No medical evidence that ongoing symptoms in knee and shoulder that worker had experienced for years were worsened by fall near work
An Ontario postal worker could not link her ongoing knee and shoulder problems with a workplace accident due to a history of symptoms long before the accident and has had her appeal denied by the Ontario Workplace Safety and Insurance Appeals Tribunal.
The 59-year-old worker as a postal worker with Canada Post, hired in 2002. In August 2009, the worker had a medical consultation for pain in both her knees which she had experienced after slipping on stairs six weeks earlier. She was diagnosed with bilateral crepitus — grating, cracking, and popping sensations under the skin and in the joint of the knee caused by air in the tissue — with the condition more pronounced in the right knee.
X-rays showed mild degenerative change in the worker’s knee and her doctor believed the slip on the stairs aggravated underlying degenerative arthritis. The worker had an MRI in December 2009, which revealed meniscal tears in both knees and mild osteoarthritic changes. Her family physician noted ongoing problems with both knees and prescribed the worker medication to treat the pain.
Over the course of 2010, the worker saw her physician several times and the doctor noted the symptoms remained consistent with “good and bad days.” The worker reported that she often stumbled and fell due to her knees giving out.
The worker was involved in a motor vehicle accident on Dec. 3, 2010, which caused whiplash in her neck and right shoulder. She received physiotherapy and massage treatments to deal with her injuries.
The worker had x-rays on her knees in May 2012 that showed arthritic degeneration and mild osteoarthritis in both knees but worse in the right. The physician also reported arthritis flaring up in both knees and the worker’s left foot.
On Feb. 5, 2013, the worker visited her physician complaining of a right shoulder spasm. Her physician thought it might be tendonitis in her right arm and neck, which had been causing symptoms since 2010.
Worker slipped on ice outside workplace
On Feb. 8, 2013, the worker was on her way to work when she slipped on some ice that was covered in snow in front of the steps of her workplace. She fell and an ambulance was called to take her to the hospital, where she was diagnosed with a right knee injury.
The worker was approved by the Ontario Workplace Safety and Insurance Board (WSIB) for health care benefits for soft tissue injuries to her right knee and right shoulder. She was also granted loss-of-earnings benefits for the period of time she was off work and partial benefits for the time she worked part-time, ending when she returned to her regular duties on March 25, 2013.
The worker was assessed by an orthopaedic specialist two weeks after her workplace accident and noted tenderness in the joint, effusion of the right knee, and “early stage of degenerative change of the knee.” The specialist saw her again in July 2013 and reported “degenerative change of the knee which has become symptomatic as a result of a fall that she had in February.”
The worker’s family physician reported that her arthritis in her right knee and right shoulder flared up from the fall at work and in May 2013 noted that her right shoulder was tight and her right knee was “still sore from acute exacerbation of her old right knee problems. He said the worker’s pain was “settling down to previous level with good days and bad days.”
The worker made a further request for benefits to cover ongoing medical treatment including injections for her right knee and shoulder. Her request was denied because of an absence of medical evidence showing it was a recurrence of the workplace injury or a continuity between her ongoing symptoms and the workplace injury.
An appeals resolution officer upheld the decision on appeal and the worker appealed once again to the tribunal.
Worker had symptoms before workplace accident
The tribunal found that the medical records didn’t support the worker’s position that her ongoing symptoms in her right shoulder were related to her workplace accident. It was clear that she had been dealing with tendonitis since at least 2010 and the motor vehicle accident also caused some issues. In fact, the worker saw her physician complaining of a shoulder spasm three days before her workplace accident, the tribunal pointed out.
The tribunal also found that the worker didn’t establish a continuity and compatibility of her right knee problems with her workplace accident. The medical records showed that the worker had knee problems going back as far as 2009 — four years before the workplace accident for which she was filing a claim. Though a specialist referred to the workplace accident when assessing the worker’s symptoms a few months later, he didn’t have the worker’s full medical history and the worker was able to return to her regular duties less than two months after the accident.
The tribunal agreed with the earlier decisions that the worker’s injury was resolved and her ongoing knee and shoulder symptoms were not related to her workplace accident. It upheld the rejection of the worker’s claim for benefits and denied her appeal.
For more information see:• Decision No. 3478/17, 2018 CarswellOnt 3918 (Ont. Workplace Safety and Insurance Appeals Trib.).