Worker claimed repeated reaching overhead aggravated shoulder condition, but evidence didn’t prove underlying condition was worsened by job duties
An Ontario worker’s shoulder condition was not caused or aggravated by repetitive reaching overhead at work and was more likely related to an earlier car accident, the Ontario Workplace Safety and Insurance Appeals Tribunal has found in denying the worker entitlement to benefits.
The 46-year-old worker was an admitting clerk in the emergency area of an Ontario hospital, handling paperwork for patient admissions, liaising with doctors, nurses, and patients, and managing health insurance data for patients. She was hired in 2000.
In December 2013, the worker was in a motor vehicle accident and suffered injuries to her right side. The accident was unrelated to her job and the worker wasn’t eligible for workers’ compensation benefits.
About 10 months after the accident, in October 2014, the worker reported that she was experiencing gradual onset pain in her right shoulder that developed from frequent reaching over her head at work for the past four years, which the worker said had increased in recent months. She sought medical treatment and was diagnosed with a repetitive stress injury. The injury forced her to go on modified duties at the hospital that involved working three eight-hour shifts per week.
A couple of months later the hospital carried out an ergonomic assessment of the worker’s work area. The worker reported that her work station itself didn’t present any problems for her physically and her shoulder symptoms were only exacerbated when she retrieved papers from the printer, which was on a shelf above the work station. She also said she didn’t stand up to retrieve copies from the printer because she had a right hip condition stemming from the December 2013 motor vehicle accident. The ergonomist noted that there were two workstations — the shelf containing the printer was between the stations — and when the worker used the left workstation, she had to use her right arm to retrieve printed papers but when she was at the right workstation, she could use her left arm. The ergonomist recommended the printer be relocated to floor level so the worker wouldn’t have to reach up and reduce the stress on her right shoulder.
Worker went off work, had shoulder surgery
The worker continued to perform modified duties until January 2015, when she had to go off work completely due to her shoulder pain. An MRI in July showed mild chronic tendinitis of the right shoulder tendon and a tear in the fibres of another tendon in the area. The worker also had a bursal surface tear and a posterior labrum tear.
The worker underwent surgery in late 2015 to repair her shoulder injuries. She applied for workers’ compensation benefits for disablement from the injury from the time she had to start working part-time, modified duties in October 2014.
The Ontario Workplace Safety and Insurance Board (WSIB) and a WSIB appeals resolution officer both denied the worker’s claim, finding there was no causal relationship between the worker’s duties and the tears in her right shoulder. The worker appealed the decision to the tribunal.
In June 2017, the worker was assessed at Occupational Health Clinics for Ontario Workers (OHCOW) and was diagnosed with tendinosis, tendon tears, and joint arthritis. The doctor also reported rotator cuff syndrome that was likely related to the motor vehicle accident but also aggravated by the worker’s repetitive reaching up at work.
The tribunal noted that the WSIB had established a five-point checklist to determine if a claim could be allowed: There must be an employer, a worker, a personal work-related injury, proof of accident, and compatibility of diagnosis to accident or disablement history. The first three were clearly present, but the question of proof of accident and compatibility were in question.
The tribunal also noted that there was no “moment of accident,” as the worker reported a gradual onset of right shoulder pain leading to disablement. It had been established that entitlement for disablement required “an injuring process associated with the employment that made a significant contribution to the worker’s disability.”
The tribunal found that the tendinosis found in the MRI was described as mild and the worker accessed the printer with different arms depending on which of the two stations at which she was sitting. While performing her duties, the worker sometimes used her left arm instead of her right arm to reach up to the printer, but she experienced no problems with her left shoulder at work. She only complained of pain while using her right shoulder, which was injured in the non-compensable motor vehicle accident in December 2013, said the tribunal.
As a result, the tribunal determined that the mechanism of the injury did not line up with the worker’s shoulder injury. It noted that the OHCOW doctor believed the worker’s job duties aggravated her shoulder condition, but he didn’t refer to the ergonomist’s report or how often the worker would be required to lift her right shoulder to reach this conclusion, making it difficult to use it as persuasive support of the worker’s claim, the tribunal said.
The tribunal found the motor vehicle accident was “a severe, acute trauma” that likely contributed to the worker’s condition and the worker’s duties didn’t require repetitive or prolonged use of arms above the shoulder level — it estimated the worker reached overhead to extract paper from the printer about once every 10 minutes, or six times an hour, and that included the times she used her left arm.
In addition, the tribunal referred to its discussion paper on shoulder disabilities, which stated that “work requiring repetitive or prolonged use of arms above the shoulder level may accelerate the progress of degenerative tendinitis” but “middle-aged or older people” could have weakened tendons where tears could happen easily.
The tribunal dismissed the worker’s appeal, finding no causation in the worker’s job duties with the development or aggravation of the tears and tendinitis in the worker’s shoulder.
“The fact that the problems with the tears (in the worker’s right shoulder) became manifest while the worker was employed does not signify that the work necessarily contributed to or caused an aggravation,” said the tribunal. “I find an insufficient basis in the sedentary, occasional and light duties performed by the worker to conclude that the workplace duties aggravated the tears.”
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