The Appeal CommissionThe Workers Compensation Act of Manitoba

Preamble

The worker is appealing a number of decisions made by the Workers Compensation Board ("WCB") regarding his claims for accidents occurring on August 15, 2011 and April 26, 1985. A hearing was held on September 14, 2016 to consider the worker's appeals.

Issue

Accident Date: August 15, 2001

Whether or not the worker's psychological condition is related to the August 15, 2001 accident; and

Whether or not the worker is entitled to wage loss benefits after January 6, 2016.

Accident Date: April 26, 1985

Whether or not responsibility should be accepted for the worker's right wrist difficulties in relation to the April 26, 1985 accident.

Decision

Accident Date: August 15, 2001

That the worker's psychological condition is not related to the August 15, 2001 accident; and

That the worker is not entitled to wage loss benefits after January 6, 2016.

Accident Date: April 26, 1985

That responsibility should not be accepted for the worker's right wrist difficulties in relation to the April 26, 1985 accident.

Background

Accident Date: August 15, 2001

On August 15, 2001, the worker suffered an injury to his left hand when a steel coil slipped and pinned his hand and wrist. The claim for compensation was accepted based on the diagnosis of a contusion to the dorsum of the left wrist. In 2013, the worker contacted the WCB to advise that he was having ongoing difficulties with his wrist which he felt was related to the 2001 accident.

On February 13, 2014, a hearing took place at the Appeal Commission as the worker disagreed with the WCB decision that his left wrist difficulties were not related to the August 15, 2001 compensable injury. On May 16, 2014, the appeal panel determined that the worker's left wrist arthritis was secondary to scapholunate dissociation from a tear to the ligament at the time of the compensable injury. For additional information regarding claim history, please refer to Appeal Commission Decision No. 60/14 dated May 16, 2014.

Following the appeal panel's decision, the file was returned to Compensation Services to determine the worker's entitlement to benefits. It was determined that the worker had restrictions related to his compensable injury prior to August 2013. The worker was paid for his absences from work up to August 9, 2013 to attend medical appointments for his compensable injury.

On July 30, 2014, it was determined by the WCB that the worker was not entitled to benefits after August 9, 2013 as they attributed his loss of earning capacity to a work suspension that was unrelated to his compensable injury. On December 10, 2014, the WCB's Review Office determined that the worker did have a loss of earning capacity after August 9, 2013 due to his compensable injury and that he was entitled to wage loss benefits after August 9, 2013.

In a report to the WCB dated March 16, 2015, a counsellor noted that the worker began treatment in January 2014. With respect to a psychological or psychiatric diagnosis, the report stated that the worker's symptoms were Post-Traumatic Stress Disorder due to mistreatment and harassment that he suffered while he was working at his current workplace.

In a memo to file dated June 8, 2015, a WCB psychiatric consultant reviewed the hospital information regarding the worker's admission from December 4 to 16, 2013. The worker had some psychological care after he was suspended from work in August 2013. The worker stated that work was important to him and that he felt a loss. The discharge diagnoses were Major Depression Disorder, Alcohol Use Disorder, and Obsessive Compulsive Personality Disorder, in addition to overdose and cutting injury. The WCB psychiatric consultant stated that the file information did not support a diagnosis of PTSD.

On June 10, 2015, the WCB psychiatric consultant further stated:

There a (sic) number of factors contributing to symptoms of depression (depressed mood, chronic passive suicidal ideation, self blame) including long standing maladaptive coping strategies, pain, social isolation, and his work situation. He was diagnosed in December 2013 at HSC as having Major Depressive Disorder. His current counselor, with whom he frequently meets, does not offer this as a current diagnosis. It is not evident, from file review, whether he has a current psychiatric diagnosis. His personality disorder, as described by HSC, increases the risk of a brief reactive depression when coping skills become overwhelming.

In a decision dated October 14, 2015, the worker was advised that based on consultation with a WCB psychiatrist, it was determined that his mental health symptoms were pre-existing and not related to his current claim.

In a further decision dated October 28, 2015, the worker was advised that in the WCB's opinion, his position as a Shipper/Receiver was within his compensable restrictions and as such, there was no further loss of earnings related to the claim. The worker was advised that wage loss benefits would be extended to January 6, 2016 inclusive.

On November 18, 2015, a worker advisor wrote Review Office appealing the WCB decisions that the worker's current psychological condition was not related to the August 15, 2001 left hand/wrist injuries and that he was capable of returning to work as a Shipper/Receiver.

In a decision dated March 24, 2016, Review Office determined that the worker's psychological condition was not related to the August 15, 2011 left hand injury. Review Office referred to the worker advisor's contention that the worker's pre-existing depression was aggravated by his increased left wrist pain and the work circumstances.

Review Office noted that following the 2001 injury, the worker did not report having any psychological difficulties related to his left wrist injury. He continued working except for some periods of time loss due to other work-related injuries. In 2013, the worker experienced frustration with his employer's inactions regarding his increased left wrist pain, and his actions led him to be escorted off the premises. It found that the worker's psychological condition was related to his reaction to the employer's lack of accommodation and this was not the WCB's responsibility. It found that any reactive depression experienced in 2013 would have resolved in time and by March 2015, the worker's counselor did not diagnose the worker with depression.

Review Office also determined the worker was not entitled to wage loss benefits beyond January 6, 2016. Review Office noted the worker advisor's contention that the worker was not capable of performing his regular duties as a shipper/received in 2013 as his left wrist function had not improved. The worker also disagreed with the employer's description of his job duties.

Review Office referred to the work site assessment that was carried out by a WCB rehabilitation specialist (RS) in November 2014 which concluded that the worker's job duties were within his permanent workplace restrictions. Then, in April 2015, the worker outlined what he thought were inaccuracies in the RS assessment. This led to a second work site assessment on October 22, 2015.

After reviewing the two worksite assessments, Review Office was unable to find that the job duties of a shipper/receiver were outside of the worker's permanent restrictions. It found the worker did not have a loss of earning capacity related to the August 2001 workplace injury and he was not entitled to wage loss benefits beyond January 6, 2016.

Accident Date: April 26 1985

On April 26, 1985, the worker suffered an injury to his right hand on a piece of steel tubing while operating a manual cutting lathe. On the same day of accident, the worker attended a hospital facility for treatment. In a discharge report dated April 28, 1985, it stated:

This…man had a pipe stuck in his right palm and he lacerated the flexor pollicis longus tendon (95%) and the radial digital nerve to the thumb and the insertion of all the thenar muscles. The ulna neurovascular bundle to the thumb was intact. He also had a distally placed flap overlying the area just proximal to the metacarpal phalangeal joint. He underwent debridement and repair of both structures. He was discharged home…

When seen at a follow-up assessment on July 27, 1985, the attending physician reported that the worker had good range of motion of the IP joint of the right thumb and his strength was slightly decreased. It was reported that the worker would be seen again on August 7, 1985 at which time he could likely return to work.

On August 20, 2015, the worker advisor submitted a report from an orthopedic surgeon dated July 20, 2015 who stated:

[Worker] has radioscaphoid, CMC and ST arthritis of the right wrist.

This is likely secondary to the crush injury of his right wrist though it may be related to the type of work that he previously did as well.

Current right hand restrictions would be no repetitive forceful gripping, twisting or squeezing with the right hand.

The worker advisor noted in her appeal that the worker said he did not regain feeling on the outside portion of his right thumb following the April 26, 1985 incident and used his left hand to compensate when performing work duties. The worker had difficulty using both his hands when he was transferred to a work plant in April 2007 and the controls were different from the controls at the other plant. The worker said his right hand difficulties had increased over the years and he saw the hand specialist for a medical assessment.

In December 2014 and January 2015, a WCB case manager spoke with the worker regarding his right wrist difficulties.

At the request of the case manager, a WCB medical advisor was asked to comment on whether the medical information established a probable relationship between the original compensable diagnosis and the current diagnoses related to the right hand. In a response dated February 22, 2016, the medical advisor stated:

In summary, i) the April 26, 1985 mechanism of injury was that of a distal radial palm laceration, and there was no apparent medical evidence to support a crush injury to the right wrist at that time, ii) postoperative medical reports indicated successful repair and good healing of the FPL tendon and thenar muscles, and iii) subsequent medical information from 1993 supported that the right thumb April 26, 1985 injury healed well, with good range of motion and strength and no intrinsic muscle wasting, and indication by [worker] that he was quite pleased with the results of the April 27, 1985 repair. In light of the above, as the medical evidence on file did not indicate a crush injury to right wrist in relation to the April 26, 1985 workplace injury, and the medical information indicated satisfactory healing following treatment of the April 26, 1985 injury, the medical information on file does not support a probable pathoanatomic relationship between the April 26, 1985 workplace injury and current right wrist radioscaphoid, CMC and ST arthritis.

In a decision dated March 8, 2016, the WCB case manager advised the worker of the WCB medical opinion outlined on February 22, 2016 and concluded that there was no information to support a relationship between his right hand workplace injury in 1985 and the right hand/wrist problems he was now experiencing. On March 10, 2016, the worker advisor appealed the decision to Review Office.

On March 24, 2016, Review Office confirmed that responsibility would not be accepted for the worker's current right wrist difficulties.

Review Office referred to medical evidence on the worker's 1993 claim for bilateral hand difficulties and to the worker's claim for a left wrist injury sustained on August 15, 2001. Review Office also referred to the July 20, 2015 report from the orthopedic surgeon and the WCB medical advisor's opinion dated February 22, 2016.

Review Office accepted the February 22, 2016 medical opinion. It noted that the opinion of the worker's orthopedic surgeon was based on a misunderstanding or misinformation regarding the mechanism of injury. It placed less weight on this opinion as the file evidence showed the worker did not sustain a crush injury to his right wrist on April 26, 1985. It did not dispute the diagnoses provided by the orthopedic surgeon but it was not able to relate these diagnoses to the 1985 workplace injury which was a laceration to the worker's right palm from which the worker made a satisfactory recovery. Any restrictions imposed on the worker's right wrist difficulties would not be the responsibility of the WCB.

On April 1, 2016, the worker advisor appealed the decisions made by Review Office dated March 24, 2016 to the Appeal Commission and an oral hearing was arranged. On August 17, 2016, the worker advisor provided the appeal panel with literature for consideration regarding Flexor Tendon Injuries, Hand-Nerve Damage, Thenar Eminence and Carpometacarpal Osteoarthritis.

Reasons

Applicable Legislation

The Appeal Commission and its panels are bound by The Workers Compensation Act (the “Act”), regulations and policies of the WCB Board of Directors.

The worker has several claim files and is appealing decisions relating to his 2001 claim and his 1985 claim. The legislation in place on the dates of the accidents is applicable to the adjudication of each claim.

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.

The employer did not participate in the appeal.

2001 Accident

Issue 1. Whether the worker's psychological condition is related to the August 15, 2001 accident

Applicable Policy:

Claims for psychological conditions are adjudicated under WCB Policy 44.05.30, Adjudication of Psychological Injuries (the "Psych Injuries Policy”), which sets out guidelines applicable to claims for psychological injuries. The effective date is November 1, 2012, for all claims regardless of the accident.

The relevant portions of the Psychological Injuries Policy are as follows:

Accident

The definition of accident in The Workers Compensation Act (WCA) has various components. A psychological injury can be caused by:

* a chance event; * a wilful and intentional act; or * the injury can be an occupational disease (an acute reaction to a traumatic event or post traumatic stress disorder).

Any of these events can injure a worker physically. However, they can also injure a worker psychologically without injuring the worker physically.

The definition of “occupational decease” as contained in the Act is as follows:

"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.

With respect to injuries arising from employment related matters, the Act contains the following limitation:

Restriction on definition of "accident"

1(1.1) The definition of "accident" in subsection (1) does not include any change in respect of the employment of a worker, including promotion, transfer, demotion, lay-off or termination.

Worker's Position

The worker was represented by a worker advisor who provided an oral and written brief of the worker's appeal on each issue. The worker answered questions from his representative and the panel.

The worker's representative submitted that the worker's psychological condition was predominantly attributable to the progressing symptoms of his compensable left wrist injury. She submitted that the worker's psychological condition was further aggravated by the employer and co-worker relations resulting in his current diagnosis of Post-Traumatic Stress Disorder. The worker advised that his psychological difficulties began within three months after he was transferred to the employer's rural premises in approximately 2007.

Regarding his medical condition, the worker denied being given any counseling or medications for depression before this transfer but acknowledged that he attempted an overdose of medication when he was 18 years old.

The worker said that initially there were seven staff at the rural plant but this was later reduced to two. He said his duties were heavy, "60 to 80 pounds, stacking that, cutting it, putting on the trailers, spreading plastic over the trailers." He provided a detailed description of the process of loading and unloading trailers and other duties.

He advised that performing his duties involved moving a crane with a control, either a pendant that hung on a cable from the ceiling or a remote control. The worker said that he preferred the pendant. He explained how using the remote control would aggravate both wrists.

In reply to a question about the force used to operate the controls, he replied "It really wasn’t that much force…" He said he would have the remote control in his hand for up to half the day. He advised that he would use the right hand to hold the back of it, because if he tried to push it in, the right hand would lock up and he was having to do everything with the left hand. He described the device as:

Too flat, too narrow and, like I say, instead of having your hand expanded and you controlling it with our tip of your thumb, you were pushing in and aggravating the thumb and the wrist.

The worker's representative submitted that his psychological condition was also impacted by relations with his employer and co-workers. The worker said his property was stolen from his locker and his parking spot taken by a co-worker. He said the employer did not support him when he complained. He said that he was suspended for smoking after the employer had given him approval to smoke and harassed over time off for his grandmother's funeral. He said that he was often assigned the most difficult tasks.

The worker explained the circumstances at work in August 2013 where he was perceived as making a threat and was barred from the premises.

The worker informed the panel about the medications he has been prescribed for his wrist and psychological condition. The worker advised that his current psychological condition as diagnosed by his counselor is post-traumatic stress disorder. He said he has also been diagnosed with depression and obsessive compulsive disorder.

The worker's representative submitted that:

In conclusion, [worker] became very emotionally distraught from increased left wrist pain and dysfunction. His employer's refusal to provide accommodation and the board's denial of responsibility, as well negative co-worker relations, further aggravated [worker's] psychological condition.

The worker's representative submitted that the following polices are applicable to the worker's appeal:

* Further Injury Policy - the psychological condition was predominantly attributable to the progressive symptoms of his compensable left wrist injury. * Pre-existing Conditions Policy - the pre-existing depressive disorder was aggravated by his chronic left wrist pain. * Psychological Injures Policy - the work-related events had a significant impact on the worker's emotional state and resulted in a psychological condition.

The worker's representative advised that:

I’m arguing that [worker's] condition of depressive disorder was aggravated by his situation, his wrist situation, and that it did continue after he left the Health Sciences Centre. [Worker] believes, however, his current diagnosis of post-traumatic stress disorder applies to his situation…

Analysis:

For the worker's appeal of this issue to be approved, the panel must find, on a balance of probabilities, that the worker sustained a psychological injury arising out of and in the course of his employment. The panel was not able to make this finding.

The worker stated that his work aggravated his wrist injury. He said the crane controls at the rural worksite aggravated his wrist injury.

The worker's representative noted that the worker had frequently complained to his employer about the difficulty he had using the new controls. She noted that the employer did not replace the controls so the worker had to continue to use them. She submitted that this aggravated the worker's depressive disorder. The worker's representative noted that physicians at the treating hospital diagnosed the worker with major depressive disorder.

It was also submitted that the worker's psychological injury was due to mistreatment by co-workers and the employer. The worker's counselor opined that the worker suffered from post-traumatic stress disorder as a result of this mistreatment and harassment that he suffered while he was working at his current workplace for the last seven and a half years.

The panel notes the opinion of the WCB psychiatric consultant as set-out in memos on August 17 and August 24, 2015. On August 17, 2015, the WCB psychiatric consultant opined that:

There are a number of factors contributing to symptoms of depression (depressed mood, chronic passive suicidal ideation, self-blame) including long standing maladaptive coping strategies, pain, social isolation and his work situation. He was diagnosed in December 2013 at HSC as having Major Depressive Disorder. His current counselor, with whom he frequently meets, does not offer a current diagnosis. It is not evident, from file review, whether he has a current psychiatric diagnosis. His personality disorder, as described by HSC, increases the risk of a brief reactive depression when coping skills become overwhelming.

In an August 24, 2015 memo, the WCB Psychiatric Consultant opined that:

It is evident [worker] has significant mental health problems. They are multifactorial. On balance, they are not related to this WCB claim.

The panel attaches greater weight to the opinion of the WCB psychiatric consultant and finds that the worker's psychological condition is not related to the August 15, 2001 workplace accident. With regards to the diagnosis of PTSD, the panel notes that this diagnosis was provided by the worker's counselor and not by a psychiatrist or psychologist. In any case, the panel finds that the worker's complaints appear to relate to changes in respect of his employment and his working conditions which are excluded by section 1(1.1) of the definition of "accident."

The worker's appeal on this issue is dismissed.

Issue 2. Whether or not the worker is entitled to wage loss benefits after January 6, 2016

Worker's Position

The worker is seeking wage loss benefits after January 6, 2016. The worker maintains that he cannot perform his duties. The worker's representative noted that the WCB conducted two work site assessments in the absence of the worker.

The worker disagreed with the worksite assessment reports. The worker stated that the assessments were staged and did not accurately represent the work performed. He stated that the assessments "were not done by people who suffer from significant osteoarthritis of the wrist. Tasks that appear light or low force to a normal person, can be very painful and difficult for someone with osteoarthritis."

The worker provided a detailed description of his duties. He disagreed with the description provided at the worksite assessments. He reviewed the photographs that were on file and explained in detail the duties and equipment involved. He disagreed with much of the assessments, including:

* the tasks were only demonstrated once but the worker performs them multiple times throughout the day. * the assessment did not show "the stuff that’s 10, 12 feet in the air when you got that 30-foot bar, and you got to jab it from the top and use your body weight to swing it out." * he used the pry bar less at the Winnipeg plant than at the rural plant, and that prying "rattles your wrist." * he disagreed that the operation of the controls was not difficult, he stated "on a scale of 1 to 10, I would put it at 15, it was so painful to operate those things." * the assessment did not show a typical load of pipes. * the dunnage was heavier than reported, up to 80 pounds. * the volume of trucks was greater than 10 trucks per day. * he did not have the use of an office or computer. * the bundles weighed up to 20,000 pounds not 5,000 to 6,000 pounds. * the remote control in the picture is not the model he used. * the photograph demonstrating the use of the pry bar was inaccurate. * temps were not employed to help load and unload trucks.

The worker explained that the main problem at the rural workplace was the difficulty using the crane controls. He advised:

…when I was shipped to the [rural] plant and they had the different controls, and I just couldn’t. I told them, like, the first week I was there that I, I wouldn’t last two months with these controls and we have some stock and we put them in, and they just said no, these work fine, good enough, if you don’t, this is the only job we have for you and they…

The worker's representative noted that surgical treatment has been recommended to treat the worker's left wrist condition but he has not had surgery to date. The orthopedic surgeon recommended in a report dated February 22, 2013 that the worker avoid activity that aggravates the left wrist.

The worker's representative submitted that the worker's left wrist condition has not functionally improved and he is not capable of performing the duties of a shipper/receiver.

Analysis

The working is seeking wage loss benefits after January 6, 2016. For the worker's claim to be approved, the panel must find, on a balance of probabilities, that the worker sustained a loss of earning capacity due to his workplace accident, or in other words, he could not perform his duties as a result of his hand injuries and related restrictions. The panel was not able to make this finding.

The panel finds, on a balance of probabilities, that the worker was not totally disabled after January 6, 2016, and that his job duties were appropriate and not inconsistent with his medical restrictions. The panel notes that the worker's restrictions were to limit firm grasping with the left hand, no firm grasping with the left hand if safety is an issue, no repetitive movements of the left wrist against force, and no lifting, pushing, pulling, and carrying greater than 20 lbs.

The panel notes the worker had concerns regarding the veracity of the workplace assessments. He disagreed with the information in the assessments and noted that he was not permitted to attend the assessments. The panel notes that the 2015 assessment was conducted to address the specific concerns noted by the worker with the 2014 assessment. While it is unfortunate that the worker was not permitted to attend the assessments, the panel finds that the worker was provided with opportunities to identify his concerns.

Regarding the workplace assessments, the panel listened to the worker's concerns and reviewed the worker's job duties and worksite assessments (2014 and 2015). The panel finds that the worksite assessments provide a reasonable description of the worker's duties and activities. The panel finds that the assessments do not identify duties which are outside the worker's restrictions. The panel notes that the 2014 assessment was prepared by a WCB rehabilitation specialist and finds that it provided a thorough and reasonable review of the worker's duties.

Given that the panel has found that the workplace duties were appropriate and consistent with his abilities and restrictions, the panel finds that the worker is not entitled to wage loss benefits after January 6, 2016.

The panel notes that much of the worker's complaints appear to arise out of labour-management issues which are not within the panel's jurisdiction.

The worker's appeal of this issue is dismissed.

Accident Date: April 26, 1985

3. Whether or not responsibility should be accepted for the worker's right wrist difficulties in relation to the April 26, 1985 accident.

The worker described the accident which resulted in an injury to his right hand in 1985. He said that he was cutting round tubing to specific lengths when a co-worker unexpectedly put another piece of tubing on the cutting machine. He said that, due to the action of a co-worker, he jammed his hand into the machine, his wrist was jammed and pinned between two rollers. He said that:

Apparently the muscle and the tendon were cut all the way through and...the nerve was nearly cut all the way through.

The worker said it was not just a cut rather his hand was twisted.

The worker said that he never regained full strength or feeling of his right thumb and compensated for it with his left hand. He said that the feeling never returned on the outside half of the thumb, and he never recovered complete range of motion but was able to compensate for it while working at the Winnipeg plant. However, when he was transferred to the rural plant he could not hold the button on the control for a full minute, it would immediately start locking up and it was painful. The worker described the right hand symptoms after the accident. He said that his hand would lock up and the pain was in both the thumb and the wrist. In answer to a question of where he had pain he said "exactly the same spot as the left hand" and pointed to an area near his watch band.

The worker's representative reviewed the medical reports on file. The worker's representative submitted that evidence supports a relationship between the worker's 1985 compensable injury and his current right thumb condition. Therefore, ongoing responsibility should be accepted.

The worker's representative also noted that at a call-in examination in 1993, a WCB medical advisor commented that it is possible that in view of the repetitive nature of the worker's work duties, that he can develop tendonitis of his wrist bilaterally and this can be resolved by anti-inflammatory medication, and by wearing a brace.

The worker advised that he was unable to wear a brace because it would not fit under his gloves and he would not be able to open his hand wide enough to operate the crane control.

The worker's representative referred to literature regarding injuries to the thumb and also the relationship of hand injuries to the development of arthritis. She suggested that the information shows a possible relationship between the worker's work duties and the onset of right hand CMC osteoarthritis.

The worker relied on the July 2015 opinion of the orthopedic specialist who reviewed the medical information on the file. The worker's representative commented that the specialist stated that the worker's hand condition could be attributed to the type of work he did. The specialist recommended restrictions of no repetitive forceful gripping, twisting or squeezing of the right hand.

The worker's representative submitted that:

In conclusion, medical information on file supports [worker] experienced progressive right thumb symptoms following the 1985 compensable injury that affected his ability to perform his duties. It is our opinion, evidence supports a relationship between [worker's] 1985 compensable injury and his current right thumb condition. Therefore, the board should accept ongoing responsibility.

Analysis

The issue before the panel is whether responsibility should be accepted for the worker's right wrist difficulties in relation to the April 26, 1985 accident. For the worker's appeal of this issue to be approved, the panel must find, on a balance of probabilities, that the worker's current right hand difficulties are related to the 1985 accident. For reasons that follow the panel was not able to make this finding. The panel finds that the description of the injury provided by the worker at the hearing differs from the description provided at the time of the injury in 1985. The panel places greater weight on the description provided in the worker's original injury report:

Cut right hand with a piece of 2" od x11 G steel tubing while operating a manual cutting lathe.

The panel notes that the employer's report contains the same description.

The panel also notes that the report does not indicate a twisting injury or wrist injury and that the treatments subsequent to the injury did not include treatment for a wrist injury. The panel finds, on a balance of probabilities, that the worker did not sustain an injury to his right wrist in the 1985 accident.

The worker's representative has asked the panel to give weight to the July 20, 2015 report from an orthopedic surgeon which indicates that the worker has radioscaphoid, CMC and ST arthritis of the left wrist which is "…likely secondary to the crush injury of his right wrist though it may be related to the type of work that he previously did as well."

The panel is not able to rely upon this report as the mechanism of injury is incorrect. The evidence does not establish that the worker sustained a crush injury to his right wrist in the 1985 accident.

In making this decision, the panel has reviewed the various medical reports on file and places significant weight on the February 22, 2016 opinion of the WCB medical advisor who reviewed the worker's file and concluded that:

…as the medical evidence on file did not indicate a crush injury to the right wrist in relation to the April 26, 1985 workplace injury, and the medical information indicated satisfactory healing following treatment of the April 26, 1985 injury, the medical information on file does not support a probable pathoanatomic relationship between April 26, 1985 workplace injury and current right wrist radioscaphoid, CMC and ST arthritis.

With respect to the worker's representative's comments on a cumulative injury, the panel notes that this issue has not been adjudicated and is not before the panel.

The worker's appeal of this issue is dismissed.

Panel Members

A. Scramstad, Presiding Officer
A. Finkel, Commissioner
P. Walker, Commissioner

Recording Secretary, B. Kosc

A. Scramstad - Presiding Officer
(on behalf of the panel)

Signed at Winnipeg this 19th day of October, 2016