Worker was already performing modified duties because of degenerative condition when he strained his back at work
An Ontario worker is not entitled to workers’ compensation benefits for a back injury that was related to an existing condition, not a work accident, the Ontario Workplace Safety and Insurance Appeals Tribunal has ruled.
The 54-year-old worker was employed as a shipper/receiver in a warehouse environment. In January 2011, the worker suffered a right arm injury at work and received a non-economic loss award from the Ontario Workplace Safety and Insurance Board (WSIB). He was unable to return to his full duties because of the injury, so he was placed on modified duties to last until the modified work was no longer available in January 2013. Once this time was up, the worker was expected to start a work transition program where he would be moved to another job that met his medical restrictions.
In May 2012, the worker saw his family doctor complaining of progressive back pain. At the time, his was laid off and didn’t return to modified duties until June. The doctor determined the worker had a back sprain with compression neuropathy, so he went for an MRI that showed a degenerative condition in his lumbar spine.
Back injury while performing modified duties
In January 2013 — while performing modified duties — the worker was driving a standing forklift and passed over a dock plate. As the forklift trundled over the dock plate, the worker felt pain in his lower back. He went to his family physician, who diagnosed a low back soft-tissue sprain or strain. The doctor wrote a report for the employer indicating the worker could return to modified duties three days later while undergoing physiotherapy treatments.
The worker filed a claim for health care benefits and loss of earnings benefits and the WSIB accepted the claim, granting the worker benefits for one week ending on Jan. 21, 2013.
Because of the new injury, the worker was unable to participate in the work transition program once the modified work contract ended. The WSIB granted additional loss-of-earnings and health care benefits until March 25, 2013. The WSIB determined benefits would end on March 25 because an earlier medical report had revealed degenerative changes in the worker’s lumbar spine that was a pre-existing condition and any disability beyond March would be related to “the natural course” of the condition and therefore not work-related.
The worker appealed the decision, asking for benefits beyond March 25, arguing the back strain was work-related and the reason he couldn’t proceed with the work transition program. He had an MRI on Apr. 9 that confirmed degenerative disc disease in his spine, which had not changed since an MRI a year earlier.
An appeals resolution officer upheld the decision that the worker’s back strain would be healed by March 25 and any ongoing disability would be from his non-compensable “underlying degenerative condition.” The worker appealed once again.
The appeals tribunal found that the medical documentation on file did not show a causal link between the worker’s ongoing back issues and the strain he suffered while operating the forklift. The forklift injury was a soft-tissue strain, while the ongoing problems were related to the discs in the worker’s spine, said the tribunal.
The tribunal noted that the worker began reporting back pain to his doctor in May 2012, about nine months before the forklift incident. This pain wasn’t the result of a specific injury, but instead gradually progressed over time and led to increasing pain and numbness in the lower back and spreading down to the buttocks and legs. In addition, the worker’s pain increased to the point of needing to see his doctor while the worker was laid off and not even working, said the tribunal.
The tribunal also pointed out that the medical documentation showed the worker’s back and leg symptoms remained unchanged from the initial reporting in May 2012 up to the present — meaning the forklift injury didn’t aggravate the condition.
The tribunal noted that neither the worker’s family doctor nor any of the specialists he saw — including a neurosurgeon, neurologist, and internists — felt that there was a link between the worker’s condition and the forklift injury.
“(The worker’s family doctor) did not suggest that the worker’s symptoms were work related. We also find it significant that there does not appear to be any other medical opinion on file which supports an injury-related cause for the worker’s ongoing low back and leg symptoms,” said the tribunal. “In our view, the medical record supports a conclusion that the worker’s ongoing symptoms were related to the natural progression of his degenerative disc disease, as evident in the x-ray, CT scan, and MRI reports on file, from 1992 onwards.”
The tribunal also had a medical discussion paper put together by orthopaedic surgeons that indicated aging without injury could cause disc problems and there was no consistent evidence that a non-traumatic injury could aggravate or accelerate pre-existing aging changes.
The tribunal determined that the worker’s pre-existing degenerative disc disease was “a symptomatic pre-accident impairment” which had been identified and for which the worker was receiving treatment before the forklift accident and injury. As result, there was no entitlement to ongoing benefits for the pre-existing condition. As far as entitlement for an aggravation of the worker’s condition, the worker already received benefits from Jan. 14 to March 25, 2013, which covered any possible entitlement for aggravation from an acute episode such as the forklift incident. The worker’s appeal was denied.
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