Condition showed up on tests following accident but was likely pre-existing: Tribunal
The Ontario Workplace Safety and Insurance Appeals Tribunal has denied a worker’s claim for hypertension stemming from a work-related injury.
The 43-year-old worker started his employment as an assembler for a bus company in September 1997. On Nov. 3, 2010, he was working on the roof of a bus assembling parts when he was struck on the neck and head by a metal door and fell on his neck. The worker was taken to the hospital, where he was diagnosed with whiplash and hypertension.
The worker spent six weeks in the hospital and when he was released he began suffering from dizziness and nausea along with pain in his neck. However, after various tests were performed, no significant long-term injury was found. The worker received loss of earning benefits for the neck injury, but the Ontario Worker’s Safety and Insurance Board (WSIB) found his hypertension was not work-related.
The worker continued to have ongoing symptoms such as dizziness and nausea and insisted he didn’t have them before the accident. He said he couldn’t lie down or look up or down without getting nauseated and vomiting. He was also limited to driving no more than 15 minutes at a time. He saw an inner-ear specialist and had several other tests that came back normal. None could find the cause of the worker’s symptoms. In July 2011 the worker reported vomiting three times per day and he had gained 28 pounds since leaving the hospital.
An assessment in August 2011 reported the worker engaging in “pain behaviour” and complaining about nausea, as well as dry heaving but not vomiting. He eventually had to stop the testing.
In November 2011, the board determined the worker had fully recovered from the
injury and was able to perform the duties of his assembler position. A graduated return-to-work was approved with the intention of him performing his full duties and not requiring any benefits by Jan. 9, 2012.
The worker worked for three hours on Nov. 18 and then said he had to go home to rest. He never returned to work, claiming his condition prevented him from working “in any capacity.” He claimed he was at the point where he could only move around for 20 minutes a day. He challenged the determination that he was fully recovered and argued his hypertension – which was still a problem – was related to the injury since he hadn’t had it before the workplace accident.
A WSIB medical consultant examined the worker and said it wasn’t clear how the worker’s head and neck injury could contribute to the development of hypertension. There was no other medical evidence supporting a causal connection between the worker’s injury and his hypertension.
Two medical reports – one in December 2011 and one in January 2012 – indicated the worker had “a number of medically unexplained symptoms” but no “significant abnormalities.”
The WSIB denied the worker’s claim for hypertension and the worker appealed to the tribunal.
The tribunal acknowledged that the worker suffered a neck injury in a workplace accident, but noted that “cardiovascular conditions of this nature (hypertension and high blood pressure) are usually underlying and the fact that it may only have been detected following the worker’s accident does not necessarily mean that it arose out of and in the course of his employment.”
Further, the tribunal found the worker had undergone numerous tests and treatment, none of which could link the worker’s hypertension to his neck injury. The WSIB and its medical experts even gave the worker clearance to return to work in November 2011, said the tribunal.
The tribunal also noted the documented instances of vomiting during assessments were really more like retching and dry heaving, and the fact the worker gained 28 pounds in the wake of the accident could have been a contributing factor to his state.
“The worker received numerous specialized medical investigations, including objective diagnostic testing, which could not determine any diagnosis that was responsible for (the symptoms),” said the tribunal.
