Medical reports couldn’t distinguish effects of earlier workplace accident from more recent one; no physical restrictions indicated
The appeals Resolution Office of the Ontario Workplace Safety and Insurance Board (WSIB) has upheld the rejection of a claim for workers’ compensation benefits for a permanent back injury that the worker claimed was the result of a workplace accident more than two decades ago.
The worker, now 63, was lifting a box while on the job on Feb. 12, 1991, when he felt pain in his lower back. He went to the doctor two days later with muscle spasms and a decreased range of motion. The worker took some time off work and “improved slowly” but had similar pain twice more over the next two months, which were considered recurrences of the injury. He was eventually diagnosed with irritation of the lumbar spine.
The worker continued to suffer from recurrences of lumbar spine irritation in August 1995, February 1996, and February 1997. His family doctor diagnosed him with chronic low back pain and after the 1996 flare-up, his chiropractor said he could return to work but shouldn’t lift boxes heavier than 25 pounds for one week.
After the 1997 flare-up, the worker was diagnosed with lumbar strain and couldn’t perform his usual work. However, he was cleared for modified work. A CT scan in April 1997 showed “mildly bulging disc but no focal disc herniation” along with “mild degenerative changes involving the facet joints.” The degenerative chances were attributed to degenerative disc disease.
The worker filed workers’ compensation claims for each of these instances claiming a permanent impairment, but the WSIB rejected all of them on the grounds there was insufficient evidence to support the idea that these recurrences were directly related to his work accident.
Worker’s back problems began with earlier accident
In May 1997, the worker’s family doctor wrote to the WSIB to say the worker was “disabled because of his work-related back injury” and likely ongoing back problems in the future. The doctor referred to a 1984 workplace accident that injured his back but indicated the 1991 injury changed the worker’s lifestyle and aggravated his problems.
In July 1998, a rheumatologist examined the worker and reported that the worker had restricted range of motion and lower back tenderness that was “made worse by lumbar flexion, extension, and lateral flexion.” An anesthetist followed up with a report soon after indicating that the worker suffered from “myofascial pain syndrome” and joint inflammation. Both experts determined the 1984 and 1991 workplace accidents contributed to the worker’s condition.
The worker appealed to the tribunal, providing a written report from his family doctor stating that he had no back problems before his 1984 work accident, after which he had recurrent back problems causing him to miss work and perform modified duties. He also had reports from two other doctors supporting his contention that his degenerative disc disease was “not the primary source of pain” and his symptoms were consistent with the injuries he suffered in his two workplace accidents.
The tribunal agreed that the worker suffered from low back pain after his 1984 workplace accident and again after his 1991 accident, but agreed with the Appeals Resolution Office that there was no “substantial medical evidence of significance” that indicated the pain was causally linked to the 1991 work injury.
The tribunal found that the medical opinions indicated that the worker suffered from back pain since his 1984 workplace accident. However, that accident wasn’t the subject of the worker’s appeal, only the 1991 accident.
Pain not a permanent impairment
The tribunal also noted that the doctors’ reports stated that the worker was “disabled,” but in order to be eligible for benefits, the worker must have a permanent impairment – defined in the Ontario Workplace Safety and Insurance Act as “impairment that continues to exist after maximum medical rehabilitation has been achieved.” However, the worker’s diagnosis was of lower back pain, and it had been established that pain alone was not a permanent impairment.
In addition, the worker had no physical restrictions documented. At one point, his doctor indicated he required modified duties for a short period of time before returning to full duties.
“While I accept there was pain, which at times was significant, there is no substantial evidence before me which would suggest a permanent physical or functional abnormality or loss resulting from the 1991 workplace accident…” said the tribunal.
The tribunal also found that while the doctors’ opinions indicated the worker’s back pain was caused by the two workplace accidents, there was no indication as to the “relative contributions” of each accident and nothing to support a finding that the 1991 accident caused a permanent impairment.
The tribunal denied the worker’s appeal, upholding the findings of the WSIB and Appeals Resolution Office that the back injury the worker suffered in the 1991 workplace accident had “resolved with no permanent impairment.”
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