Decision #38/13 - Type: Workers Compensation
Preamble
The worker is appealing the decision made by Review Office of the Workers Compensation Board which determined that her claim was not acceptable as it was unable to establish she sustained an accident as defined in the Act. A hearing was held on February 13, 2013 to consider the matter.
Issue
Whether or not the claim is acceptable.Decision
That the claim is acceptable for the swollen hand/wrist injury which was reported on April 26, 2012 and resolved by May 14, 2012.Decision: Unanimous
Background
The worker filed a claim with the WCB for a right hand and wrist injury that occurred on April 26, 2012 while employed as an assembler. The worker reported that she was testing units with a manual tester. She would plug 3 connectors and it was very hard to push in and take out. She did 28 units on April 26, 2012.
The employer's accident report noted that the worker completed a green card on April 26, 2012, indicating that she hurt her arm the day before while using a manual testing jig. The worker claimed to experience numbness and soreness in her right fingers and wrist. On May 1, 2012, an accident investigation team gathered to understand the details of the incident. The worker said she used the manual jig for 3 hours on April 25, plugging and unplugging 3 connectors to and from each of the 28 units she was working on. She did intermittent testing and packing within those 3 hours. The worker believed that she sustained grave injury from handling the manual testing.
The employer noted that the worker completed her full shift on April 25 plus one hour of overtime where she was assigned to a different product area. On April 26, the worker worked her full shift in addition to 1.25 hours of overtime. The manual jig was introduced in February. The worker had used the jig for a total of 3 hours on one day only.
Medical information on file confirmed that the worker was seen for medical treatment and was diagnosed with de Quervain's tenosynovitis and bilateral carpal tunnel syndrome ("CTS").
On May 8, 2012, the worker spoke with a WCB adjudicator regarding her work activities. The worker felt that her condition was 100% related to her employment. The worker said she was constantly using her right hand and fingers. She needed to twist a manual screwdriver for several hours. She needed to turn the screw driver fast to keep up. She used an air screwdriver that required repetitive pulling with trigger finger that made her hand and finger sore. The worker reported that she had worked for her employer for 12 years, full-time. The worker reported that she was involved in three stages of production: assembly, testing the circuit board and packaging the final product.
On May 16, 2012, the employer advised the WCB that the worker returned to work on May 14, 2012 at one-handed duties. They involved labelling boards and inserting capacitators with a pen. The employer indicated that on May 16, 2012, the worker reported that her left hand was beginning to hurt due to these one-handed duties. (This information was confirmed by the worker to her WCB adjudicator on May 16, 2012.)
A WCB rehabilitation consultant attended the employer's worksite in July 2012 to view the areas where the worker performed her regular and modified job duties and the nature of her job duties. The consultant's report is on file dated July 26, 2012.
On July 31, 2012, a WCB medical advisor reviewed the file and the report authored by the WCB rehabilitation consultant. The medical advisor indicated that the current diagnoses of bilateral CTS and right de Quervain's tenosynovitis did not appear to be consistent with the nature of the job duties (regular or modified) as outlined in the report. "In order for CTS or de Quervain's tenosynovitis to be considered as related to the workplace activities, tasks must be repetitive and forceful in nature. In this case, the majority of duties are noted to be light in nature, requiring neutral wrist positioning, with opportunity to change wrist positions."
On July 31, 2012, the worker was advised by the WCB her claim for compensation was not acceptable as it was felt her diagnosed condition of bilateral CTS and de Quervain's was not consistent with the nature of her job duties described by the adjudicator as follows:
"In the testing and packing area it was noted that it was a short lived task to apply cables to one unit due to the eight minute wait time in-between. One unit weighed four point four pounds, when lifting a full box the weight would be sixteen point zero pounds, lifted and carried bilaterally with open palms for approximately three to four feet. No awkward hand positions, no extreme ranges of movement, no vibration.
The assembly process was reviewed. The following is noted for the process. Very light in nature. Variety of grips required. Minimal vibration noted when using powered screwdriver. Hands, fingers and wrists in constant motion. No heavy weights, awkward positioning required. Forces are low. The alternate duties were also reviewed. In summary, repetitive work with left hand is noted. Very light work, no awkward hand movements."
On October 4, 2012, the worker appealed the decision to Review Office stating that she was 100% sure that her diagnosed conditions were work-related.
On November 22, 2012, Review Office confirmed that the claim was not acceptable. Review Office noted that CTS was a condition that could develop from both work related and non work related risk factors. Review Office indicated that it placed weight on the WCB rehabilitation specialist's report describing the worker's job duties. "In the packaging and testing area, the lifting requirements were light and brief, and there were no awkward hand movements, extreme ranges of motion, or vibration. The duties in the assembly area were described as being very light, requiring a variety of grips for short periods of time, and minimal vibration. The hands were used on a constant basis but the weights involved were light and the force involved was low. Again, there were no awkward movements and the wrists were in neutral to middle ranges of movement. The Rehabilitation Specialist also reviewed the duties the worker performed when she returned to work with restrictions in May 2012. These duties were performed with the left hand. The duties were described as being repetitive, very light, requiring little force, no awkward hand positions, and no vibration."
Review Office concluded that the worker's job duties did not involve sufficient anatomical movements which would place her at risk for the development of either bilateral CTS or right de Quervain's tenosynovitis. On November 25, 2012, the worker appealed Review Office's decision to the Appeal Commission and a hearing was arranged.
Reasons
Applicable Legislation
In considering appeals, the Appeal Commission and its panels are bound by The Workers Compensation Act (the Act), regulations and policies of the Board of Directors.
Subsections 1(1) and 4(1) of the Act set out the circumstances under which claims for injuries can be accepted by the WCB, and state that the worker must have suffered an injury by accident that arose out of and in the course of employment. Once such an injury has been established, the worker is entitled to the benefits provided under the Act.
This appeal deals with claims acceptance. The key issue to be determined by the panel deals with causation and whether the worker’s injury arose out of and in the course of her employment.
Worker's Position
In an application to appeal filed November 25, 2012, the worker advised that she was 100% sure that her problem came from her employment. She said her job is repetitive and requires strength to perform.
The worker attended the hearing with her son. The worker answered questions from the panel relating to her job duties and injuries. The worker's son assisted the worker with answering some questions.
The worker confirmed that she received a printed copy of the worksite assessment which was prepared by the WCB rehabilitation specialist. She did not receive a copy of the DVD of the site visit. The worker acknowledged that she was present when the assessment was performed.
The panel reviewed the worker's duties in detail with the worker. The panel referred to a copy of the worksite assessment and the pictures on file, to assist with this process.
The worker advised that she began wearing a brace on her right wrist two years before her injury. The brace was supplied by the employer. She said that her left wrist problems developed later than the right. She said the problems with her left hand were the same as her problem with her right. She also said that the pain she felt when she went off work was the same pain that she felt over the last two years.
The worker described her medical treatment. She indicated that she has had surgery on her right wrist. She advised that on December 13, 2012 she returned to work to modified duties at 4 hours per day. Surgery has not yet been scheduled on her left wrist.
Employer's Position
The employer did not participate in the appeal.
Analysis
The issue before the panel is whether the worker’s claim for injury arose out of and in the course of her employment. In order for the appeal to be successful, the panel must find, on a balance of probabilities, that the worker's injury was caused or aggravated by the worker’s job duties. The panel finds, on a balance of probabilities, that the worker's swollen right hand/wrist, which was reported to the employer on April 26, 2012, was caused by her work duties. However, the panel finds that the worker's bilateral carpal tunnel syndrome and right de Quervain's tenosynovitis are not related to her employment.
In making this decision the panel relies upon the following information:
- Employer Accident Report notes that worker reported injuring her right hand and wrist on April 25, 2012 after using a manual testing jig. The report notes the jig was introduced in February 2012 and that the worker used the jig for a total of 3 hours.
- Memo by WCB adjudicator dated May 9, 2012 of a conference call with employer representatives which notes that when the worker showed some members of the management team her injury they observed that it "resulted in obvious right hand/wrist swelling."
- Worker Incident Report which notes that "I test with manual tester, 3 plug connectors are very hard to push in and take out. 28 units that day."
It was noted that the worker was able to work overtime on April 25 and 26. In response to the concern that this suggested that she was not injured, the worker explained that her co-worker assisted with her duties.
The panel is satisfied that the use of the manual tester on April 25, 2012 resulted in a specific local injury to the worker's right arm/wrist which had resolved when she returned to work on May 14, 2012.
In deciding that the worker's bilateral carpal tunnel syndrome and right de Quervain's tenosynovitis are not related to the worker's employment, the panel relied upon the worker's evidence at the hearing. The panel carefully questioned the worker regarding her job duties and activities including hand, wrist and arm movements. From the worker's answers, the panel was not able to identify any of the movements or activities or volumes/repetition that are normally associated with the development of carpal tunnel syndrome or de Quervain's tenosynovitis. The panel finds that the worker's duties were highly varied, generally light in nature, involved no heavy weights, no awkward positions, no extreme ranges of movement, no forceful repetition, and no forceful hand movements.
The panel also places significant weight upon the worksite assessment conducted by the WCB rehabilitation specialist. This assessment, which was conducted in the presence of the worker, considered the worker's usual job duties and alternate duties she returned to when she returned to work with restrictions in May 2012. The panel is of the view that this assessment did not identify activities or movements known to be causal of bilateral carpal tunnel syndrome or de Quervain's tenosynovitis.
The worker's appeal is allowed in part.
Panel Members
A. Scramstad, Presiding OfficerA. Finkel, Commissioner
P. Walker, Commissioner
Recording Secretary, B. Kosc
A. Scramstad - Presiding Officer
Signed at Winnipeg this 20th day of March, 2013