatives attended.

At the hearing the employee confirmed that the 2007 Functional Job Analysis (“FJA”) of her position was accurate except for an occasional duty requiring that she tape boxes that was added after the time that the analysis was prepared.

The worker described the repetitive nature of the different aspects of her job duties. When working on the cartons, the worker described how she must carry, fold and assemble shipping boxes and drop them down the chutes. According to the FJA, the workers generally must assemble 50-70 boxes per hour, per line. The evidence at the hearing was that the worker was responsible for 6 to 7 lines at once.

The worker also described the repetitive nature of her job packing bags of potato chips and how she must grab each bag from a conveyor belt with her right hand and transfer it to her left to place in boxes. According to the FJA, there is a set production schedule and workers packing the bags handle 28-50 bags per minute.

The worker explained that during the time when she first began experiencing pain, the plant had increased its production. During the period from approximately May to September 2009, the worker testified that she was working extra shifts on the weekends as well as an hour overtime on each shift during the week. The employer confirmed that during this period the plant increased its production capacity to cover for a sister facility by adding an extra hour of overtime as well as adding 15 Saturday shifts. The worker also testified that, during this period of increased production, the line was running more efficiently with more potato chip bags closer together, requiring her to work faster grabbing bags off the conveyer.

The worker also testified that during this period of increased production she noticed that her hand was sore and swollen leading up to the day when she went to reach for a box in the chute and experienced shooting pains in her right hand and forearm that made it difficult to grab the box. This is when she reported the pain to her lead hand and treated her hand with ointment and ice and applied a tensor bandage.

Reasons

• The hospital physician had diagnosed the worker with a possible repetitive strain injury on October 5, 2009. The worker’s physician also diagnosed the worker’s injury as a repetitive strain injury; and

• The worker’s hand difficulties developed over a short period of approximately one week and were exacerbated on September 30, 2009 when she was working on the boxes. She sought medical treatment, followed the treatment plan and after resting her hand for approximately two weeks, the condition improved and she returned to work. This short timeline suggests that the condition was less likely related to her regular duties over the past 6 years and the development of carpal tunnel syndrome. Rather, it suggests that the worker suffered some other type of a repetitive strain injury, caused by overuse or excessive strain during the period that production increased.

Based on the foregoing, the panel is satisfied that on a balance of probabilities the worker suffered an injury to her right hand as a result of performing her duties at work. The worker’s appeal is therefore allowed.

Panel Members

M. Thow, Presiding Officer
R. Koslowsky, Commissioner
M. Day, Commissioner

Recording Secretary, B. Kosc

M. Thow - Presiding Officer

Signed at Winnipeg this 10th day of March, 2011