Decision #36/16 - Type: Workers Compensation

Preamble

The worker is appealing the decision made by the Workers Compensation Board ("WCB") that her claim for compensation was not acceptable. A hearing was held on February 9, 2016 to consider the worker's appeal.

Issue

Whether or not the claim is acceptable.

Decision

That the claim is not acceptable.

Background

The worker filed a claim with the WCB on June 8, 2015. The worker reported that her employment as a long haul truck driver required long hours of holding the steering while driving. She can't bend her left thumb and when it's knocked or bent, it was extremely painful. She had no full range of motion in her entire left arm. The pain goes to her neck and spine. This caused her to injure her left arm, wrist, elbow, left thumb, spine and neck. The worker indicated that her physiotherapist attributed her injuries to repetitive work as a truck driver over time and suggested that she file a claim.


The worker reported that she first began to notice symptoms at the end of March 2015. She reported the injury to her employer on March 30 and mentioned it to the dispatcher.


Medical information shows that the worker underwent electrodiagnostic studies and was seen by a neurologist on June 10, 2015. The diagnoses outlined by the consultant based on the test results were rotator cuff arthropathy with a component of adhesive capsulitis on the left side and flexor tenosynovitis of the left thumb.

 

On June 12, 2015, the treating physiotherapist diagnosed the worker with left median and ulnar neuritis, medial epicondylitis, wrist flexor tendonitis, carpal tunnel and rotator cuff strain.


On June 16, 2015, the worker described to a WCB adjudicator her left thumb symptoms that started in March and left arm symptoms that started in the middle of April 2015. The worker reported that she is right-handed and holds the steering wheel with both hands. She holds the steering wheel more with her left hand. The worker was unable to recall any specific incident at work. The worker described other job duties she performed while driving which involved lifting a moose bumper that was attached to the truck.


On June 30, 2015, the worker spoke again with the WCB adjudicator and answered questions related to the symptoms in her left thumb, fingers and left arm, the positioning of her left hand on the steering while, her normal work schedule/work history and the work involved when lifting the moose bumper.


In a letter to the WCB dated July 16, 2015, the treating physician stated, in part, that it was very likely that the worker's job as a truck driver for long periods of time and lifting/unloading from her truck caused her medical conditions of left thumb trigger finger or tenosynovitis, left elbow medial epicondylitis, left shoulder rotator cuff tendonitis and possible adhesive capsulitis. It was noted that the worker did not participate in any physical activity or recreational activity that would precipitate those types of symptoms.


In a decision dated July 17, 2015, the worker was advised by Compensation Services that her claim for compensation was denied as the WCB was unable to establish a causal relationship between the onset of her symptoms and her job duties. The WCB stated: "Based on a review of your work duties, the evidence does not support that there is repetitive/resisted forceful gripping with the left thumb or hands. You report using your left arm/shoulder for the lifting overhead once a day for the majority of the time. In addition, you report experiencing symptoms in the left arm, hand and thumb with any use, while driving and when you are not driving." On August 3, 2015, the worker appealed the decision to Review Office.


In a letter to the WCB adjudicator dated August 4, 2015, the treating physiotherapist commented that the worker's pain and symptoms in her shoulder, elbow, wrist and thumb now increased with driving even short distances. These injuries were related to the constant repetitive positions of the shoulders and hands.


On September 18, 2015, Review Office determined that the claim was not acceptable as it was unable to find that the worker's job duties, on a balance of probabilities, were causally related to her bilateral arm/hand symptoms. Review Office stated, in part, that the findings of the worker's rotator cuff suggested a degenerative process without any known cause or trigger. The worker's description of her hand positioning on the wheel while driving would not support a cause and effect relationship with the diagnosis of tenosynovitis. The paresthesia in her hands and finger 

could not be explained by her duties of driving. On September 28, 2015, the worker appealed the decision to the Appeal Commission and a hearing was arranged.

Reasons

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.


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.


Subsection 1(1) sets out the definition of accident and occupational disease:


"accident" means a chance event occasioned by a

physical or natural cause; and includes


(a) a wilful and intentional act that is not the act of the worker,

(b) any

(i) event arising out of, and in the course of, employment, or

(ii) thing that is done and the doing of which arises out of, and in the course of,

employment, and

(c) an occupational disease,


and as a result of which a worker is injured;


"occupational disease" means a disease arising out of and in the course of employment and resulting from causes and conditions


(a) peculiar to or characteristic of a particular trade or occupation; or

(b) peculiar to the particular employment;

but does not include

(c) an ordinary disease of life; and

(d) stress, other than an acute reaction to a traumatic event;

Subsection 4(1) provides when compensation is payable:


Compensation payable out of accident fund

4(1) Where, in any industry within the scope of this Part, personal injury by accident arising out of and in the course of the employment is caused to a worker, compensation as provided by this Part shall be paid by the board out of the accident fund, subject to the following subsections.


The worker is appealing the WCB Review Office decision that her claim is not acceptable.


Worker's Position


The worker was self-represented. She outlined her reason for appealing the WCB decision. She explained that the WCB declared that her claim is not acceptable and stated that her injuries could be degenerative. She said that she did not think the WCB understood the occupation of a truck driver and the effects it has on the body. She said that "I strongly feel it is due to my

work, the long hours, sitting as a truck driver."


She told the panel that her doctor and physiotherapist advised her that these injuries are common in truck drivers. She said they agreed that her work is related to her injury, or her injury is related to her work. The worker said she wanted to have another set of eyes review the claim.


The worker answered questions from the panel regarding her injury and her job duties.


When asked what her condition is, she responded that:


I know now through an MRI that I have, they’re calling it tendonitis of the shoulder, and frozen shoulder on the left side. I do have trigger thumb. I’ve avoided surgery with that thus far...

In my spine I am showing some mild osteo, and I think there is a few, between the C4 and the C7 discs there’s some flattening on the right side.


Regarding blood work and other tests, she advised that the blood work results were normal.


She advised that she was given a hydrocortisone shot in shoulder. She felt better in two days. She has better function now but is not sure the improvement is due to the cortisone shot. She said that her family physician advised her that "with the frozen shoulder it can take a very long time to heal, but it will heal on its own." He did not mention that there was a surgery that could fix it but she has found there is surgery for her shoulder condition. She said that she has been told that her problems are from a repetitive strain.


She said that she is not currently working, but had tried to return in September driving a shorter distance. She was not able to continue as her condition reverted to where it was in June.


Regarding her job as a truck driver, she advised that:


  • she drives long distance and is usually on the road between 12 and 16 days.

  • she delivers a load and picks up another load for the return trip.

  • she never loads or unloads the trailer.

  • she sweeps the empty trailer and, if needed hires someone to wash the interior of the trailer.

  • she does daily checks which require her to open the hood.

  • to open the hood, she must lower a special bumper. She demonstrated lowering and raising the bumper - she said that raising it is more difficult.

  • she must unscrew and screw large bolts with her right hand to lower the bumper.

  • she lowers the bumper 2 or 3 times each day.

  • she cranks the dolly legs on pick up but can go for 2 weeks without lowering the dolly.

  • she opens and closes the large doors which can be difficult.

  • the truck was a newer model (2013) in good condition.

  • she has been driving trucks for 12 years.

  • she has been driving the current route for about 2 years.

  • the truck has an air ride seat but she does not use it due to her height.

  • she finds the steering wheel easy to use but noted that it was necessary to constantly correct due to the slope of the roads.

  • trips are mainly freeways with no city deliveries.

  • she does limited backing up.

  • her truck had an automatic transmission.

  • she does not do any strapping of loads.

She demonstrated that when driving her arms are almost fully stretched out. She advised that her thumbs are just below the cross piece on the wheel between 2 and 3 o'clock on the right and 9 and 10 o'clock on the left (clock reference). She said that she uses her left hand to operate a button on the wheel to flash lights. She said that she cannot reach the arm rest and she does not rest her arm on the door.


Regarding the onset of her symptoms, the worker said that her arm was sore and then her thumb started clicking. She said her whole arm was sore, " I thought something’s wrong and my arm, my elbow, it felt like my funny bone."


With respect to her thumb symptoms, she advised that:

Very quickly, it became extremely painful, and if it actually clicked, I wasn’t able to click it back into a straight position, it would lock and I would have to force it and I literally felt like I was breaking my thumb, or would break my thumb by forcing it to go straight.





She said that her 4th and 5th fingers would become numb and the 4th finger would also click.


The worker said that she thought she had a rotator cuff injury but could not recall an actual accident or anything happening at work to cause it. She said that she thought her injuries were due to "a lot of long hours on the steering wheel", "the vibration", and "not a lot of time to sleep, not enough rest."


The worker described her elbow injury as both golfer's elbow and tennis elbow. In reply to a question about incidents which may have precipitated her elbow condition, she referred to one incident where she had to fix the air ride suspension on the trailer. She said that she was underneath the trailer in an awkward position, taking the bolt off, which was quite rusted on. She said this likely occurred in January. She used both arms to perform this repair while squatting under the trailer. It took about an hour and a half to complete the repair.


The worker was asked whether any job duties take her hand close to her shoulder. She replied that:


My trailer doors, when you got the trailer doors open, on the back of the door there’s this little ring, and on the side of the trailer there’s a hook. And you hook that ring on to hold the doors open so you can back into a dock.


She agreed this would happen about four times over a 12 day trip.


The worker was asked what may have contributed to the two problems in her shoulder, the supraspinatus tendonitis and the frozen shoulder condition. She said that she just assumed that it was from holding the steering wheel, bouncing and vibrating in the truck. She noted that the resistance of the steering wheel on the road because the roads are all angled "You’re constantly pulling the steering wheel back to stay in your lane."


The worker advised that she does not currently have any problems with her right hand. In reply to a question about the job duties which may have contributed to her hand issues, the worker indicated that it may have been the trailer door latches but that she did not know.


With respect to the repetitive overhead activities referenced by her family physician, the worker said that the steering wheel is about shoulder height and that in turning, her arms go above shoulder height.


Employer's Position


The employer did not participate in the hearing.



Analysis


The worker is appealing the WCB Review Office decision that her claim for a workplace injury is not acceptable. For the worker's appeal to be approved, the panel must find that the worker sustained an injury by accident arising out of and in the course of her employment. The panel was not able to make this finding.


The worker is a long haul truck driver who has been driving trucks for about 12 years. At the time of the injuries, she had been driving the same route for about two years and confirmed there were no recent changes in her job duties.


The worker described a variety of conditions, which developed at nearly the same time and which she believed were caused by her occupation as a truck driver. Generally, the worker attributed her conditions to holding onto the steering wheel for long periods of time and the related vibration she felt as she drove the truck.


The panel considered the conditions but was not able to find any work-related causes for the conditions.


Regarding the worker's elbow condition, the file information identifies three possible diagnoses for her condition: tennis elbow, golfers elbow and an ulnar nerve issue. The panel found that the worker's duties did not involve significant grasping, activating the large muscles in the front or back of her forearm which would possibly be causative of the elbow problem. She does not rest her left arm on the arm rest or the door. In response to a question about duties which brings her arm or hands to her shoulder, she identified the task of opening and hooking the doors as such a task. The panel notes that she performs this task only three or four times on a 12 to 16 day trip. The panel finds, on a balance of probabilities, that the worker's elbow difficulties are not related to work as a truck driver and therefore are not compensable.


The worker has also been diagnosed with supraspinatus tendinitis and frozen shoulder. The worker advised that she assumed the shoulder issues was "from holding the steering wheel, bouncing and vibrating in the truck." The panel finds that these duties are not causative of these conditions and was not able to identify any other aspect of the worker's duties which would be causative of her shoulder issues and accordingly finds, on a balance of probilities, that the worker's shoulder conditions are not related to her work duties.


The worker was also diagnosed with trigger thumb and trigger finger. She had symptoms of trigger finger in both hands. She advised that her right hand is not causing her any difficulties. At the hearing, the worker was not able to identify duties which involve the fingers pushing into her hand with a lot of pressure. The duties she identified were performed infrequently. The panel finds, on a balance of probabilities, that the worker's trigger finger conditions are not related to workplace duties.


Finally, the panel notes there was a reference to the worker's spine. The panel notes that the January 16, 2016 MRI found mild osteoarthritic and disc degenerative changes. These conditions are not part of the worker's claim.


The worker's appeal is dismissed.

Panel Members

A. Scramstad, Presiding Officer
A. Finkel, Commissioner
M. Kernaghan, Commissioner

Recording Secretary, B. Kosc

A. Scramstad - Presiding Officer

Signed at Winnipeg this 9th day of March, 2016

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